Antimicrobial resistance (AMR)

AMR is when microorganisms like bacteria, viruses, fungi or parasites no longer respond to antimicrobials like antibiotics.

It also includes resistance to antiviral, antiparasitic and antifungal medicines.

AMR is a major problem because it makes infections harder to treat, meaning:

• people stay sicker for longer and the risk of dying increases
• there is more opportunity for spread of infections to others
• medical procedures such as surgery and cancer treatment become riskier
• cost to patients, whānau and the health system increases.

Antimicrobial resistance, particularly among gram-negative bacteria, is steadily growing in Aotearoa New Zealand. This is making it increasingly hard to treat common infections like cystitis.

The 2 key actions healthcare providers can take to slow development of AMR are:

• antimicrobial stewardship — use antimicrobial medicines, including antibiotics, wisely because all use (appropriate and inappropriate) encourages selection of resistant strains
• infection prevention and control — every infection prevented lessens the need or want for antimicrobial medicines.

• Talk to patients about appropriate antibiotic use and the dangers of AMR.
• When antibiotics are not indicated, provide advice about other ways to manage symptoms.
• Talk to patients about how to prevent infections and their spread, including immunisation, good hand hygiene, safe sex and proper food handling.
• Ask patients to return unused antibiotics to the pharmacy to make sure they are disposed of correctly.
• Use hand hygiene to prevent the spread of resistant organisms and infections.

Prescribers

Use the Aotearoa antibiotic guidelines, Te Whata Kura, to guide treatment decisions.

Te Whata Kuraexternal link

• ·    Use diagnostics to inform treatment decisions, where possible.
• Prescribe antibiotics only when infection is likely or confirmed.
• Review prior microbiology to guide antimicrobial selection.
• Check the veracity of penicillin allergy labels.
• Get appropriate samples before antibiotics where possible.
• Use the oral route rather than the IV route where possible.
• Seek expert infectious diseases or clinical microbiology advice if unsure.

Antimicrobial guidelines and antibiograms