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Act Now Against Antibiotic Resistance. Your choices today could transform their tomorrows.

Collage of patients

A Global Health Crisis

Lead the way in the fight against resistance

From the moment they were discovered, antibiotics have transformed medicine, and saved millions of lives. However, the rapid emergence of antibiotic resistance is threatening the very existence of these life-saving drugs, and their benefit to you, and your patients.1 Meaning, considering the right drug, dose and duration is now more essential than ever in tackling this health crisis2,3

With dermatology being the top antibiotic prescriber specialty in the U.S., you are uniquely positioned to take the lead in what has become a global fight against antibiotic resistance5–7

By continuing to uphold your responsibility to antibiotic stewardship, you can help protect the future of these vital medicines for generations to come2,8

10 million lives

Antibiotic resistance is on track to claiming 10 million lives a year by 2050. That is 10 million people dying from previously-treatable bacterial infections4

Your choices today, could change their tomorrows

Antibiotic resistance has now become a universal threat. it can affect anyone, of any age, in any country making us all key in the fight against it Jesse Jacob, Associate Professor of Medicine, Emory University School of Medicine

Act Now Against Antibiotic Resistance9

Right Drug

Illustration saying Right Drug + Right Dose + Right Duration = Protect Future Health. Advancing the response to antibiotic resistance.

Without action

Without effective antibiotics, currently safe procedures like organ transplantations, chemotherapy, and surgeries become life-threatening, and other infectious diseases may become difficult to treat. Without a real change in prescribing behavior, we are putting the achievements of modern medicine, and the lives of many, at risk2,5

  • In the U.S. alone, each year at least 2.8 million people get an antibiotic-resistant infection2

  • Economic losses of about $35 billion annually have been recorded, related to lost productivity, due to antibiotic resistances in U.S. healthcare systems alone10

  • Methicillin-resistant Staphylococcus aureus (MRSA) infections alone, among the highest of all antibiotic-resistance threats, are said to cost the U.S. healthcare system ~$60,000 per patient and ~$9.7 billion a year11

Antibiotic Misuse

The problem we are facing is real. Without urgent action, antibiotic resistance could claim 10 million lives a year by 205012

Without a real change in prescribing behavior, we risk the effectiveness of our antibiotics2,5

What are currently safe medical procedures, could become life-threatening2,5

Did You Know, In the U.S.:

~8.2 million oral antibiotic prescriptions are prescribed for dermatological conditions every year, with dermatologists prescribing antibiotics more commonly than any other physician group6

~75% of all oral antibiotics prescribed by dermatologists are tetracyclines, particularly doxycycline and minocycline6

20% of patients prescribed antimicrobials in dermatology are individuals with acne or rosacea5

Not Actual Patients

COVID-19 and antibiotic resistance

The misuse and overuse of antibiotics is fueling resistance into becoming a bigger global health crisis than it already is, one that threatens the effectiveness of these drugs that we all rely on – regardless of background, age, or location12

Health organizations warn that the current COVID-19 pandemic threatens to strengthen bacterial resistance worldwide, ultimately leading to more deaths during this crisis and beyond13,14

Did You Know:

More than 70% of COVID-19 patients received antimicrobial treatment, however only 8% of those had a bacterial or fungal infection requiring such treatment14

The Science Behind Antibiotic Resistance

  1. 1

    There are lots of bacteria, and a few are resistant to antibiotics

  2. 2

    When antibiotics kill bacteria causing illness, they also kill good bacteria protecting the body from infection

  3. 3

    The antibiotic-resistant bacteria grow and take over

  4. 4

    Some bacteria give their antibiotic resistance to other bacteria, causing more problems

Antibiotics fight bacteria, however they can fight back and find new ways to survive. These defense strategies are called resistance mechanisms. Only the bacteria, not people, become resistant to antibiotics2

  1. Bacteria develop new cell processes that avoid using the antibiotic’s target
  2. Bacteria change or destroy the antibiotics with enzymes, proteins that break down the drug
  3. Bacteria restrict access by changing the entryways or limiting the number of entryways
  4. Bacteria get rid of antibiotics using pumps
  5. Bacteria change the antibiotic’s target so the drug can no longer fit and do its job

Visuals adapted from: Centers for Disease Control and Prevention (CDC)2,15

A typical path for the emergence of antibiotic-resistant bacteria, and the subsequent spread throughout a healthcare facility could look like:16

  1. 1

    Patient receives antibiotics

  2. 2

    The bacteria in the gut are killed, unless they have a gene for resistance

  3. 3

    With little competition, those bacteria now flourish

  4. 4

    The patient visits a hospital, and uses the bathroom, failing to wash their hands properly

  5. 5

    Someone else touches something this patient has been in contact with, and contracts the resistant infection

The resistant bacteria can then spread from patient to patient, or on medical equipment, and into sterile, surgical environments16

Adapted from: Antibiotic Research UK16

The consequences of resistance related to antibiotic-use may not always be readily detectable or easy to spot by you or your patients.6 However, in dermatology, where high doses of antibiotics can be used for a long period of time, signs of resistance may include:5,17,18

  • Treatment failure of skin conditions in response to antibiotics
  • Disturbance in the normal flora of the skin*, and other places in the body, possibly increasing chances of infections, such as upper respiratory tract infection
  • The introduction and growth of opportunistic pathogens, locally and systemically

Generally, antibiotic-resistant skin infections may present in patients the same as any other common infection – the infected area is usually:19

  • Red

  • Hot

  • Painful

  • In some cases, a patient might have a fever, or feel hot and cold

Antibiotic-resistant infections will not respond to the antibiotics most often used to treat it, though there may be others that can be used. With these infections, a swab test can help identify which bacteria are present, and the best antibiotic(s) to use19

*Culture and susceptibility testing before and after antibiotic treatment can help identify changes in skin flora and the presence, type and severity of resistance bacteria, if infection is suspected17

Need For Change

Everyone who depends on antibiotics must join forces to help detect and prevent the emergence, and spread of antibiotic resistance

The world urgently needs to change the way it prescribes, and uses antibiotics – without behavior change, antibiotic resistance will not only remain a major threat, but an active reality2,4,12

Combating antibiotic resistance is not just a national, but a global priority, with the U.S. government, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) all actively launching initiatives, supporting research and outlining guidance, with hopes to tackle the devastating threat that antibiotic resistance poses2,20,21

Fighting this threat is a public health priority. It requires a collaborative global approach across sectors to detect, prevent, and respond to these threats when they occur CDC, 2020

As part of the ongoing battle against resistance in the U.S., the CDC proposed core actions to better prepare the nation for this threat that continues to emerge worldwide – antibiotic stewardship is an integral cornerstone in this strategy:2,9

  1. 1

    Infection prevention
    and control

    Prevent infections, and their spread by continuing to follow infection prevention, and control guidelines

  2. 2

    Tracking
    and data

    Share data, and improve data collection around infection patterns, while staying informed of current resistant outbreaks/trends

  3. 3

    Antibiotic use
    and access

    Improve appropriate use of antibiotics, reduce unnecessary use (antibiotic stewardship), and ensure improved access to antibiotics

  4. 4

    Vaccines, therapeutics,
    and diagnostics

    Invest in development, and improved access to vaccines, therapeutics, and diagnostics for better prevention, treatment, and detection

  5. 5

    Environment and
    sanitation

    Keep antibiotics, and antibiotic-resistant threats from entering the environment through actions like improving sanitation, and improving access to safe water

You can confidently take the lead as an antibiotic steward in your field, by simply ensuring that the right drug, dose and duration is prescribed to your patients9,22

Act Now Against Antibiotic Resistance

Real change starts with you
Choose the right drug, dose and duration

With first-hand experience of the life-changing impact antibiotics can have on patients, and with dermatology being the top antibiotic prescriber specialty in the U.S., you are key in leading the global fight against antibiotic resistance6

Antibiotic stewardship can be used across all healthcare settings, and is the cornerstone of efforts in improving antibiotic use, and slowing the spread of resistance. The goal is to maximize the benefit of antibiotic treatment while minimizing harm both to individuals, and to communities9

One change in how you prescribe, is one step further in the fight against resistance:6,17

  • Identify, and assess whether an antibiotic is truly needed
  • Consider sub/non-antibiotic alternatives where possible
  • Consider the shortest regimen required to treat

Continue to ask your patients if they have been on an antibiotic (what dose and duration) in the past 12 months to avoid cumulative effects of any medication

What is antibiotic stewardship?

Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by:9

  • Ensuring the right drug, dose, and duration are selected when an antibiotic is needed
  • Prescribing and using antibiotics only when needed
  • Minimizing misdiagnoses or delayed diagnoses leading to underuse of antibiotics

CDC, 2020

Take action against antibiotic resistance

Aside from opting for the right drug, dose and duration, there are more ways you can uphold your commitment to antibiotic stewardship, and help decelerate the threat in this fight against antibiotic resistance9,23

  • Prevent and control

    • Help prevent infections, and their spread by continuing to follow infection prevention and control guidelines (ensuring hands, instruments, and environment are clean)23
    • Stay informed of current infection outbreaks, and aware of resistance patterns using available surveillance tools23,24

  • Educate

    • Talk to your patients about how to take antibiotics correctly, antibiotic resistance, and the dangers of misuse9,23
    • Provide patient education materials:9
      • On appropriate antibiotic use
      • On potential adverse drug events from antibiotics5
      • On the management of common infections

  • Self-evaluate

    • You can use self-evaluations to align antibiotic prescribing practices with updated evidence-based recommendations and clinical practice guidelines9
    • If you were to come across antibiotic-resistant infections, your valuable report to surveillance teams could guide changes in practice, and be used to assess progress in improving antibiotic prescribing24
    • Be aware of infections, and resistance patterns in your direct facility, and community23
    • Ensure you are notified immediately when antibiotic-resistant germs are identified in your patients23

By considering sub-antibiotic dose treatments, you are not only offering your patients effective options, but also choosing to protect future health by opting for a treatment that does not contribute to antibiotic resistance22,25