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Chapter 38 : Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission

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Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission, Page 1 of 2

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Abstract:

Dovetailing with WHO’s longstanding Essential Medicines program, Alliance for the Prudent Use of Antibiotics (APUA) emphasizes the need for dissemination of guidelines and resistance information, independent of commercial interests. The organization aims to improve current infectious disease treatment today while prolonging the effective life span of antibiotics for the children of tomorrow. In numerous analyses from rich and poor nations, APUA and its chapters have documented massive misuse of these powerful life saving agents and demonstrated that improving antibiotic use and curtailing antimicrobial resistance saves money without discernable adverse health outcomes. While APUA focuses on a single therapeutic modality, its work affects myriads of medical therapies and millions of people of all ages, economic strata, and nations. Drug resistance is a concept that is more difficult to explain and understand than the dangers of any single disease. Comprised of the world’s most knowledgeable scientific experts and former Institute of Medicine participants, an expert panel presented its bottom line, concluding that elimination of nontherapeutic use of antimicrobials in food animals and agriculture would lower the burden of antimicrobial resistance in the environment with consequent benefits to human and animal health. The recent creation of an NIH Drug Discovery and Mechanisms of Antimicrobial Resistance (DDR) Study Section signifies a new government commitment to investigation of new antimicrobial agents that could be deployed in bioterrorism and to study of evolution mechanisms, resistance transmission, and strategies for prevention of antimicrobial resistance.

Citation: Young K, O'Brien T. 2005. Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission, p 519-527. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch38

Key Concept Ranking

Bacterial Diseases
0.45022038
Antimicrobial Resistance
0.44903
Toxic Shock Syndrome
0.42861962
Infectious Diseases
0.42756513
0.45022038
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Figures

Image of Figure 1.
Figure 1.

APUA's antibiotic effectiveness program.

Citation: Young K, O'Brien T. 2005. Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission, p 519-527. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch38
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Image of Figure 2.
Figure 2.

APUA country chapters. Chapters are located in Argentina, Australia, Bangladesh, Belarus, Bolivia, Brazil, Bulgaria, Chile, China, Columbia, Costa Rica, Croatia, Cuba, Dominican Republic, Ecuador, El Salvador, Fiji Islands, Georgia, Greece, Guatemala, India, Italy, Kazakhstan, Kenya, Lebanon, Mexico, Moldova, Nepal, Nicaragua, Nigeria, Pakistan, Panama, Paraguay, Peru, Philippines, Poland, Russia, Senegal, Serbia and Montenegro, South Korea, Spain, Sweden, Taiwan, Turkey, Ukraine, United Kingdom, Uganda, Uruguay, Venezuela, Vietnam, and Zambia.

Citation: Young K, O'Brien T. 2005. Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission, p 519-527. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch38
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References

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1. American Lung Association. Trends in tuberculosis morbidity and mortality. November 2003. American Lung Association.
2. APUA, The Alliance for the Prudent Use of Antibiotics. April 2003. Framework for Use of Antimicrobial Resistance Surveillance in the Development of Standard Treatment Guidelines. Under subcontract with the Rational Pharmaceutical Management Plus Program at the Management Sciences for Health, Arlington, Va.
3.APUA, The Alliance for the Prudent Use of Antibiotics. September 2005. The Alliance for the Prudent Use of Antibiotics GAARD Report: Global Antimicrobial Resistance. Clin. Infect. Dis. 41(Suppl. 3), in press.
4. Barza, Michael,, S. L. Gorbach (ed.). 1 June 2002. A Report of the Alliance for the Prudent Use of Antibiotics. The Need to Improve Antimicrobial Use in Agriculture: Ecological and Human Health Consequences. Clin. Infect. Dis. 34 (Suppl. 3).
5. Brower, J.,, and P. Chalk. 2003. The Global Threat of New and Reemerging Infectious Diseases: Reconciling U.S. National Security and Public Health Policy, p. 6970. RAND, Santa Monica, Calif.
6. Centers for Disease Control and Prevention. 1997. Reduced susceptibility of Staphylococcus aureas to vancomycin—Japan, 1996. Morb. Mortal. Wkly. Rep. 46:624626.
7. Centers for Disease Control and Prevention. 2000 Staphlylococcus aureus with reduced susceptibility to vancomycin— Illinois, 1999. Morb. Mortal. Wkly. Rep. 48:11651167.
7a.. Committee on International Science, Engineering, and Technology (CISET). 25 July 1995. Global Microbial in the 1990s. Report of the NSTC Committee on International Science, Engineering, and Technology (CISET) Working Group on Emerging and Re-emerging Infectious Diseases. National Science and Technology Council.
8. Drexler, M. 2002. Secret Agents: The Menace of Emerging Infections, p. 119157. Joseph Henry Press, Washington, D.C.
9. Hamburg, M. A.,, J. Lederberg,, and M. S. Smolinski (ed.). 2003. Microbial Threats to Health. The National Academies Press, Washington, D.C.
10. Infectious Diseases Society of America (IDSA). 2004. Bad bugs, no drugs: as antibiotic discovery stagnates . . . A public health crisis brews. IDSA White Paper. [Online.] http://www.idsociety. org. Accessed 5 April 2005.
11.Reference deleted.
12. Levy, S. B. 2002. From tragedy the antibiotic age is born, p. 114, 305. In The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers. Perseus Publishing, Cambridge, Mass.
13. Murray, B. E. 2000. Vancomycin-resistant enterococcal infections. N. Engl. J. Med. 342:710721.
14. O’Brien, T. F. 1998. Towards coordinated surveillance of antimicrobial resistance: The need to merge databases, APUA Newsl. 16:2.
15. Rotun, S. S.,, V. McMath,, D. J. Schoonmaker,, P. S. Maupin,, F. C. Tenover,, B. C. Hill,, and D. A. Ackman. Staphylococcus with reduced susceptibility to vancomycin isolated from a patient with fatal bacteremia. Emerg. Infect. Dis. 1999 ;5:147149.
16.U.S. Food and Drug Administration, Center for Veterinary Medicine. FDA Administrative Law Judge Daniel J. Davidson’s decision issued March 18, 2004. See www.fda.gov/cvm/index/updates/baytrilup.htm.
17.U.S. Interagency Task Force on Antimicrobial Resistance. 2001. Public health action plan to combat antimicrobial resistance. [Online.] http://www.cdc.gov/drugresist/actionplan/aractionplan/pdf. Accessed 28 June 2004.
18. World Health Organization. 2001. Global strategy for containment of antimicrobial resistance, Geneva, Switzerland (WHO/CDC/CSR/DRS/2001.2) [Online.] http://www.who.int/csr/resources/publications/drugresist/en/EGlobal_Strat.pdf. Accessed 28 June 2004.
19. World Health Organization. 2000. Overcoming antimicrobial resistance, Geneva, Switzerland. [Online.] http://www.who.int/infectious-disease-report/2000/. Accessed 28 June 2004.

Tables

Generic image for table
Table 1.

Annual costs of common infectious diseases to the United States

Adapted from CISET ( ).

Costs of monitoring or containing bioterrorist events are not included.

Citation: Young K, O'Brien T. 2005. Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission, p 519-527. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch38
Generic image for table
Table 2.

Top seven antibiotic resistance problems in the U.S. in 2004

Compiled by the staff of the Alliance for the Prudent Use of Antibiotics from various sources ( ).

Abbreviations: MRSA, methicillin-resistant CA-MRSA, community-acquired methicillin-resistant VISA, vancomycin-intermediate (resistant) VRSA, vancomycin-resistant VRE, vancomycin-resistant and DRSP, drug-resistant MDR, multidrug resistant.

Citation: Young K, O'Brien T. 2005. Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission, p 519-527. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch38

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