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Kia āta kōwhiri Choosing Wisely

The Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment.

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Urgent global action needed on the overuse of antibiotics

Infection prevention and control
18 November 2020

As a result of increasing levels of antimicrobial resistance, antibiotics and other antimicrobial[1] medicines are becoming ineffective, and health workers and the public are urged to unite to take action.

Last year, antimicrobial resistance was named as one of the top 10 threats to global health by the World Health Organization. It has been estimated that by 2050 10 million people could die from infections caused by antimicrobial-resistant microorganisms each year if we do not act now.

The Health Quality & Safety Commission is one of many organisations nationally and internationally raising awareness about antimicrobial resistance and highlighting the critical importance of using antimicrobials with care, in World Antimicrobial Awareness Week.

Doctor Sally Roberts says antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines used to prevent or treat infection caused by these microorganisms. This makes common infections harder to treat and leads to longer hospital stays, higher medical costs and increased likelihood of death.

'World Antimicrobial Awareness Week highlights the need to use antimicrobials carefully.'

She says many factors have accelerated the threat of antimicrobial resistance worldwide – including overuse and misuse of medicines in humans, livestock and agriculture, as well as poor access to clean water, sanitation and hygiene.

Doctor Roberts says it is vital that any reduction in the use of antibiotics does not increase health inequities, and this is a big focus for the Commission.

'A recent project supported by the Commission and PHARMAC which aimed to decrease unnecessary antibiotics prescriptions was carefully targeted to ensure groups such as Māori and Pacific communities, were not negatively impacted.'

To support the week, health care workers in Aotearoa are being encouraged to think carefully before prescribing antimicrobials, including discussing with consumers when antibiotics are needed, and when they won’t make a difference. For example, colds and flu can’t be fixed by antibiotics because they’re caused by viruses, not bacteria and antibiotics also don’t help most ear infections get better any faster.

The Choosing Wisely campaign has a number of resources for consumers with information about when antibiotics may not be needed, and alternatives for treating common illnesses.

World Antimicrobial Awareness Week runs from today until 24 November. For further information, visit the WHO website.

About antimicrobial resistance

The World Health Organization has declared that AMR is one of the top 10 global public health threats facing humanity. Misuse and overuse of antimicrobials are the main drivers in the development of drug-resistant pathogens. Lack of clean water and sanitation and inadequate infection prevention and control promotes the spread of microbes, some of which can be resistant to antimicrobial treatment. The cost of AMR to the economy is significant. In addition to death and disability, prolonged illness results in longer hospital stays, the need for more expensive medicines and financial challenges for those impacted. Without effective antimicrobials, the ability of modern medicine to treat infections, including during major surgery and cancer chemotherapy, would be at increased risk.

What are antimicrobials?

Antimicrobials – including antibiotics, antivirals, antifungals and antiparasitics – are medicines used to prevent and treat infections in humans, animals and plants.

What is antimicrobial resistance?

Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.
As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.

Why is antimicrobial resistance a global concern?

The emergence and spread of drug-resistant pathogens that have acquired new resistance mechanisms, leading to antimicrobial resistance, continues to threaten our ability to treat common infections. Especially alarming is the rapid global spread of multi- and pan-resistant bacteria (also known as "superbugs") that cause infections that are not treatable with existing antimicrobial medicines such as antibiotics.

Without effective tools for the prevention and adequate treatment of drug-resistant infections and improved access to existing and new quality-assured antimicrobials, the number of people for whom treatment is failing or who die of infections will increase. Medical procedures, such as surgery, including caesarean sections or hip replacements, cancer chemotherapy, and organ transplantation, will become riskier.

What accelerates the emergence and spread of antimicrobial resistance?

AMR occurs naturally over time, usually through genetic changes. Antimicrobial resistant organisms are found in people, animals, food, plants and the environment (in water, soil and air). They can spread from person to person or between people and animals, including from food of animal origin. The main drivers of antimicrobial resistance include the misuse and overuse of antimicrobials; lack of access to clean water, sanitation and hygiene (WASH) for both humans and animals; poor infection and disease prevention and control in health-care facilities and farms; poor access to quality, affordable medicines, vaccines and diagnostics; lack of awareness and knowledge; and lack of enforcement of legislation.


  1. Antimicrobials is a term that encompasses antibiotics, antivirals, antifungals and antiparasitic medicines used to prevent or treat infections in humans, animals or plants.