During 20 years of administering antibiotics, we still fail to fight the virus

Antibiotic resistance is a problem that cannot be solved by single doctors or hospitals.

In response to the fight against drug-resistant viruses, over the past two decades, many countries and health organizations have developed programs under the " Antimicrobial stewardship (AMS)" model. The main principle of this solution is to limit the maximum use of antibiotics. This means that antibiotics are only allowed to be used in cases where it is absolutely necessary and to produce the best possible results.

After more than 20 years of implementation, you can come across a model of antibiotic management in any country. The US Centers for Disease Control and Prevention (CDC) even recommends that all hospitals in the United States have a program of antibiotic management.

The deployment activities of a program often include many general actions. Some of them can be mentioned: organizing a contingent of experts to build guidelines on antibiotic use, limited list of antibiotics, criteria for drug resistance, surveying the status of antibiotic use, training training , review and report the program .

It seems to be effective, but so far antibiotic management programs cannot help us win the war against drug-resistant viruses. In an article on The Conversation, associate professor Sergio Diez Alvare from Newcastle University, Australia pointed out: "Antibiotic management is unable to keep the viruses under control". Let's find out why.

"Antibiotic management is unable to keep the viruses under control."

When looking at reporting the results of the antibiotic management program in any hospital, you will certainly realize a positive change. But a comprehensive report in Clinical Microbiology and Infection magazine found that on a national scale, an antibiotic management program has no definition of success.

The authors can only use a few criteria such as: reducing the use of the overall number of antibiotics, specific antibiotic lines, some special infections and the mortality rate to temporarily say the management program Antibiotic management in some countries is "successful" put in quotation marks. The table of combined results succeeds and fails, only records the results for readers to evaluate themselves.

That said, in theory, antibiotic management seems to be a great solution. But in reality, it is too complicated to implement and evaluate. There are many barriers that make the overall antibiotic management programs successful only on paper to date still fail in real life.

First of all, must return to the main purpose of antibiotic management. It is a program to prevent the "nightmare" of antibiotic resistance that is happening globally. And because antibiotic resistance is a global problem, it also requires a global solution.

However, the survey showed that many hospitals around the world still do not have antibiotic management programs.The main reason is due to lack of funding. Even in hospitals that have implemented the program, half of them have no consistency in the assessment.

In addition, antibiotic management needs to be deployed in a wide range of fields , not just health. For example, agriculture, where antibiotics used in livestock production can develop antibiotic resistance to spread back to people.

Antibiotic resistance is a problem that cannot be solved by single doctors or hospitals.

Antibiotics are also widely used in the community. And that is a problem. Take, for example, France, over the past 10 years, three national action campaigns have been carried out against drug-resistant bacteria.

As a result, in the first years, they could reduce up to 25% of the amount waiting for antibiotics on every 100 people. However, when the outpatient use rate increased in recent years, the positive results immediately leveled off.

So while the antibiotic management program is very organized in the hospital, the same thing should be done through community-oriented health organizations and activities.

Finally, antibiotic resistance is a problem that cannot be solved by single doctors or hospitals. Actions such as antibiotic management must be coordinated to be implemented synchronously at the national, regional and global levels. This is really too difficult. For example how to solve a current problem, when convenient traffic is making drug-resistant bacteria spread more easily among many countries?

How to solve the problem before it's too late?

One thing is certain that antibiotic management solutions need to overcome its limitations can become effective. Besides, the antibiotic management program alone cannot win the global resistance war.

The World Health Organization estimates that up to 50% of antibiotics are used for animals. This antibiotic is contributing to the increasing resistance of bacteria to bacteria. However, there have been many positive moves from countries in this regard.

For example, Denmark has banned the use of antibiotics in agriculture since 2000. This has become a lesson for many countries, such as the European Union, has stopped using antibiotics in livestock since 2006. The US also plans to do this in 2017 and even countries like Thailand and Vietnam can stop using antibiotics in livestock in 2017 and 2018.

Recently, there is also a positive signal about funding for the war against antibiotics that may be mobilized by corridors. Funding will be used for public health activities and seeking treatment, preventing multi-drug resistant infections.

Scientific research will open new solutions.

Meanwhile, scientists will also do their job to find a creative path to solving the problem of drug-resistant bacteria. The truth is that we can hardly expect a new antibiotic.

An economic barrier is making pharmaceutical companies forget this market and targeting more lucrative sources of income, such as the cancer market and chronic diseases. Even if some new antibiotics will be on the market in the next decade, it is not much different from current drugs. Since 1984, no new antibiotic class has been produced.

Therefore, the new path for current research is to use the immune system to treat certain strains of bacteria. The lessons learned from cancer research have shown us that the immune system can sometimes be disabled by certain strains of bacteria, such as "Legionella" . If we can refine the immune system with targeted drugs, it will help us fight infections.

Another option is to optimize antibiotics through accurate testing methods. This allows the doctor to decide whether to use antibiotics and if so, how to use them optimally. If the dose and duration of treatment can be controlled most closely, the risk of resistance will be reduced to the lowest level.

Since 1984, no new antibiotic class has been produced.

Finally, recalling the results of more than two decades of the antibiotic management program, although there are positive results on a small scale, it has not yet reached expectations, helping to prevent the spread of the virus. across the globe. The antibiotic management program, however, cannot alone win the war against antibiotic resistance today.

As a consolation, in the report in Clinical Microbiology and Infection, the authors reiterated a statement from former British general Winston Churchill: "Success is not the end, failure is not ear It is the courage to continue to be important ".