The Social Burden of Antimicrobial Resistance in Australia
The social burden of antimicrobial resistance in Australia: Long term survivors’ therapeutic quests
Antimicrobial Resistance | Drug-resistant Infection | Bacteria | Bacterial Infections | Chronic Infection
Antimicrobial resistance (AMR) is defined as a global health emergency by the World Health Organisation (WHO). Already within Australia, there is a growing burden of morbidity and mortality due to AMR infections, sometimes referred to as "Superbugs". An AMR infection refers to any bacterial infection where there are no antibiotics that can successfully treat it. While efforts are underway to develop new interventions to prevent and treat such infections, little research has been undertaken on the social costs and implications of these infections, particularly within patients who have survived, but continue to suffer from the sequelae of AMR infection.
As numbers of infections increase it is important to understand how people live with AMR and how best to support them. Often thought of in terms of an acute illness episode, in reality, AMR infections encompass a plethora of infections from acute through to chronic complications. For example, long-term infections may lead to a cascade of chronic medical complications that cannot be treated, repeated hospitalisations and medications, amputations, chronic disabilities, mental health problems and social stigma. In many cases patients have exhausted all traditional medical options and undertake their own extensive searches for alternative therapies, including medical travel overseas in search of experimental treatments, such as Phage therapy. Phage therapy is the use of bacterial viruses, commonly known as bacteriophages, to treat and eradicate an underlying bacterial infection. Currently, Phage therapy is not available in Australia and for patients seeking this treatment, the only option is international travel to clinics in Georgia in Eastern Europe. Some patients do pursue this at a large financial cost for uncertain results.
An empirical study of the lives of AMR survivors will enhance our understanding of the social burden associated with AMR, the psychosocial and medical needs for such patients, and the implications of their travel in search of cures.
As the numbers of patients with these infections increase, the outcomes from this study will inform better psychosocial supports for patients, assist in health messaging for the general public around the nature of AMR, while for clinicians it will provide new insights into better management of this unique and under-appreciated cohort of patients.
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WHO’s top 12 priority pathogens for new antibiotics
Priority 1: Critical
- Acinetobacter baumannii, carbapenem-resistant
- Pseudomonas aeruginosa, carbapenem-resistant
- Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: High
- Enterococcus faecium, vancomycin-resistant
- Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
- Helicobacter pylori, clarithromycin-resistant
- Campylobacter spp., fluoroquinolone-resistant
- Salmonellae, fluoroquinolone-resistant
- Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: Medium
- Streptococcus pneumoniae, penicillin-non-susceptible
- Haemophilus influenzae, ampicillin-resistant
- Shigella spp., fluoroquinolone-resistant