Consultation is open on a new national antimicrobial resistance (AMR) strategy for 2020 and beyond.

The new Strategy, like the existing 2015-2019 document will take a One Health approach to AMR by addressing the inter-relatedness of human, animal and ecosystem health.

While the current strategy focussed on antibacterial resistance, the new strategy will expand to include other antimicrobial resistance.

A consultation background paper said the Strategy should have a clear 20-year aspirational vision, but be flexible enough to accommodate changing priorities over time.

It should also encompass shorter-term action plans that align with Commonwealth and state and territory budget cycles.

It acknowledged that many of the strategies used in antimicrobial stewardship programs in hospitals were not transferrable to community health settings, including residential aged care.

“The absence of the strong accreditation driver (which accelerated change in the hospital sector) and the economics of primary care are significant barriers. Innovative approaches to address these barriers to best practice prescribing and sustain antimicrobial stewardship in these settings are needed.”

Another challenge was that AMR surveillance was not in “real time” or consistently linked to a public health response in jurisdictions.

“There is a clear need to incorporate the surveillance and response network for important resistant organisms into the national communicable diseases surveillance framework.”

It said widespread use of polymerase chain reaction (PCR) for diagnostic testing in human health meant that, without organism culture and resistance testing, information about AMR was not collected.

“This lack of data has implications for individual patient care as well as for surveillance and public health action.”

“In human health, whole genome sequencing could provide AMR information in terms of the presence of resistance mechanisms, but may not always reflect the phenotypic characteristics necessary for patient care.”

It said the potential for ‘pathogenomics’ to help rapidly track resistant organisms across sectors and geographical areas was immense.

Public consultation closes Friday, 28 June 2019.