Preface |
Preface
There is growing concern over the inexorable rise in antimicrobial resistance affecting both human and veterinary medicine. Indeed, the two disciplines are closely entwined with regard to problems of antimicrobial therapy.
Antibiotics and antimicrobial chemotherapy are one of the major achievements of the twentieth century, beginning with the introduction of the synthetic sulphonamides in the 1930s and followed closely by the distillation of bacterial fermentation products and molecular manipulation leading to the range of antibiotics available today. However, success has carried a price. Bacteria (and now viruses) have adapted to the antimicrobial onslaught, and along with a failure to acknowledge the need for prudent use of antimicrobial agents, widespread resistance has emerged.
The 1997 Standing Medical Advisory Committee (SMAC) report ‘The Path of Least Resistance’ highlighted the need for good antimicrobial prescribing in both human and veterinary medicine – it was clear that further measures were required.
The Specialist Advisory Committee on Antimicrobial Resistance (SACAR) was set up in 2001 to provide scientific advice to the Government, following the House of Lords Select Committee on Science and Technology's report ‘Resistance to Antibiotics and other Antimicrobial Agents’. SACAR has a UK mandate and its remit was to progress a strategy to minimize the morbidity and mortality due to antimicrobial-resistant infections and maintain the effectiveness of antimicrobial agents for the treatment and prevention of microbial infections in man and animals. The Committee has drawn on relevant expertise from both human and veterinary medicine.
Terms of reference included both short- and long-term measures to minimize emerging antimicrobial resistance and its possible impact. The Committee was also tasked with ‘horizon scanning’ to ensure that measures were in place in a timely manner to meet threats to clinical (including veterinary) management.
Professor Richard Wise was appointed Chairman from the outset. Under his guidance, SACAR has, over the past 5 years, made marked progress with these aims, and shown considerable influence. Key items include helping the Department of Health take forward public awareness campaigns featuring ‘Andybiotic’ in the ‘Antibiotics - Don't Wear Me Out’ series, organizing conferences for clinical hospital pharmacists and working with the Healthcare Commission on medicine management.
Antimicrobial resistance is a global problem requiring international co-operation. SACAR has taken the lead in a number of initiatives to bring together international experts in this field to identify practical solutions.
The role of SACAR was recognized in the report on strategy for combating infectious diseases, ‘Getting Ahead of the Curve’, and also in ‘Winning Ways – working together to reduce Healthcare Associated Infection in England’, which highlights the need for prudent use of antibiotics in clinical practice. SACAR's work has supported this with, for example, the SACAR prescribing template (available on the SACAR website and as a Appendix in this Supplement).
Finally, in 2006 the Health Act introduced a Code of Practice for the prevention and control of healthcare-associated infections. SACAR members helped to develop this document, which requires all Acute Trusts to have up-to-date guidelines on the use and control of antimicrobial agents.
This report covers in some detail the current position with regard to antimicrobial resistance and usage in the UK, in both human and veterinary medicine. The individual reports reflect the invaluable expertise that the authors have given to SACAR. I am delighted to commend its contents to you.
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