Antibiotic resistance occurs when microorganisms such as fungi and bacteria develop the capacity to overcome the toxicity of antibiotic drugs that are designed to kill them (Elizabeth et al., 2007; Komolafe, 2003). In essence, antibiotic-resistant microorganisms are not only able to survive normally lethal concentrations of microorganisms, they, continue to grow and thrive. Assault infections that are caused by antibiotic-resistant microorganisms often prove to be cumbersome and at times impossible to treat (Komolafe, 2003). Usually, infections with antibiotic-resistant infections require patients to be hospitalized for extended periods in addition to extra follow-up visits by the doctor and treatment with very expensive and toxic antibiotic alternatives (Ha, Haste & Gluckstein, 2019). It is important to recognize that when describing antibiotic resistance it is not the human body that becomes resistant to the antibiotic but it is the microbial cells that acquire the capacity to resistant concentrations of antibiotics that are designed to kill them. Also, the term antibiotic resistance is often used synonymously with drug resistance and antimicrobial resistance (Komolafe, 2003). It would therefore be prudent to analyze the importance of education on antibiotic-resistant organisms and proper antibiotic use.
The Rationale for the Policy
All kinds of people at different stages of their lives have the potential to be affected by antibiotic resistance (Centers for Disease Control and Prevention, 2012). That includes people working in different kinds of careers that require the constant administration or use of antibiotics such as veterinary care, healthcare, agriculture, and medical research which makes antibiotic-resistant one of the most pressing concerns for public health agencies and organizations (Centers for Disease Control and Prevention, 1991; Georgia House of Representatives, n.d.). Each year, in the United States (U.S) over 2.8 million people are affected by the problem of antibiotic-resistant infections caused by either bacteria or fungi. At the same time, over 35,000 people die in America alone as a result of antibiotic-resistant infections (Ha, Haste & Gluckstein, 2019). It is not possible to completely avoid the risk of getting infected with antibiotic-resistant infections but some individuals have a higher risk of infection than others for instance people with weakened immune systems such as those with chronic illnesses (Centers for Disease Control and Prevention, 1991; Georgia House of Representatives, n.d.). Antibiotic resistance is a rapidly growing problem and if in time antibiotics become ineffective in killing infectious microorganisms them health procession will lose the ability to treat infections and control threats to public health (Elizabeth et al., 2007; Shehadeh, Suaifan & Hammad, 2016). At the same time, most recent medical advances such as organ transplants, joint replacement, chemotherapy and the treatment of chronic illnesses are highly dependent on the ability to treat infections using conventional antibiotics.
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There is consensus among all healthcare professionals that the problem of antibiotic resistance poses a great threat to human health (Shehadeh, Suaifan & Hammad, 2016). Despite that consensus, there is still a lack of sufficient crucial surveillance data from most parts of the world makes it challenging to get a full picture of the current antimicrobial resistance problems (Centers for Disease Control and Prevention, 2012; Komolafe, 2003) The existing data shows that the rates of antimicrobial resistance are increasing rapidly across the globe and that there are considerable differences in the burden caused by the problem of drug resistance between continents and countries. In the year 2014, the first world report on the surveillance of drug resistance was published by the World Health Organization (WHO) (Shehadeh, Suaifan & Hammad, 2016). The dossier from 114 countries across the globe revealed some alarming statistics that every year 50,000 people lose their lives as a result of antibiotic-resistant infections just n the U.S and Europe (Ha, Haste & Gluckstein, 2019). This is however just a tip of the iceberg as just seven selected species of bacteria were included in the surveillance report (Mangione-Smith et al., 2004). Also, these figures were only from the direct causes of death due to antimicrobial resistance and they did not account for the indirect causes of death as a result of health problems that are related to the development of antimicrobial resistance (Mangione-Smith et al., 2004). It is also widely recognized by health professionals and medical researchers that the problem of antimicrobial resistance has much more devastating consequences for the poor and low-income countries where for instance lack of treatment for infections such as pneumonia and septicemia among children results in antibiotic-resistant infections that are the cause of death for thousands of people especially children and those with chronic health problems (Mangione-Smith et al., 2004).
Problem Statement
The Review of Antimicrobial Resistance estimates that across the globe the yearly fatalities as a result of antibiotic-resistant infections will rise from the present 750,000 to 10 million by the year 2050 if comprehensive action is not taken to address the problem once and for all (Chokshi et al., 2019; Shehadeh et al., 2016). To put such grim statistics into perspective there are at present over 8 million deaths across the globe as a result of various types of cancers. As such it is expected that without adequate measures the problem of antibiotic-resistant infections will surpass cancer and become one of the leading causes of death across the globe (Chokshi et al., 2019). From an economic perspective, antimicrobial resistance poses a huge economic burden of $55 billion each year I the U.S and 1.5 million Euros in Europe alone and over the cause of the next five years, these figures are set to double if no measures are put in place to stem the problem once and for all (Chokshi et al., 2019). Such research evidence makes the case for why it is necessary to develop this policy to address the problem of antibiotic resistance and antibiotic use in the primary healthcare setting.
Implementing the Policy
The education policy will involve imparting knowledge as well as the delivery of practical skills to both healthcare practitioners at the primary healthcare setting as well as among the general public (Shehadeh, Suaifan, & Hammad, 2016). It will focus on what antibiotic resistance is, what causes it and the implications of antimicrobial resistance to the individual and the healthcare system. The training will be conducted at various levels and through the adoption of different pedagogical approaches (Shehadeh, Suaifan, & Hammad, 2016). At the level of the healthcare practitioners, the training will be more comprehensive at it will involve several training strategies such as seminars, focus group discussions and the use of the provision of reading materials such as pamphlets with descriptive Pictographic and written information about the antibiotic resistance (Ha, Haste & Gluckstein, 2019; Shehadeh, Suaifan, & Hammad, 2016). This comprehensive training is aimed at providing healthcare providers such as nurses and physicians who are directly involved in the prescription, administration and follow up of antibiotic therapies at the primary care setting with the necessary knowledge and practical skills to take the leading role in the fight against antibiotic resistance (Ha, Haste & Gluckstein, 2019). As for the members of the public, e-education initiative on antibiotic resistance and use of antibiotic will be aimed at sensitizing them on what antibiotic resistance is and the dangers it poses to patients as well as on the importance of adhering to antibiotic regimes as prescribed by the physician as a way of preventing the development of antibiotic resistance (Shehadeh, Suaifan, & Hammad, 2016). The members of the public will also be sensitized on the dangers of self-prescription of antibiotics as well as the misuse of antibiotics which are factors that lead to the development of antibiotic resistance. For the public, the education initiative will be implemented in the form of awareness campaigns through the use of local media outlets such as radio, television and print media such as newspapers and magazines (Ha, Haste & Gluckstein, 2019). To make the initiative successful it is expected that a multi-sectorial approach that involves collaborative efforts by interdisciplinary teams such as doctors, nurses, researchers, the community leaders, and the general community will be adopted. It is also expected that the input of other partners such as public health agencies and practitioners, local donor agencies and others will be an important part of the initiative.
Possible Challenges and their Solutions
Several challenges are expected to face the implementation of the education initiative about antibiotic resistance and antibiotic use. The first challenge is in regards to finances and logistics. Comprehensive financial resources will be needed to effectively implement the initiative and the funds will be sought from the local, state and federal health organizations and agencies (Centers for Disease Control and Prevention, 2012). These agencies will also be expected to provide logistical support for the inactive such as training personnel, facilities, and equipment. Also, it is expected that community participation will be a major challenge for the initiative due to the laxity of the community to participate in the mass participation part of the initiative (Centers for Disease Control and Prevention, 2012). This challenge will be overcome through working with the community leader and community mobilizers to drum up support for the initiative and encourage the members of the public to fully participate in it.
References
Centers for Disease Control and Prevention. (2012). Eliminating healthcare associated infections: state policy options.
Center for Disease Control. (2011). Policies for Eliminating Healthcare-Associated Infections . Astho.org. Retrieved from https://www.astho.org/HAI_Policy_Toolkit/.
Centers for Disease Control and Prevention. (1991). Profile of State and Territorial Public Health System, 1991. Atlanta, GA: US Department of Health and Human Services
Chokshi, A., Sifri, Z., Cennimo, D., &Horng, H. (2019). Global contributors to antibiotic resistance. Journal of Global Infectious Diseases, 11(1), 36.
Elizabeth E. Foglia, B., Victoria J. Fraser, M., & Alexis M. Elward, M. (2007). Effect of Nosocomial Infections Due to Antibiotic‐Resistant Organisms on Length of Stay and Mortality in the Pediatric Intensive Care Unit. Infection Control and Hospital Epidemiology, 28(3), 299.
Georgia House of Representatives. Representative Jasmine Clark . House.ga.gov. Retrieved 7 April 2020, from http://www.house.ga.gov/Representatives/en-US/member.aspx?Member=4953.
Georgia House of Representatives. Representative Viola Davis . House.ga.gov. Retrieved 7 April 2020, from http://www.house.ga.gov/Representatives/en-US/member.aspx?Member=4947.
Ha, D. R., Haste, N. M., & Gluckstein, D. P. (2019). The Role of Antibiotic Stewardship in Promoting Appropriate Antibiotic Use. American Journal of Lifestyle Medicine, 13(4), 376.
Komolafe, O. O. (2003). Antibiotic resistance in bacteria-an emerging public health problem. Malawi medical journal , 15 (2), 63-67.
Shehadeh, M. B., Suaifan, G. A., & Hammad, E. A. (2016). Active educational intervention as a tool to improve safe and appropriate use of antibiotics. Saudi Pharmaceutical Journal , 24 (5), 611-615.
