Clinically Speaking: Important Questions to Ask About Antimicrobial Resistance

Medically reviewed by Dr. Chad Sanborn

Decades of overuse and misuse of antimicrobials has led to the global health threat known as antimicrobial resistance (AMR), which is when germs change over time and no longer respond to common medications. This makes infections harder to treat or not treatable at all.

Each year, more than 2.8 million antibiotic-resistant infections occur in the United States alone, and more than 35,000 people die as a result of AMR. The situation has become so dire that the World Health Organization declared AMR a top global health threat facing humanity.

How did we get here? Antimicrobial drugs like penicillin have saved countless lives over the past century. The problem now lies in relying on those same drugs to clear infection, but the resistant bacteria — also known as superbugs — continue to grow and spread.

“You’re then left with more drug-resistant microbes, or AMR,” said Dr. Chad Sanborn, a physician trained in pediatric infectious disease with KIDZ Medical Services in Florida.

“A superbug sounds scary, for sure, but is just a term used for a microbe which is resistant to most classes of antimicrobials used to treat it,” Sanborn explained. “You will want to know if you have a superbug as these often require IV antimicrobials, longer treatment courses or combinations of medications to treat them appropriately.”

Poor infection and disease control in healthcare facilities and lack of proper sanitation also contribute to the spread of AMR. Sanborn said patient empowerment is crucial to protecting yourself and your family. In addition to practicing good hygiene, ask your healthcare provider (HCP) if any prescribed antimicrobials are in fact necessary and if your HCP has noticed an increase in AMR in your community.

Am I at risk for AMR?

Why this question is important:

According to the World Health Organization, AMR can affect anyone because antimicrobial resistant organisms are everywhere — in people, food, plants, water, animals and the surrounding environment. This question will help ensure that your HCP is using the most focused and simplest drug to treat infection, or, if you are getting an anti-infective medication for another reason, you would want to know if and how this may increase your chance of developing AMR.

If I have a chronic condition, how do I avoid developing AMR?

Why this question is important:

It is vital to work with your provider on managing chronic conditions. You may be at risk for more infections and therefore more antibiotic treatment, particularly if the condition is poorly controlled. So, it is important to work with your provider to stay as healthy as possible and keep any health conditions you have under control. This will put less strain on your organs and allows your immune system to focus on treating the infection so you may not need antibiotic treatment to begin with. Also, your HCP will be less likely to prescribe a “just in case” antibiotic if they know your condition is under good control.

What is the difference between antibiotic resistance and antimicrobial resistance?

Why this question is important:

Understanding these terms allows us to combat it. Antimicrobial resistance is the broader term used to describe the ability of bacteria, viruses, fungi and parasites to defeat the drugs (antibacterials, antivirals, antifungals and antiparasitics respectively) that are commonly used to treat them. Antibiotic resistance is the more specific term that refers to the ability of bacteria to overcome the medications (antibiotics) used to treat them. Antibiotic resistance is a type of antimicrobial resistance. This is important to ask because, while less common, you can develop resistance to antifungal and antiviral medications.

How should I adjust my or my children’s use of antibiotics?

Why this question is important:

It is useful to know from your provider what infection is being treated and to be sure that you or your child needs an antibiotic. Common viral infections such as rhinovirus (a cause of the common cold) will not respond to commonly used antibiotics. Don’t ask to be given an antibiotic if your provider doesn’t feel it’s necessary as this will increase the chances of normal bacteria living inside you becoming resistant to medications.

What is the importance of completing an antibiotic regimen?

Why this question is important:

Stopping antibiotics if you feel better — before the regimen is complete — may not mean that the infection is gone. If not completely eradicated by treatment, the bacteria being treated may become resistant to the antibiotic used. The same goes for skipping doses of the medication — if a bacteria is exposed to a less consistent dose of medication this too will often decrease the effectiveness of the medication. If you’re experiencing any side effects from the medication that are making it difficult to complete the regimen, speak to your HCP about your options instead of simply stopping your medicine.

What do vaccines have to do with AMR?

Why this question is important:

It is much easier to deal with the infection you never get. There are a number of vaccines to prevent infections, including vaccines against bacterial and viral infections. Getting vaccinated appropriately will prevent you and your family from getting or spreading these infections. Vaccines also indirectly protect unvaccinated people in your community, such as infants too young to be vaccinated or people with certain medical conditions. The equation is simple — if there are less infections to begin with, there will be less antibiotics used and less resistance will develop. Ask your HCP what vaccines you need and make sure you’re up to date on all of your vaccines.

What can I do to help combat AMR?

Why this question is important:

Talk with your provider about your role in preventing AMR as we all need to be aware and work together to fight this growing problem. While certainly you should seek out medical assistance when ill, don’t just seek out antimicrobials for you or your child. Use the medications as prescribed and don’t share medications among family members. Don’t take antibiotics to try to prevent infection unless indicated (for example, don’t ask for antibiotics for yourself if your child is ill and you are trying to avoid becoming ill). Take control of underlying medical conditions and make sure vaccinations are up to date. Let your provider know if you are having bad effects or lack of improvement with a particular antimicrobial — what usually works may not work each time.

This resource was created with support from Pfizer Inc.

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