Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A Position Paper
Jean-Yves Maillard, American Journal of Infection Control 2020.04.011
Highlights
•Global and national AMR action plans focus on infection prevention in healthcare settings
•Evidence demonstrates home and everyday life settings are important for infection transmission, acquisition and spread of antibiotic resistant pathogenic and commensal strains
•Studies show targeted hygiene helps to maximize protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for AMR development across the world, including low-and middle-income countries
•Reducing AMR requires greater consideration of the role of hygiene in preventing infections in the home and community
ABSTRACT
Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of healthcare facilities with home and everyday life settings barely addressed.
As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms.
This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in healthcare settings requires a mirrored reduction in the community.
The authors call upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.