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Control of Antimicrobial Resistance Requires an Ethical Approach

Parsonage, Ben; Hagglund, Philip K.; Keogh, Lloyd; Wheelhouse, Nick; Brown, Richard E.; Dancer, Stephanie J.

Authors

Ben Parsonage

Philip K. Hagglund

Lloyd Keogh

Richard E. Brown



Abstract

Ethical behavior encompasses actions that benefit both self and society. This means that tackling antimicrobial resistance (AMR) becomes an ethical obligation, because the prospect of declining anti-infectives affects everyone. Without preventive action, loss of drugs that have saved lives over the past century, will condemn ourselves, people we know, and people we don't know, to unacceptable risk of untreatable infection. Policies aimed at extending antimicrobial life should be considered within an ethical framework, in order to balance the choice, range, and quality of drugs against stewardship activities. Conserving availability and effectiveness for future use should not compromise today's patients. Practices such as antimicrobial prophylaxis for healthy people 'at risk' should receive full debate. There are additional ethical considerations for AMR involving veterinary care, agriculture, and relevant bio-industries. Restrictions for farmers potentially threaten the quality and quantity of food production with economic consequences. Antibiotics for companion animals do not necessarily spare those used for humans. While low-income countries cannot afford much-needed drugs, pharmaceutical companies are reluctant to develop novel agents for short-term return only. Public demand encourages over-the-counter, internet, black market, and counterfeit drugs, all of which compromise international control. Prescribers themselves require educational support to balance therapeutic choice against collateral damage to both body and environment. Predicted mortality due to AMR provides justification for international cooperation , commitment and investment to support surveillance and stewardship along with development of novel antimicrobial drugs. Ethical arguments for, and against, control of antimicrobial resistance strategies are presented and discussed in this review.

Citation

Parsonage, B., Hagglund, P. K., Keogh, L., Wheelhouse, N., Brown, R. E., & Dancer, S. J. (2017). Control of Antimicrobial Resistance Requires an Ethical Approach. Frontiers in Microbiology, 8, https://doi.org/10.3389/fmicb.2017.02124

Journal Article Type Article
Acceptance Date Oct 18, 2017
Online Publication Date Nov 2, 2017
Publication Date Nov 2, 2017
Deposit Date Nov 1, 2017
Publicly Available Date Nov 1, 2017
Journal Frontiers in Microbiology
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 8
DOI https://doi.org/10.3389/fmicb.2017.02124
Keywords Microbiology (medical); Microbiology
Public URL http://researchrepository.napier.ac.uk/Output/1004887
Contract Date Nov 1, 2017

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
Copyright: © 2017 Parsonage, Hägglund, Keogh, Wheelhouse, Brown and Dancer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.









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