[Table of Contents]

Volume: 23S7 - November 1997

CONTROLLING ANTIMICROBIAL RESISTANCE
An Integrated Action Plan for Canadians

CONFERENCE OBJECTIVES AND RECOMMENDATIONS

WORKING GROUP ISSUES

3. Working Together to Create Partnerships

The working groups in this area were asked to address issues relating to the coordination and cooperation required on the one hand among public agencies, private organizations, governments and industry to limit antimicrobial resistance, and on the other hand among the various health care sectors in order to ensure that the system is responsive to the needs of patients and communities affected by antimicrobial-resistant organisms. It was recognized that adequate resources for infection control programs and personnel in the restructured health care setting should be considered an integral part of an overall program to limit transmission.

Participants felt that there is a short-term window of opportunity for action on the issue of antimicrobial resistance. If the opportunity is not seized, then higher costs and more challenging "catch up" efforts will be necessary in the future. Awareness of the problem needs to be promoted across stakeholder groups and made a priority for action, whether in the form of access to expertise and funds for research contributed by industry, government, voluntary agencies and academic departments or in the development of case definitions and "flagging" protocols across local health care settings.

Recommendation 13

To mobilize leadership mechanisms to address antimicrobial resistance.

Recommendation 14

To generate, interpret and disseminate information that will support evidence-based approaches to dealing with antimicrobial resistance.

Recommendation 15

To identify structures and key human resources at the care-setting and (local) regional levels that are/will be most responsible for coordinating the care of clients/ patients/consumers affected by antimicrobial-resistant organisms.

Recommendation 16

To communicate information that will improve understanding and actions concerning antimicrobial resistance.

Recommendation 17

To ensure that adequate resources for infection control programs and personnel exist in all Canadian health care settings (including home care, acute care, long-term care, and childhood and adult day-care programs) and to recognize that these programs should be an integral part of the overall program to limit the transmission of antimicrobial resistance.

Recommendation 18

To urgently review (within 1 year) infection control guidelines regarding the resources and personnel required in the changing health care environment.

Participants discussed several ways of achieving these recommendations:

• distribution of a consensus statement from the conference as a tool to drive shared awareness of the problems and risks associated with antimicrobial resistance;
• formation of a National Steering Committee to mobilize leadership mechanisms; the Committee would have a broad membership base (e.g., LCDC, Canadian Infectious Disease Society, Canadian Pharmacists Association, Canadian Paediatric Society, consumer representatives, Canadian pharmaceutical industry), a full-time secretariat, provision for working groups and advisory committees, and a high-profile spokesperson;
• establishment of a national clearinghouse for disseminating information;
• creation of a pool of funds to support targeted research on controlling antibiotic resistance;
• designation of key individuals or teams to develop agreements on case definitions, protocols for care, flagging systems and management plans across health care settings;
• use of communications experts to reach the public with effective messages about risk, appropriate uses of antimicrobial agents and ways of dealing with the problem of resistance;
• assessment of infection control guidelines regarding the resources needed to optimally reduce or prevent transmission of antimicrobial organisms in the health care setting.

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