Stemming the rising tide of antibiotic resistance: Aetna International's approach to antibiotic stewardship

31 January, United Arab Emirates:   Antibiotic resistance is one of the world’s deadliest health crises. Without concerted action, the annual death toll could reach 10 million by 2050 which is more than the number of deaths from cancer, cholera, measles and traffic accidents combined.  The cumulative impact on global economic output could reach $1 trillion by 2050. Aetna International is committed to raising awareness of this critical health challenge as well as promoting effective, value-based care solutions. These effective strategies are outlined in the new whitepaper Antibiotic resistance: Toward better stewardship of a precious medical resource. Click here for the full report.  

 

 

The main causes of antimicrobial resistance (a broader category that also encompasses drug-resistant viruses, fungi and parasites) are misuse and over-prescription; the use of antibiotics in agriculture; a lack of research and an anaemic drug pipeline; and poor hygiene and sanitation. A 2014 survey of 1000 primary care doctors in the UK found that 55 percent felt under pressure, mainly from patients, to prescribe antibiotics, even if they were not sure they were necessary.  This highlights the urgent need for a greater effort to educate individuals about the use of antibiotics. A large proportion of the population mistakenly believe they should stop taking an antibiotic once they begin to feel better.  

 

Dr Mitesh Patel, Medical Director, Aetna International, says: “We strongly advocate action through proactive education, early intervention, data analysis and an emphasis on value-based care. The antibiotic resistance is a crisis that effects everyone globally and we need to address this issue now with a global, multifaceted strategic solution.”

 

 

Aetna International believes it is imperative to tailor antibiotic stewardship strategies to individual countries. Each country will differ on a case by case basis, which means alternative strategies are needed to combat antibiotic resistance. A 12-country survey by the WHO in 2015 demonstrates the differences between countries. At least 75 percent of respondents from Egypt, India, Mexico and Sudan reported taking an antibiotic within the last six months, compared with just 35 percent of those from Barbados. Nearly 90 percent of South Africans understand they should take the full course of antibiotic, compared with just 47 percent of Chinese.  Aetna International is calling for carefully tailored solutions to local situations. 

 

 

In order to succeed, an integrated, multi-sectorial antibacterial resistance strategy is needed. The WHO Global Action Plan looks at ways to improve understanding of antimicrobial resistance, with methods such as increasing research to strengthen the current knowledge and evidence base. It also suggests reducing infection through effective sanitation and optimising the use of antimicrobial medicines in human and animal health.  

 

Aetna International supports accrediting bodies to make antimicrobial stewardship a true standard in hospitals and outpatient settings, as well as building awareness and educating clients and members about antibiotic usage. Aetna International data indicates that among their expatriate members living in the US, they have reduced utilisation since 2014. Between 2014 and 2016, antibiotics utilisation across Aetna International membership population decreased by one-third, dropping from 27 percent in 2014 to 18 percent in 2016. 

 

Dr Mitesh Patel, Medical Director, Aetna International, says: “Stemming the rising tide of antibiotic resistance will take a global, multipronged effort. The industry must become better stewards of the antibiotics we have today, whilst working to develop more antibiotics for tomorrow. A focus on harnessing big data will inform strategies that create better care for patients as well as significantly decreasing the financial cost from antimicrobial resistance. “