What is Antimicrobial resistance and what are the risks? Explanation by Dr. Stefan Surdu

Antimicrobial resistance (AMR) occurs when microorganisms - such as bacteria, viruses, parasites, and fungi - no longer respond to the medications used to treat them. In such cases, treatments become ineffective, and infections caused by resistant microorganisms can lead to severe outcomes, including death in critical cases, explained Dr. Ștefan Surdu, a specialist with the National Agency for Public Health, IPN reports.

Antimicrobial resistance includes various forms: antibiotic resistance in bacteria, antiviral resistance in viruses, and antifungal resistance in fungi. Each type of microorganism requires specific drugs for treatment, and the general term "antimicrobial resistance" encompasses all these forms.

The most common cause of AMR is the irrational, improper, or excessive use of antimicrobial agents.

Infections caused by resistant microorganisms often have a severe progression. If the microorganism is multi-drug-resistant, doctors may run out of treatment options, as managing infections relies solely on antimicrobial drugs. Natural remedies cannot replace them, as they are not used in medical institutions. The World Health Organization (WHO) recommends the rational use of antimicrobials, starting with first - line treatments and reserving second-line or backup treatments for exceptional cases.

Dr. Stefan Surdu noted an increase in resistant bacteria over the years, particularly those causing healthcare-associated infections. In response, antimicrobial resistance is becoming a growing concern. To address this, the National Program for Combating Antimicrobial Resistance (2023–2027) was approved in 2023. This program integrates efforts across sectors, including human health, animal health, and the environment, aiming for the rational use or even reduction of antimicrobial agents in these domains.

Over the years, restrictions have been implemented on dispensing antimicrobial drugs in pharmacies, including veterinary pharmacies, to prevent misuse by the public. For instance, antibiotics are unnecessary for treating the flu or common colds, as they are ineffective against such conditions.

Since 2018, the Ministry of Health has established a surveillance system based on microbiological testing of biological samples (e.g., blood, urine). This system provides physicians with crucial information to select appropriate antimicrobials, ensuring more effective and targeted treatments. Participants in this system include hospital laboratories, private labs, and the laboratory of the National Agency for Public Health, which serves as a reference laboratory. From this year, the system is set to expand to include fungal investigations, such as Candida species.

From November 18–24, 2024, Moldova will join the global initiative to mark World Antimicrobial Awareness Week (WAAW). This year’s theme, "Educate. Advocate. Act Now," emphasizes the importance of raising awareness about AMR through effective communication, education, and the involvement of all stakeholders in promoting best practices to prevent and combat this phenomenon.

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