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Contents

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Part 1:

1.1 Introduction to Antimicrobial-resistance

Antimicrobial resistance is an increasing risk to international public wellbeing(Huband et al.,

2019). The abuse and overuse of antibiotics by humans and agriculture is accelerating the

process of antibiotic resistance. China and 14 other ministries and commissions issued the

"National Health Action Plan to Contain Antibiotic Resistance 2016-2020" to ensure a clear

multi-sectoral approach to address this growing problem. The Chinese health department has

taken measures to reduce the proportion of inpatients using antibacterial drugs from 67.3% in

2010 to 36.9% in 2017.

1.2 Estimated Burden

Superbug is a term used to describe bacteria that cannot be killed by most existing antibiotics.

Therefore, infections caused by these antibiotic-resistant "super bacteria" are often life-

threatening and extremely difficult to treat.

1.3 Nature of the problem:

The rapid emergence and spread of "super bacteria" poses a serious threat to public health in

South Korea and the world. To discover new antibacterial agents that are effective for "super

bacteria", our research strategy is to 1) expand the knowledge of bacterial physiology and drug

resistance mechanisms, 2) use this knowledge to develop new screening systems, and 3) identify

new entities by Developed system (Muraki et al., 2016).

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1.4 Affected population:

Antibiotic resistance is one of the biggest public health challengesSouth Korea faces. Annually,

more than 2.8 million people get an antibiotic-resistant infection, andover 35,000 fatalities.

1.5 Factors contributing to the issue:

Drug resistance (AMR) occurswhen microorganisms (bacteria, viruses, fungi, parasites, etc.)

mutate and become resistant to antibacterial drugs (antibiotics, antivirals, antifungals,

anthelmintic,antimalarials) used to treat infections caused by them. Microbes that produce AMR

are commonly referred to as "super bacteria" because they cannot be treated with effective drugs,

leading to persistent infections, raising the threat of spreading the infection to others.

Part 2:

2.1 Summary and evaluation of existing interventions: (include the social-ecological

model of health)

Intervention: Global Antimicrobial Resistance Surveillance System (GLASS)

GLASS promotes the growth of the national surveillance system, to standardize, compare, and

validate AMR between different countries, collect, analyze, and share data(Lee et al., 2018).

Established in 2016,the Korean AMR surveillance systems Kor-GLASS matches GLASS

platform standards, with respect to standards of professionalism, representativeness, localization,

and uniformity. KCDC operated a nationwide AMR surveillance system between 2002 and

2015. However, due to differences in antimicrobial susceptibility testing methods and hospital

interpretation breakpoints, problems regarding the reliability of KARMS data(Safdari et al.,

2017) arise. System collected the laboratory data to easily monitor AMR as well as to detect

resistance from hospitals. However, problems regarding data reliability raised for KARMS,

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resulting from the differences in antimicrobial susceptibility testing techniques and interpretation

breakpoint (Liu et al., 2019). New system is totally based on collection of the non-duplicate

clinical isolates plus data by the specimen from hospitals.

South Korea currently faces challenges in AMR. The latest KARMS report states that meticillin-

resistant Staphylococcus aureus is common (approximately 66% of Staphylococcus aureus) in

2015, almost 85% tested were imipenem-resistant positive. The establishment of Kor-GLASS is

a method to target this problem in Korea (Lee et al., 2018).

2.2 Stakeholder and involvement in the intervention

Stakeholders include in in antimicrobial resistant are nurses, physicians, pharmacists, or patients,

their medical representatives, relatives, pharmaceutical industries, distributors, policymakers and

regulatory agencies. Kor-GLASS has an operation and advisory committee in Korea,

comprisingmembers with extensive knowledge in infectious illnessesor clinical microbiology

(Sirijatuphat et al., 2020).

The ability of the diagnostic microbiology laboratory to produce correct and repeatable data is

another consideration. Clinical isolates collected through this system are scrutinised in analysis

centre with hard- as well as software suitable for the AMR study. The capability of diagnostic

microbiologic laboratories to produce reproducible and accurate data was another consideration

(Liu et al., 2019). To reflect the AMR traits of South Korea, the GLASS manual has been

customized as follows: three target pathogens are included: Enterococcus faecalis,  P.

Aeruginosa,and E. faecium blood isolates to monitor the carbapenem and glycopeptide

resistance critical in clinical settings of South Korea; also target antimicrobials to classify multi-

drug resistance are added, hence in S. Aureus case tested not only cefoxitin as in GLASS manual,

but erythromycin, clindamycin, quinupristin-dalfopristin, vancomycin, mupirocin, teicoplanin,

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tigecycline and linezolid are also tested settings and strain typing to assess molecular

epidemiology of drug-resistant clones dominant in the country (Theuretzbacher, 2013).

All tripartite institutions (WHO, FAO, and OIE), partners and stakeholders communicate on

antimicrobial resistance (from awareness-raising to behavior change interventions and

accountability monitoring) Both are the cornerstones of the Global Antimicrobial Resistance

Action Plan. As of the AMR National Action Plan. Antimicrobial management is an area where

pharmacologists can play a major role. Pharmacologists need to actively work with

microbiologists, infectious disease doctors, and other relevant personnel to formulate

antibacterial policies in the hospital. Such a working group is essential for the development and

implementation of antimicrobial use guidelines(Turnidge&Meleady, 2018). Pharmacologists can

also use their knowledge in activities such as prescription review, feedback, and monitoring of

antimicrobial use throughout the hospital. Another area might be in interpreting the minimum

inhibitory concentrations values when hard treatment decisions have to be made because of

AMR.

Education and training are core areas, and pharmacists should use their experience and vantage

point to shape future prescribers with the correct attitude. In medicine, pharmacy and nursing

courses, teachers of pharmacology and other related subjects should invest enough time, and

emphasize the use of antibacterial drugs and treatment options. This method will be of great help

in providing future health professionals with the basis for practicing the responsible use of

antibacterial drugs. Needless to say, the evaluation mechanism needs to be adapted

accordingly(Huband et al., 2019).

The role of pharmacologists need not be limited to hospitals. It is important to increase AMR

awareness, improve the appropriate use of antimicrobial drugs, and develop community

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monitoring systems. Local development of antimicrobial use research is essential to develop

local guidelines. Affordability and accessibility are major issues and pharmacoeconomic

research will help reduce the burden on patients with lower health system funding and privileges.

Pharmacologists can also assist in continuing education programs so that physicians,

pharmacists, and nurses have the latest knowledge of the evidence-based practice.

Pharmacologists, with their knowledge of pharmacodynamics and kinetics, can become ideal

promoters of antibacterial drug conversion studies between physicians and the pharmaceutical

industry(Muraki et al., 2016).All in all, all stakeholders should play a role in containing AMR.

Pharmacologists especially, have a responsibility as researchers, subject experts, and teachers to

be true stewards of the antimicrobial use in the hospital as well as outside the community. The

launch of the WHO GAP provides current initiatives, which provide pharmacologists with the

opportunity to take the lead in cooperation with other disciplines to implement relevant aspects

of the plan.

2.3 Cultural and ethical issues in implementing the intervention

Ethical behavior encompasses actions that completely benefit both self as well as society it

means that addressing AMRbecomes a moral obligation, as the prospect of a decline in the

number of anti-infective drugs affects everyone. If preventive measures are not taken, the loss of

life-saving drugs in the previous century will expose to unacceptable risk of untreatable infection

(Safdari et al., 2017). Guidelines aimed at prolonging the life of antimicrobial must be

considered in an ethical framework to balance the scope, choice, and drug quality and regulatory

activities. Maintain effectiveness and usability for the future use must not compromise today’s

patients.

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Public demand motivates over-the-counter drugs, the Internet, counterfeit drugs and black

markets, all of which undermine international regulation. Prescribers themselves need

educational support to strike a balance between treatment options and collateral harm to the

environment and body. The expected mortality caused by AMR provides a reason for global

cooperation, investment, and commitment to supporting monitoring and management and the

development of new antibacterial drugs. The moral implications of the action and non-action

constitute desire for the ethical consideration. This includes the control and prevention of AMR.

This is improper, particularly after humanity has gone through the "golden age of the

antibiotics." Whatever action is taken to correct AMR, it is necessary to strike a balance between

personal needs and common interests for example prescribers might try to limit the consumption

of drugs, but the benefits of reducing AMR for future use may cause severe sepsis in current

patients (Shortridge et al., 2020). What standards are needed to retain or release therapeutic

medicinesand even potentially life-saving drugs? If to choose between the risk and efficacy of

resistance then what constitutes a prudent and appropriate prescription. Other ethical dilemmas

that involve the use of antimicrobial prescriptions for a subset of patients with specific illnesses,

which is related to the prescription of influential drugs to advanced and elderly patients

(Sirijatuphat et al., 2020). Antimicrobial agents utilized to decrease the threat of infection in the

certain (healthy) patient populationmust are reduced because these patients are usually in good

condition. Although physicians have obligations to help the patients, they are simply expected to

desist from causing harm.

Theoretically, the term can also be used in the present practice of giving antibiotic as a surgical

prevention, which may be privilege in future. Without choosing a specific moral system, ReAct

believes that the right to health is a human right, no matter who they are and where you live

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(Theuretzbacher, 2013). This means that it is our moral obligation to promote the fair, reasonable

and sustainable distribution of antibiotics. Antibiotic efficacy can be viewed as a common

interest and a potentially non-renewable resource. In this way, it may become another example of

the tragedy of the commons. In this case, the interests of various stakeholders jointly cause the

exhaustion of resources. Therefore, action against antibiotic resistance must be taken consistently

across the globe. Any attempt to decrease unsuitable uses of the antibiotics moreover reduce the

risks of resistance needs systematic understanding of histories & cultures of the medicine uses,

structural problems surrounding health care, moreover an appreciation of cultures of risk. To

achieve sustainable results, it is necessary to understand existing and local health care conditions

and develop a sense of ownership of ABR issues. Like many health-related challenges, culture is

not only an obstacle to implementing policies. Various social, commercial, and cultural drivers

of drug prescription and use (cultural background) can confuse "one size fits all" policies

(Turnidge&Meleady, 2018). While managing the use of antibiotics, a series of possible drivers of

antibiotic resistance (culture and ecological environment of resistance) should be considered.

Conclusion

Advances in biomedicine have led to greatly improved human health prospects in many parts of

the world. However, in recent years, many complex health-related challenges still exist or

emerge. Science and technology alone are difficult to solve these challenges. Attention must be

paid to social and cultural dynamics that affect health and disease patterns and experiences. The

aging population, health inequality and poverty, isolation, loneliness and mental illness have

devastating health effects, all determined by complex, interrelated cultural, social and

environmental conditions. In the current situation, as indicated in the subsequent sections of this

ABR policy brief, the prescription and use of antimicrobial drugs, the spread of drug resistance,

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and the supervision and funding of research are influenced by cultural and social as well as

biological and technological factors. .

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References

Erratum: Antimicrobial susceptibility profile & resistance mechanisms of Global Antimicrobial

Resistance Surveillance System (GLASS) priority pathogens from India. (2019). Indian

Journal Of Medical Research, 149(3), 432. doi: 10.4103/0971-5916.261122

Huband, M., Pfaller, M., Shortridge, D., & Flamm, R. (2019). Surveillance of omadacycline

activity tested against clinical isolates from the United States and Europe: Results from

the SENTRY Antimicrobial Surveillance Programme, 2017. Journal Of Global

Antimicrobial Resistance, 19, 56-63. https://doi.org/10.1016/j.jgar.2019.02.017

Lee, H., Yoon, E., Kim, D., Jeong, S., Shin, J., & Shin, J. et al. (2018). Establishment of the

South Korean national antimicrobial resistance surveillance system, Kor-GLASS, in

2016. Eurosurveillance, 23(42). doi: 10.2807/1560-7917.es.2018.23.42.1700734

Liu, C., Yoon, E., Kim, D., Shin, J., Shin, J., & Shin, K. et al. (2019). Antimicrobial resistance in

South Korea: A report from the Korean global antimicrobial resistance surveillance

system (Kor-GLASS) for 2017. Journal Of Infection And Chemotherapy, 25(11), 845-

859. doi: 10.1016/j.jiac.2019.06.010

Muraki, Y., Yagi, T., Tsuji, Y., Nishimura, N., Tanabe, M., &Niwa, T. et al. (2016). Japanese

antimicrobial consumption surveillance: First report on oral and parenteral antimicrobial

consumption in Japan (2009–2013). Journal Of Global Antimicrobial Resistance, 7, 19-

23. https://doi.org/10.1016/j.jgar.2016.07.002

Safdari, R., GhaziSaeedi, M., Masoumi-Asl, H., Rezaei-Hachesu, P., Mirnia, K., & Samad-

Soltani, T. (2017). A national framework for an antimicrobial resistance surveillance

system within Iranian healthcare facilities: Towards a global surveillance system. Journal

Of Global Antimicrobial Resistance, 10, 59-69. https://doi.org/10.1016/j.jgar.2017.03.016

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Shortridge, D., Pfaller, M., Streit, J., & Flamm, R. (2020). Antimicrobial activity of

ceftolozane/tazobactam tested against contemporary (2015–2017) Pseudomonas

aeruginosa isolates from a global surveillance programme. Journal Of Global

Antimicrobial Resistance, 21, 60-64. https://doi.org/10.1016/j.jgar.2019.10.009

Sirijatuphat, R., Pongsuttiyakorn, S., Supapueng, O., Kiratisin, P., &Thamlikitkul, V. (2020).

Implementation of global antimicrobial resistance surveillance system (GLASS) in

patients with bacteriuria. Journal Of Global Antimicrobial Resistance, 20, 60-67.

https://doi.org/10.1016/j.jgar.2019.11.009

Theuretzbacher, U. (2013). Global antibacterial resistance: The never-ending story. Journal Of

Global Antimicrobial Resistance, 1(2), 63-69. https://doi.org/10.1016/j.jgar.2013.03.010

Turnidge, J., &Meleady, K. (2018). Antimicrobial Use and Resistance in Australia (AURA)

surveillance system: coordinating national data on antimicrobial use and resistance for

Australia. Australian Health Review, 42(3), 272. https://doi.org/10.1071/ah16238