1 Why do we need data on AMR, AMU and AMC?
1.1 Purpose of measuring AMR, AMU and AMC
In previous modules you learned what AMR is and why it is a problem. The scale of the problem of AMR is often expressed in statements such as:
Globally, an estimated 214 000 newborns die from blood infections (sepsis) caused by resistant pathogens each year – representing at least 30% of all neonatal sepsis deaths.
This statement, and others like it, include
Why might we also want data on AMU and AMC? You have learned previously about the relationship between AMU and AMC, and the emergence and spread of AMR (see Table 1 for refresher definitions of AMR, AMU and AMC).
| Term | Definition |
|---|---|
| Antimicrobials | Medicines used to prevent and treat infections caused by micro-organisms in humans, animals and plants. As noted in earlier modules, we will usually use the term ‘antimicrobial’ to mean antibacterial drugs. |
| Antimicrobial resistance (AMR) | Occurs when bacteria change over time. The changed bacteria are no longer killed by medicines that were once effective, making infections harder to treat and increasing the risk of disease spread, severe illness and death. AMR also occurs naturally, but is more important when it is a result of AMU, especially inappropriate and excessive use. AMR can increase due to a range of factors that increase the risk of spread of bacterial infections, such as poor infection prevention and control in healthcare settings, lack of access to water, poor sanitation and hygiene facilities, poor nutrition and other factors. As above, AMR refers to resistance in all types of infection (bacterial, viral, fungal, etc.) but this module focuses predominantly on bacterial AMR. |
| Antimicrobial use (AMU) | Estimates of the actual quantity of antimicrobial medicines administered to people or animals. |
| Antimicrobial consumption (AMC) | Estimates of the amount of antimicrobial medicines that are imported, manufactured, distributed or sold for use in human or animal medicine. AMC may be used as a proxy for AMU. |
In general, there are two broad objectives of measuring AMR, AMU and AMC:
- To detect and characterise the problem of AMR – including the scale of the problem, who is affected and in which contexts AMR occurs.
- To guide how and where to develop interventions to reduce the risk of AMR (such as specific programmes to reduce inappropriate AMU) and to evaluate whether they are effective.
If the scale and location of a problem is unknown it is difficult to allocate resources effectively. For this reason, global efforts are underway to measure AMR, AMU and AMC. Measuring and monitoring AMR, AMU and AMC is an important step towards effective interventions to slow the global acceleration of AMR.
In public and animal health surveillance programs, it is particularly important to prioritise the generation of data on aspects of AMR that can actually be targeted by interventions. For example, we might want to measure AMU in a hospital before designing an
Introduction
