Agencies unveil plan to fight antibiotic resistance

One Health is the idea that the health of people, animals and the environment are all interconnected and antibiotic use affects them all; the best solutions to antibiotic resistance will take all of them into account.

One Health is the idea that the health of people, animals and the environment are all interconnected and antibiotic use affects them all; the best solutions to antibiotic resistance will take all of them into account.

Leaders of four state agencies July 1 launched a major five-year plan to work together with partners in public health, health care, agribusiness, environmental protection and other fields to keep antibiotics working to protect the health of humans, animals and the environment in Minnesota.

The plan calls for the Minnesota Department of Health, Minnesota Department of Agriculture, Board of Animal Health and Minnesota Pollution Control Agency to work jointly with partners to promote judicious antibiotic use and stewardship in order to reduce the impact of resistant bacteria. It’s the first time all four agencies have worked together on antibiotic resistance and the first such five-year strategic plan for the state.

Health officials say widespread use of antibiotics over the past few decades has resulted in an alarming increase in antibiotic-resistant infections.  As bacteria encounter more and more antibiotics, strains of bacteria are able – through natural selection – to develop resistance. The rate of bacteria resistant to drugs has been growing while the effectiveness of certain key antibiotics has been decreasing.

The Centers for Disease Control and Prevention (CDC) has estimated that antibiotic-resistant bacteria cause 2 million illnesses in people and 23,000 deaths each year. Options for the treatment of bacterial infections are becoming increasingly limited, expensive and often more toxic, with stronger or more harmful side effects.

“Unless we can find ways to preserve the effectiveness of the antibiotics we have and slow the development of resistance to new antibiotics, we may again see increased numbers of illnesses and death due to our inability to control bacterial infections,” said Minnesota Commissioner of Health Dr. Ed Ehlinger. “Antibiotics are critical public health tools. Their effectiveness can and must be preserved. This can be done through judicious use and diligent stewardship.”

Recognizing the need, the four agencies formed the One Health Minnesota Antibiotic Stewardship Collaborative and in January 2016 convened the state’s first antibiotic stewardship summit. Participants included representatives from universities; human and animal health professional associations and boards; human health care systems and organizations, including inpatient, outpatient and long-term care; agricultural associations and cooperatives; human and animal pharmaceutical companies and other government bodies.

One Health is the idea that the health of people, animals and the environment are all interconnected and antibiotic use affects them all; the best solutions to antibiotic resistance will take all of them into account.
Themes discussed at the January summit formed the basis for the five-year plan. Technical workgroups were assigned to further develop goals and activities around each theme that all partners could agree on. The plan has four main goals and associated activities:

–To promote understanding of One Health antibiotic stewardship across disciplines. Activities will focus on sharing experiences among those who work or practice in human, animal and environmental health using online tools, interactive learning and team building.

–To improve human antibiotic stewardship efforts by developing goals, a roadmap and incentives for healthcare facilities to develop stewardship programs.

–To improve animal antibiotic stewardship efforts by supporting national efforts on antibiotic use data collection and goal-setting, livestock farmer quality certification programs, the veterinary feed directive, lab testing and resources for those working with companion animals.

–To improve understanding of environmental issues by developing a tool to measure or describe the impact of antibiotics on the environment and to advocate for environmentally-friendly antibiotic disposal.

Leaders of the four agencies stressed that the formation of the plan marks the beginning of a process, not an end. “The animal agriculture industry has been discussing the antibiotic use issue for a number of years. I’m pleased that we are putting those discussions into actions by collaborating on the One Health Antibiotic Stewardship Strategic Plan,” said Minnesota Agriculture Commissioner David Frederickson.

CDC estimates that more than half of antibiotics prescribed to outpatients in the U.S. are unnecessarily prescribed for upper respiratory infections. Most such infections are viral – for which antibiotics are not effective. Up to half of antibiotic use in hospitals is unnecessary or inappropriate, according to the CDC.

“We’re not saying don’t use antibiotics,” said Dr. Ruth Lynfield, state epidemiologist and medical director for MDH. “We’re saying use them appropriately, avoiding overuse and misuse.”

While the bulk of responsibility for combatting antibiotic resistance is largely on the shoulders of professionals, there are things the average person can do to support antibiotic stewardship:

–Decrease the need for antibiotics by avoiding infections. Wash your hands properly and get recommended vaccines.

–Do not ask for antibiotics when your health care provider thinks you do not need them.

–When you are given a prescription for antibiotics, take them exactly as prescribed. Never skip doses or stop early unless you are told to do so.

–Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Antibiotics treat specific infections. Taking the wrong medicine may make things worse.

–Do not save antibiotics for the next illness. Properly dispose of any leftover medication once the prescribed course of treatment is completed. Information on proper disposal of medication can be found at the Minnesota Pollution Control Agency website.

More information on the five-year strategic plan and what’s being done about antibiotic resistance can be found on the One Health Minnesota Antibiotic Stewardship Collaborative website.

 

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