Antimicrobial policy. Imperative need in view of the current increasing microbial resistance

Abstract

Introduction: Antimicrobials are one of the most used pharmacological groups in the clinical practice. Their relation to microbial resistance has been demonstrated. The rational use of antibiotics can be beneficial from the social and medical point of view; however, their use is not always the most correct one, which demands a systematic and special surveillance. A rational antimicrobial policy is necessary in the health care centers. Objective: To review national and international consensuses and criteria on antimicrobial policy in order to unify criteria and apply them the best way possible in health care centers. Material and method: A bibliographic review on antimicrobial policy, antibiotics commission, and antibiotics policy was made through a search on different databases; some of them were: Clinical Evidence, The Cochrane Library, PUBMED, Google Scholar, MEDLINE, LIS, Scielo, Medscape, LILACS, Latindex, HINARI, MEDIGRAPHIC-NEWS, NIH Reporter and the Web sites of the PAHO/ WHO. Development: Concepts on different Cuban publications, international consensus, human components, objectives, functions, resources, methods, strategies, and controls were considered. Conclusions: The implementation of any therapeutic modification in the medical attention has to be analyzed correctly in all its dimensions: scientific, technological, and social ones. When the microbiological study is not possible or there is no antibiogram, the selection of the antibiotic should be made on the local epidemiological and clinical basis. The creation of an Antimicrobial Policy with all its components, resources, and methodology is a necessary more than ever at present. It can be submitted to modifications with new evidences, but it has to be fulfilled to reduce both microbial resistance and the costs, in order to obtain better results. Keywords: Antimicrobial policy, antibiotics policy, antibiotics commission, microbial resistance, health actions.