A Canadian health technology company that helps doctors make informed decisions about treatment of infectious diseases has partnered with the World Health Organization (WHO) to provide new guidance for prescribing antibiotics — an initiative aimed at addressing the rising threat of antimicrobial resistance.
The WHO’s new guidance — the first of its kind from the UN agency — provides clinicians with evidence-based guidance on how to best use antibiotics, including the choice of which antibiotic to use in different scenarios, how to dose it and for how long.
The guidance, based on recommendations from an expert committee that has been working on this initiative since 2017, will be available as a book and a mobile app.
Firstline, a company based in Vancouver, B.C., will provide the WHO’s “AWaRe antibiotic book” through a web and mobile app that will be openly accessible around the world, free of charge.
AWaRe is an acronym for ‘access, watch and reserve’ and is a classification system developed by WHO that delineates antibiotics into three different classes based on the impact they have on antimicrobial resistance.
“Inappropriate antibiotic use is one of the drivers of antibiotic resistance and the (Firstline) platform is one of the tools to disseminate information on how to use antibiotics appropriately contained in the WHO AWaRe antibiotic book,” said Dr. Benedikt Huttner, secretary of the WHO List of Essential Medicines, in a statement to Global News.
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“We welcome all partners that support us in disseminating our guidance on how to best use antibiotics and help us reach more people… Smartphone applications are clearly an interesting way to widely disseminate information that can be available at the point of care,” he added.
Jason Buck, chief strategy officer and co-founder of Firstline, says the partnership with WHO was a natural one for his company, which is experienced at taking large amounts of evidence and information on infectious diseases and distilling it down into guidance suitable for use by doctors at the point of care.
“This World Health Organization project is really about filling in that enormous void where there should be good clinical knowledge, good clinical guidance to help doctors make the right decisions about prescribing antibiotics in every country,” Buck told Global News.
Antimicrobial resistance has been identified by the WHO as a rising threat to global health, which contributes to millions of deaths worldwide every year.
It also leads to the creation and spread of so-called ‘superbugs’ that are resistant to antibiotic medications and cause significant illness and death every year.
Dr. Susan Poutanen, a medical microbiologist and infectious disease physician at the University Health Network and Sinai Health, told Global News last week an estimated 14,000 deaths every year in Canada are associated in some way with antimicrobial resistance.
“This is somewhat of an unrecognized, quiet or silent pandemic,” Poutanen said.
The main driver of antimicrobial resistance is the misuse and overuse of antibiotics, both in human disease management and in industrial agriculture and food production, according to the WHO.
Buck says the WHO’s new guidance on antibiotic use is especially timely, not only because of increasing concerns about rising rates of resistance, but also because parts of the world have been experiencing a shortage of some antibiotics, including Canada.
Many doctors are prescribing antibiotics for regimens of 14 days — a period that many infectious diseases experts say should be shortened to seven days, Buck said.
If more prescribers have access to WHO’s new guidance through Firstline’s mobile app, they will have a better understanding of this, which will not only help fight antimicrobial resistance, but also lessen the demand for supplies of the medications, he said.
“It’s very difficult for infectious disease experts to get that knowledge into the hands of the prescribers actually writing into the prescription 14 days rather than seven,” Buck said.
“And of course, when you halve the prescribing length, you’re effectively doubling the supply of those medicines.”
Making guidance available alone will not be sufficient to stop the growing threat of superbugs and antibiotic resistance and “additional interventions will be necessary,” Huttner said.
But WHO hopes making the information in its guidance more widely available will allow more health-care professionals to be exposed to the concept of “access, watch and reserve” antibiotics.
“Access” antibiotics are those that can fight a wide range of common pathogens while also showing lower resistance potential than antibiotics in the other groups.
“Watch” antibiotics have higher resistance potential, and WHO says they should be prioritized for monitoring.
“Reserve” antibiotics include those that should be reserved to treat only confirmed or suspected illness caused by “multi-drug-resistant organisms” and should be used only as a “last resort,” the WHO guidance says.
“The reduction in the overuse of ‘watch’ antibiotics is an important factor to limit the emergence and further spread of antibiotic resistance,” Huttner said.