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Antimicrobial Resistance

Drugs active against microorganisms (antimicrobial agents) include antibiotics, antifungals, antivirals, and antiprotozoals. Unfortunately, the use and misuse of antimicrobials have accelerated the emergence of antimicrobial-resistant (AMR) microorganisms. AMR is a significant issue that substantially threatens future healthcare delivery. The World Health Organisation ranks the rapid development of antibiotic resistance as one of the greatest threats and challenges to human health.

In 2019, The Changing the Culture 2019-2024: One Health. Tackling antimicrobial resistance in Northern Ireland, a five-year action plan was jointly developed by three government departments in Northern Ireland (the Department of Health, Department of Agriculture, Environment and Rural Affairs, and the Food Standards Agency) working with professionals in associated agencies, in recognition of the importance of a ‘one health’ approach to AMR. The action plan was prepared in conjunction with the UK’s 20-year Vision and five-year National Action Plan (NAP), and it provides actions specific to Northern Ireland. It is recognised that the COVID-19 pandemic has impacted the implementation of the UK and Northern Ireland AMR Action Plans.

Northern Ireland’s previous AMR strategy laid out an approach for antimicrobial stewardship in primary and secondary care and emphasised the importance of a hospital-community interface.

To slow down the development of antibiotic resistance, it is crucial to use antibiotics in the right way. Antimicrobial stewardship is a coordinated programme that promotes the appropriate use of all antimicrobial agents, improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by resistant microorganisms. Failure to address the problem globally could result in 10 million deaths alongside a cumulative cost of $100 trillion by 2050.

A recent analysis by Antimicrobial Resistance Collaborators estimates that in 2019, 1.27m deaths were the direct result of drug-resistant bacterial infections – a value nearly the same as ‘global HIV deaths and malaria deaths combined, ranking behind only COVID-19 and tuberculosis in terms of global deaths from infection.’. In addition, Antimicrobial resistance is also threatening the achievement of many of the UN Sustainable Development Goals.

Key references and further reading

  • Changing the Culture 2019-2024: One Health.Tackling antimicrobial resistance in Northern Ireland a five-year action plan. Belfast of Health, DAERA and Food Standards Agency, 2019.

  • Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. The review on antimicrobial resistance. 2014. London: Her Majesty Government.
  • United Nations Sustainable Development Goals.