Antimicrobial Interfaces - Biointerfaces: Where Material Meets Biology - page 411

Their use could be extended to the prevention of implant or biomaterial
related infections, which are one of the main causes of revision surgery and
to augment or replace the current prophylaxis of systemically administered
antibiotics. 77

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14.6 The Interface Between Veterinary and Human
Antibiotic Use
Antimicrobial resistance happens when organisms are able to endure anti-
microbial agents which are meant to damage them. This is a worrying trend
as unregulated and widespread use of antibacterial agents, particularly
antibiotics in veterinary applications, might have a link in the recent surge of
resistance among bacteria. Non-human use of antibiotics could be an add-
itional factor of antimicrobial resistance among humans (particularly with
regard to food-borne diseases, such as salmonellosis and campylobacter-
iosis). 128 Antibiotics have been supplemented to livestock animals even in
the absence of infection, as a means of prophylaxis and to promote growth.
Almost 70% of the antibiotics used annually are consumed by farm animals 2
and hence it is major concern for the development of antimicrobial resistant
strains of bacteria. It was reported that MRSA frequently colonises livestock
animals and might act as an extended reservoir of MRSA in humans.
Moreover, it is likely that the increased focus in research on animal MRSA
might pave the way for discoveries of other strains with atypical character-
istics that may also be riskier to human health. 129

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14.7 Strategies to Control Antimicrobial Resistance
As described in earlier paragraphs antimicrobial resistance is a global issue
and controlling its spread could only be achieved by improving our under-
standing of antimicrobial resistance using data from surveillance and
diagnostics. Furthermore, control of infection transmission between coun-
tries could be achieved by promoting good clinical practice in prescribing
antibiotics. From this angle, maintaining the ecacy of existing anti-
microbials is key. This can be achieved by applying stricter infection pre-
vention and control practices, optimising prescribing practices and
embedding antimicrobial stewardship programmes that ensure antibiotics
are used only when needed and then in the right way, at the right dose and
for the right duration. The second most important step towards anti-
microbial resistance control is supporting the development of new anti-
microbials and alternative treatments. This could be achieved by great
international collaboration to stimulate the antibiotic pipeline by en-
couraging innovative approaches to develop diagnostics, new antibiotics and
novel therapies. In this regard, the forecast that the market for anti-
microbials is likely to be US$40.3 billion in 2015 2 should encourage invest-
ment in the discovery and development of novel drugs.