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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">We must change how antibiotics are used and adopt proactive strategies, similar to those used to save endangered species. Preservation of the efficacy of antibiotics and to stabilization of antibiotic-susceptible bacterial ecosystems should be global goals.</span></p><p id="par0010" class="elsevierStylePara elsevierViewall">We urge all of you to participate in this crusade, in your own field of interest. The medical miracle of antibiotic therapy must be protected &#8211; this is a global priority and our duty. Please, help us to act NOW, by supporting this declaration, to promote wiser use of antibiotics in animal and human health, and the necessary accompanying political actions to support better education, integrated surveillance for public health action, and research.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The increase in antibiotic resistant bacteria poses a major healthcare threat. In the face of an almost complete absence of new antimicrobial drugs in development, antibiotic resistance (ABR) has become one of the main public health problems of our time. Antibiotics are a unique class of medications because of their potential societal impact; use of an antibiotic in a single patient can select for ABR that can spread to other people, animals, and the environment, making an antibacterial used in one patient ineffective for many others. Bacterial resistance can evolve rapidly. As bacteria acquire resistance mechanisms, the altered bacterial genetic material coding for resistance mechanisms can be transmitted at times readily between bacteria, broadening the reach and extent of resistance. Treatment failures because of multidrug resistant (MDR) bacteria, once rare, notable, and limited to hospitals, now occur very commonly in hospitals and increasingly in the community as well. It is estimated that a minimum of 25,000 patients in Europe and 23,000 in the USA die each year from infections caused by resistant bacteria. The cost of antibiotic resistance is tremendous, whether measured as the personal and societal burden of illness, death rates, or healthcare costs.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although it is a never-ending phenomenon, antibiotic resistance is directly related to the volume of antibiotics used. We are using increasing amounts of antibiotics in health care and agriculture, and discharging these active drugs into the environment. The impact of widespread antibiotic use is enormous, promoting the development and dissemination of antimicrobial resistance.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Safeguarding antibiotics will require a concerted effort by citizens, patients and prescribers. The primary goal of WAAAR is to raise awareness about the urgency and magnitude of the threat and to promote an international dialogue to assist in effective responses. The Alliance, in particular through this declaration, is dedicated to actively promoting antibiotic preservation and to raising awareness among antibiotic prescribers, politicians and policy-makers, patient safety and advocacy groups, the pharmaceutical industry, international health organizations, and the general population. Individual actions, no matter how well intended, are doomed to failure unless there is an international dialogue, a common sense of purpose, and broad consensus on how best to proceed.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">WAAAR advocates for the following 10 actions</span><p id="par0030" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">1.</span></span><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Promotion of awareness of all the stakeholders &#8211; including the general public &#8211; of the threat represented by antibiotic resistance</span><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Strong cooperation among international political, economic and public health organizations, which, all together, must take the lead of this action against antibiotic resistance.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">2.</span></span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Organization, in each country, ideally by Ministries of Health or regulatory bodies, of a financed national plan for the containment of antibiotic resistance, with the participation of all stakeholders, including patient advocacy groups</span></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">3.</span></span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Continuous access to antibiotics of assured quality, especially in middle and low income countries</span></p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">4.</span></span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">WAAAR advocates for the following 10 actions Integrated Surveillance of antibiotic resistance (ABR) and antibiotic use</span><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8226;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Standardized monitoring of antibiotic use and resistance at institution, regional, and country (comprehensive national data instead) level (through a Centres for Diseases Control and Prevention model) to allow comparative statistics (benchmarking), to be updated preferably in real-time and at least every 12 months. This will require adequate laboratory capacity using international standardized methods that may be facilitated by a centralized technologic coordinating infrastructure and information technology</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">5.</span></span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Use of diagnostic tests</span><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8226;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Appropriate use of existing diagnostic tests and development and implementation of new rapid, cost-effective and accurate diagnostic tests, adapted to the local context, to aid in distinguishing bacterial and nonbacterial etiologies. Rapid diagnostics may help clinicians avoid unnecessary treatments, rapidly select appropriate targeted therapies and inform the duration of treatment</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">6.</span></span><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Antibiotic stewardship (prudent, controlled and monitored approaches to the use of antibiotics)</span><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8226;</span><p id="par0080" class="elsevierStylePara elsevierViewall">In humans (hospitals, long term care facilities and primary care).</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">&#8226;</span><p id="par0085" class="elsevierStylePara elsevierViewall">In animals (animal husbandry, agriculture, aquaculture and animal health/veterinary setting), in a &#8220;one health&#8221; philosophy.</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">&#8226;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Progressive elimination of the &#8220;over the counter&#8221; (i.e. available without a prescription) access to antibiotics (systemic and topicals) for humans or animals.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">&#8226;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Ban of the use of antibiotics as growth promotion in food animals, and exceptional use in prophylaxis.</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">&#8226;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Rational use of metaphylaxis (Prophylaxis when some animals in the livestock are sick, or at high risk to be sick), and of animal treatment.</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">&#8226;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Limitation of the use of critically important antibiotics in humans and animals (e.g., carbapenems).</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">7.</span></span><p id="par0110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Educational efforts for change</span><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">&#8226;</span><p id="par0115" class="elsevierStylePara elsevierViewall">Educational programmes directed at children/teenagers on antibiotics, bacterial resistance, and infection control (e-Bug model).</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">&#8226;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Development of large coordinated, effective information and awareness campaigns directed at the public on expectations about the rational/appropriate use of antibiotics.</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">&#8226;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Continuous education and training programmes in the curriculum for all health care professionals in all settings (veterinarians, medical, dental, nursing, pharmacy and allied health care schools) and continuing professional education programmes, on the rational use of antibiotics, including indications, dosing and duration of therapy. Education of farmers.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">8.</span></span><p id="par0130" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Containment of bacterial transmission and prevention of infection</span><ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">&#8226;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Promotion of universal hand hygiene and all infection control interventions that have been proven to reduce rates of resistance.</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">&#8226;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Relentless efforts to prevent transmission of MDR organisms in healthcare, food production and animal husbandry.</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">&#8226;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Programmes to limit the contamination of drinking water with MDR bacteria, as well as contamination of the environment.</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">&#8226;</span><p id="par0150" class="elsevierStylePara elsevierViewall">Promotion of the use of available vaccines, in humans and animals.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">9.</span></span><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Basic and applied research, and development of new antibiotics</span><ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">&#8226;</span><p id="par0160" class="elsevierStylePara elsevierViewall">Increased support for basic and applied research aiming at curbing bacterial resistance in human and veterinary medicine.</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">&#8226;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Use of the principles of orphan drugs for new antibiotics.</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">&#8226;</span><p id="par0170" class="elsevierStylePara elsevierViewall">Incentives to stimulate research of new drugs (antibiotics and novel compounds) and vaccines via regulatory pathways that allow for fast track development.</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">&#8226;</span><p id="par0175" class="elsevierStylePara elsevierViewall">New economic business models to support the cost of innovation while safeguarding public health interests.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">10.</span></span><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Request for UNESCO to include the &#8220;concept of antibiotic&#8221; in the list of the intangible cultural heritage.</span></p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Funding</span><p id="par0185" class="elsevierStylePara elsevierViewall">No funding.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflict of interest</span><p id="par0200" class="elsevierStylePara elsevierViewall">No conflict of interest.</p></span></span>"
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            "apendice" => "<p id="par0245" class="elsevierStylePara elsevierViewall">WAAAR is a group of 700 individuals from 55 different countries representing all the key stakeholders (physicians, veterinarians, microbiologists, surgeons, pharmacists, nurses, evolutionary biologists, ecologists, environmentalists, patient advocacy groups). The Alliance receives support from more than 140 learned societies or professional groups throughout the world. WAAAR is a nonprofit organization open to professionals and consumers worldwide. WAAAR receives no funding from the pharmaceutical industry.</p> <p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Supporting individuals</span></p> <p id="par0210" class="elsevierStylePara elsevierViewall">Laurent Aaron (France), Mohamed Salah Abassi (Tunisia), Lilian Abbo (USA), Oladipo Aboderin (Nigeria), Edward Abraham (USA), Fekri Abroug (Tunisia), Jacques Acar (France), Wafa Achour (Tunisia), Javier Adachi (USA), Seif Al-Abri (Oman), Haifaa Al-Mousa (Kuwait), Antonio Albaya-Moreno (Spain), Corinne Alberti (France), Serge Alfandari (France), Amani Alnimr (Saudi Arabia), Celia Alpuche Aranda (Mexico), Francisco Alvarez de Lerma (Spain), Fatma Amer (Egypt), Antoine Andremont (France), Fran&ccedil;ois Angoulvant (France), Maryvonne Anguill (France), Massimo Antonelli (Italy), Eleni Antoniadou (Greece), Guillaume Arlet (France), Apostolos Armaganidis (Greece), Anne Arnera (France), Antonio Artigas (Spain), Claude Attali (France), Fr&eacute;deric Auber (France), Jean-Pierre Aubert (France), Bernard Augereau (France), Martine Aup&eacute;e (France), Olfa Bahri (Tunisia), Fran&ccedil;oise Ballereau (France), G&eacute;rard Bapt (France), Fernando Baquero (Spain), Timothy Barkhan (Singapore), Ouahid Barouti (Morocco), Marie-Anne Barthelemy (France), Greg Barton (UK), Davide Bastoni (Italy), Michel Baussier (France), Luis Bavestrello (Chile), Birgit Beger (Belgium), Samuel Benenson (Israel), Fethi Bensalem (France), Guillaume B&eacute;raud (France), Frederique Bergheau (France), Gordon Bernard (USA), Philippe Berthelot (France), Xavier Bertrand (France), Fr&eacute;d&eacute;rique Beuhorry-Sassus (France), Pascal Beuret (France), John Billington (USA), Jacques Birg&eacute; (France), Sandra Biscardi (France), Luis Blanch (Spain), Herv&eacute; Blanchard (France), Thomas Bleck (USA), Joseph Blondeau (Canada), Fran&ccedil;ois Blot (France), France Borgey (France), Alain Bousquet-M&eacute;lou (France), Jean Brami (France), Christophe Brard (France), St&eacute;phane Bretagne (France), C&eacute;dric Bretonni&egrave;re (France), Adrian Brink (South Africa), Sheldon Brown (USA), Catherine Bruant-Rodier (France), Christian Brun-Buisson (France), Fabrice Bruneel (France), Frederico Bruzzi de Carvalho (Brazil), Christophe Buhot (France), Huda Bukharie (Saudi Arabia), Andr&eacute; Cabi&eacute; (France), Thierry Calandra (Switzerland), Isabelle Caniaux (France), Manuela Cani&ccedil;a (Portugal), Rafael Canton (Spain), Philippe Carenco (France), Camille Carlet (France), Claude Carlet (France), Florian Carlet (France), Jean Carlet (France), Romain Carlet (France), Otto Cars (Sweden), Manuel Cassiano-Neves (Portugal), Bernard Castan (France), Vincent Castellan (France), France Cazenave-Roblot (France), Alain-Michel Ceretti (France), Jean-Charles Chakarian (France), Ludivine Chalumeau-Lemoine (France), John Chandy (USA), Bernard Chanfreau (France), Jean Chastre (France), Robert Chausset (France), Pascal Chavanet (France), William Cheadle (USA), Jean-Daniel Chiche (France), Christian Chidiac (France), Olivier Chosidow (France), Natalia Chueca (Spain), Jon Cohen (UK), Robert Cohen (France), Peter Collignon (Australia), Fr&eacute;d&eacute;ric Collot (France), Patrick Coloby (France), John Conly (Canada), Cruz Cordero (Brazil), Catherine Cordonnier (France), Alejandra Corso (Argentina), Sara Cosgrove (USA), Ren&eacute; Courcol (France), Steve Crane (USA), Donald Craven (USA), Adnida Crespin (France), Marces Cyrillo (Brazil), Pierre-Eric Danin (France), Jan De Waele (Belgium), Pierre Dellamonica (France), E. Patchen Dellinger (USA), Philip Dellinger (USA), Jean Delmont (France), Eric Denes (France), George Dimopoulos (Greece), Dimitri Drekonja (USA), Anahi Dreser Mansilla (Mexico), Pierre-Louis Druais (France), Sylvie Dufour-Pierrat (France), Catherine Dumartin (France), Martin D&uuml;nser (Austria), Michel Dupont (France), Ricardo Durlach (Argentina), Oliver Dyar (UK), Gabriela Echaniz (Mexico), Paul Edelstein (USA), Philippe Eggimann (Switzerland), Mohamed Elghonemi (Egypt), Naima Elmdaghri (Morocco), Rehab Elsaid (Egypt), Rehab Elsokari (Egypt), Dan Engelhard (Israel), Jacques Fabry (France), Christopher Farmer (USA), J. Fernandez (Spain), Simon Finfer (Australia), Patricia Finn (USA), Katrin Fjeldsted (Israel), Daniel Floret (France), Francesco Flozaro (Spain), Jacinthe Foegle (France), Xavier Forceville (France), Sandra Fournier (France), Ir&egrave;ne Frachon (France), Alexander Friedrich (The Netherlands), Pascal Funuel (France), Didier Gaillard (France), Jacques Gaillat (France), Tatiana Galperine (France), Karine Gambarotto (France), Bernard Garo (France), Mait&eacute; Garrouste-Orgeas (France), Petra Gastemeier (Germany), Jean-Yves Gauchot (France), Remy Gauzit (France), Ga&euml;tan Gavazzi (France), Louise Gazagne (France), Julie Gerberding (USA), Abdul Ghafur (India), Evangelos Giamarellos-Bourboulis (Greece), Eleni Giamarellou (Greece), Marine Giard (France), Mark Gilchrist (UK), Jacques Gilquin (France), Fernando Gilsanz (Spain), Marek Gniadkowski (Poland), Charalambos Gogos (Greece), Don Goldman (USA), Florence Gordon (France), Thomas Gottlieb (Australia), Ian Gould (UK), Joao Gouveia (Portugal), Jennifer Grant (Canada), Lindsay Grason (Australia), Alix Greder (France), Hajo Grundman (The Netherlands), Eric Guaguere (France), Gwena&euml;lle Gu&eacute;roult-Locher (France), Benoit Guery (France), Bertrand Guidet (France), Catherine Guignabert (France), Pradip Gupta (India), Sanjay Gupta (UK), Mohan Gurjar (India), Manuel Guzman (Venezuela), Joseph Hajjar (France), Noha Hammad (Egypt), Anette Hammerum (Denmark), Hakan Hanberger (Sweden), Regina Hanke (Germany), Stephan Harbarth (Switzerland), Anita Harel (France), Elisabeth Heisbourg (Austria), Isabelle Hermes (France), Jean-Pierre Hermet (France), Bernard Hirschel (Switzerland), Bruno Hoen (France), Aidan Hollis (Canada), Xiao Honghong (China), David Hooper (USA), Juan Pablo Horcajada (Spain), Bruno Housset (France), Waleria Hryniewicz (Poland), Li Yang Hsu (Singapore), Susan Huang (USA), James Hughes (USA), Jean-Louis Hunault (France), Lotte Jakobsen (Denmark), Nordiah Jalil (Malaysia), Hilde Jansens (Belgium), Vincent Jarlier (France), William Jarvis (USA), Dominique Jean (France), Matjaz Jereb (Slovenia), James Johnson (USA), Marie-Laure Joly-Guillou (France), Olivier Jonquet (France), Guillaume Kac (France), Deogracias Kaddu-Mulindwa (Uganda), Mitsuo Kaku (Japan), Badreddine Kilani (Tunisia), Eui-Chong Kim (South Korea), Doroth&eacute;e Kinde Gazard (Benin), Keith Klugman (USA), Stacey Klutts (USA), Jan Kluytmans (The Netherlands), Marin Kollef (USA), Despoina Koulenti (Greece), Michael Kresken (Germany), Fran&ccedil;ois Lacoin (France), Jean-Patrick Lajonch&egrave;re (France), Nathalie Landgraf (France), G&eacute;rard Larroussinie (France), Pierre-Fran&ccedil;ois Laterre (Belgium), Anne-Marie Lavenaire (France), Thierry Lavigne (France), Ramanan Laxminarayan (USA), Thi Anh Thu Le (Vietnam), Fran&ccedil;oise Leblanc-Jouffre (France), Nam Yong Lee (South Korea), Olivier Lehiani (France), Herv&eacute; Lelouet (France), Fr&eacute;d&eacute;rique Lemanach-Kergueris (France), Alain Lepape (France), Joel Leroy (France), Xavier Lescure (France), Mitchell Levy (USA), Gabriel Levy-Hara (Argentina), Ling Moi Lin (Singapore), Jeffrey Lipman (Australia), Joel Livartowski (France), David Looke (Australia), Fernando Luis Lopez Cardozo (Brazil), Francisco Lopez Medrano (Spain), Anne Lotth&eacute; (France), Jean Christophe Lucet (France), David Lupande (D. R. Congo), Jean-Yves Madec (France), Jean-Luc Mainardi (France), Sundaresan Maiylagan (Mauritius), Jordi Mancebo (Spain), Franck Mansour-Adeoti (France), Enrique Maravi (Spain), Bruno Marchou (France), Darcy Marciniuk (Canada), John Marshall (Canada), Claude Martin (France), David Martin (USA), Luis Martinez-Martinez (Spain), Alain Martinot (France), Emilio Maseda (Spain), Dimitrios Matamis (Greece), Sophie Matheron (France), Ricardo Matos (Portugal), Marie Matthews (UK), Thierry May (France), Thierry Mayet (France), John McGowan (USA), Shaheen Mehtar (South Africa), Jose Mario Meira Teles (Brazil), Marc Mendelson (South Africa), Christian Michelet (France), Albert Mifsud (UK), Magolia Mikaszewska-Sokolewicz (Poland), Jessica Minion (Canada), Christelle Miquel (France), Jean-Paul Mira (France), Jose Miro (Spain), Benoit Misset (France), Jean-Jacques Monot (France), Philippe Montravers (France), Joy Mootien (France), Rui Moreno (Portugal), Andrew Morris (USA), G&eacute;rard Moulin (France), C&eacute;cile Mourlan (France), Gilbert Mouthon (France), Wafaa Mowafy (Egypt), Elke Muhl (Germany), A. Muruganathan (India), Enani Mushira (Saudi Arabia), Babacar N&#8217;Doye (Senegal), Aburjania Nana (USA), Michael Niederman (USA), G&eacute;rard Nitenberg (France), Patrice Nordman (France), Assumpta Novira (Spain), Cyrille Nowak (France), Iruka Okeke (USA), Pedro Maria Olaechea (Spain), Abeer Omar (Kuwait), Steve Opal (USA), Carlos Ortiz Leyba (Spain), Bauke Oudega (The Netherlands), Eric Oziol (France), Bernard Page (France), Jose Arthur Paiva (Portugal), Lucy Palmer (USA), Mercedes Palomar-Martinez (Spain), Pierre Parneix (France), Didier Payen de la Garanderie (France), Eli Perencevich (USA), Trish Perl (USA), Christian Perronne (France), Georg Peters (Germany), Matthew Peters (Australia), Dominique Peyramond (France), Fran&ccedil;ois Philippart (France), Didier Pittet (Switzerland), Jean-Fran&ccedil;ois Pittet (USA), Patrick Pl&eacute;siat (France), Mathias Pletz (Germany), Marie-C&eacute;cile Ploy (France), Florence Pospisil (France), Pascal Pouedras (France), Garyphallia Poulakou (Greece), Anny Poursinoff (France), Peter Pronovost (USA), C&eacute;line Pulcini (France), Massimo Puoti (Italy), Shanmugan Puvanendiram (Sri Lanka), Michael Quintel (Germany), Christian Rabaud (France), Claude Rambaud (France), Helena Ramos (Portugal), Ossama Rassla (Egypt), Josette Raymond (France), Bernard Regnier (France), Konrad Reinhart (Germany), Jordi Rello Condomines (Spain), Jean-Claude Revil (Reveil?), (France), Agn&egrave;s Rich&eacute; (France), Paul Richman (USA), Rosana Richmann (Brasil), Viviana Rodriguez (Argentina), Jesus Rodriguez-Bano (Spain), Olivier Romain (France), Karine Romand (France), Elisabeth Rossines (France), MonIque Rothan-Tondeur (France), Jean-Fran&ccedil;ois Rousselot (France), Ethan Rubinstein (Canada), Vladimir Rudnov (Russia), Narender Saini (India), Dominique Salmon (France), Reinaldo Salomao (Brazil), Miguel Sanchez Garcia (Spain), Antonio Santos-Bouza (Spain), Marie-Caude Saux (France), Anne Savey (France), Lynora Saxinger (Canada), Benoit Schlemmer (France), Jean-Luc Schmit (France), Dietmar Schneider (Germany), Janet Schoemaker (USA), Sanjeev Singh (India), Jordi Sole-Violan (Spain), Sara Soto (France), Jean-Paul Stahl (France), Annabelle Stoclin (France), Alexis Tabah (Australia), Jean-Philippe Tabut (France), Paul Anamtharajah Tambyah (Singapore), Fabienne Tamion (France), Phillip Tarr (USA), Pierre Tattevin (France), Fred Tenover (USA), Nicolas Terzi (France), Marthe Than Lecompte (Switzerland), Jonathan Theodore (France), Didier Thevenin (France), Philippe Thevenot (France), Laurent Thiriet (France), Carol Thompson (USA), Joseph Thurn (USA), Glenn Tillotson (USA), Hanene Tiouiri (Tunisia), Antonio Torres (Spain), Fran&ccedil;ois Tr&eacute;moli&egrave;res (France), Michel Troadec (France), Rabiatu Umar (Nigeria), Garance Upham (France), Carl Urban (USA), Jan Vaarten (-), Dominique Valla (France), Nathalie Van Der Mee-Marquet (France), Jos Van der Meer (The Netherlands), Tom Van Der Poll (The Netherlands), Jacques Vancel (France), Philippe Vanhems (France), Remi Varin (France), Emmanuelle Varon (France), David Vaughan (USA), Marc Veilly (France), K. Vijayakumar (India), Alvaro Villanueva (Columbia), Jean-Louis Vincent (Belgium), Virginie Vitrat (France), Andreas Voss (The Netherlands), Robert Wachter (USA), Tim Walsh (UK), Peter Wark (Australia), Grant Waterer (Australia), Henrik Caspar Wegener (Denmark), Pierre Weinbreck (France), Robert Weinstein (USA), Scott Weissman (USA), Jeanine Wiener-Kronish (USA), Alexander Wilmer (Belgium), Benjamin Wyplosz (France), Ibrahim Yacoub-Agha (France), Melanie Young (USA), Ibrahim Yusuf (Nigeria), Emile Zein (Lebanon), George Zhanel (Canada), Stephen Zinner (USA), Jos&eacute;phine Zoungrana (Burkina Faso), Nadezhda Zubareva (Russia).</p> <p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Supporting national and international agencies</span></p> <p id="par0220" class="elsevierStylePara elsevierViewall">Centres for Disease Control and prevention (CDC).</p> <p id="par0225" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Supporting medical organizations</span></p> <p id="par0230" class="elsevierStylePara elsevierViewall">American College of Chest Physicians (ACCP) (Darcy Marciniuk), American Society of Microbiology (ASM) (Janet Schoemaker), American Thoracic Society (ATS) (Patricia Finn, Steve Crane), Analgesia and Intensive Care Medicine (SIAARTI) (Massimo Antonelli), Andalusian Infectious Diseases Society (Jesus Gomes Mateos), Asia Pacific Society of Infection Control (APSIC) (Ling Moi Lin), Associa&ccedil;&atilde;o de Medicina Intensiva Brasileira (AMIB) (Jose Mario Meira Teles), Association Fran&ccedil;aise d&#8217;Urologie (AFU) (Patrick Coloby), Association Fran&ccedil;aise de Chirurgie (Jean Pierre Arnaud), Association Fran&ccedil;aise des V&eacute;t&eacute;rinaires pour Animaux de Compagnie (AFVAC) (Eric Guagu&egrave;re, Jean-Fran&ccedil;ois Rousselot), Association of Physicians of India (Dr Muruganathan), Association Tunisienne de R&eacute;animation (ATR) (Fekri Abroug), Association V&eacute;t&eacute;rinaire Equine Fran&ccedil;aise (AVEF) (Jean-Yves Gauchot), Australasian Society for Infectious Diseases (ASID) (David Looke), Australian Society for Antimicrobials (ASA) (Thomas Gottlieb), Belgian Society of Intensive Care Medicine (SIZ) (Alexander Wilmer), Belgium Infection Control Society (BICS) (Hilde Jansens), Brazilian Society of Infectiology, British Infection Association (Albert Mifsud), British Society of Antimicrobial Chemotherapy (Nicholas Brown, Laura Piddock), Centre National de R&eacute;f&eacute;rence de la R&eacute;sistance aux Antibiotiques (Patrick Pl&eacute;siat), Sociedad Espa&ntilde;ola de Medicina Intensiva, Cr&iacute;tica y Unidades Coronarias (SEMICYUC) (Luis Blanch, Miguel Sanchez Garcia, Francisco Alvarez Lerma), Egyptian Society for Infection Control (ESIC) (Ossama Rasslan), European Federation of National Associations of Orthopaedics and Traumatology (Manuel Cassiano-Neves), European Society of Infectious Diseases and Clinical Microbiology (ESCMID) (Gunnar Kahlmeter, Murat Akova), European Society of Intensive Care Medicine (ESICM) (Jean Daniel Chiche), F&eacute;d&eacute;ration Fran&ccedil;aise de Pneumologie (Bruno Housset), Federation of European Microbiological Societies (FEMS) (Bauke Oudega), Federation of Infectious Diseases Societies of Southern Africa (Marc Mendelson), Federation V&eacute;t&eacute;rinaire Europ&eacute;enne (FVE) (Christophe Buhot, Jan Vaarten), German Interdisciplinary Association of Intensive and Emergency Medicine (Dietmar Schneider, Michael Quintel, Elke Muhl), Hellenic Society of Antimicrobial Chemotherapy (Helen Giamarellou), Hellenic Society of Intensive Care (Antonios Mavrommatis), Ho Chi Minh City Infection Control Society (Thi Anh Thu Le), Indian Medical Association (Narendra Saini, K. Vijayakumar), Infection Control Association of Singapore (ICAS) (Ling Moi Lin), Instituto Latino-Americano de Sepsis (ILAS) (Reinaldo Salomao), International Society of Chemotherapy (Ian Gould), International Society of Infectious Diseases (ISID) (Jon Cohen, Keith Klugman), Israel Society for Infectious Diseases, Italian Society of Anesthesiology, Korean Society of Clinical Microbiology (Nam Yong Lee), Lebanese Association for Medical Diagnosis and Auto-Immune Diseases (Lambda) (Georges Khalil), Pan American Society of Infectious Diseases (Luis Bavestrello), Paul-Ehrlich-Gesellschaft f&uuml;r Chemotherapie e.V. (Paul-Ehrlich-Society for Chemotherapy) (Achim Hoerauf), Polish Society of Anesthesiology and Intensive Care (Magolia Mikaszewska-Sokolewicz), Portuguese Society of Infectious Diseases and Clinical Microbiology (Helena Ramos), Portuguese Society of Intensive Care (Joao Gouveia, Ricardo Matos), Saudi Society of Medical Microbiology and Infectious Diseases (Huda Bukharie), Sociedad Espa&ntilde;ola de Enfermedades Infecciosas y Microbiologia Clinic (SEIMC) (Jose<span class="elsevierStyleHsp" style=""></span>M Miro), Sociedad Espa&ntilde;ola de Enfermedades Respiratorias (SEPAR) (Pilar de Lucas), Sociedad Espa&ntilde;ola de Medecina Intensiva, Cr&iacute;tica y Unidades Coronarias (SEMICYUC) (Luis Blanch, Miguel Sanchez Garcia, Francisco Alvarez Lerma, Pedro Maria Olaechea), Society for Healthcare Epidemiology of America (SHEA) (Melanie Young), Sociedale Paulista de Infectiologia-Brazil (Rosana Richman), Soci&eacute;t&eacute; Belge de Microbiologie Clinique (BVIKM/SBIMC) (Camelia Rossi), Soci&eacute;t&eacute; de Pathologie Exotique (Jean Delmont), Soci&eacute;t&eacute; de Pathologie Infectieuse de Langue Fran&ccedil;aise (SPILF) (Christian Rabaud), Soci&eacute;t&eacute; de Pneumologie de Langue Fran&ccedil;aise (SPLF) (Alain Didier), Soci&eacute;t&eacute; de R&eacute;animation de Langue Fran&ccedil;aise (SRLF) (Djillali Annane), Soci&eacute;t&eacute; Fran&ccedil;aise d&#8217;Anesth&eacute;sie R&eacute;animation (SFAR) (Claude Ecoffey), Soci&eacute;t&eacute; Fran&ccedil;aise d&#8217;Hygi&egrave;ne Hospitali&egrave;re (SF2H) (Philippe Berthelot), Soci&eacute;t&eacute; Fran&ccedil;aise de Chirurgie Orthop&eacute;dique et Traumatologique (Bernard Augereau), Soci&eacute;t&eacute; Fran&ccedil;aise de Dermatologie (SFD) (Olivier Chosidow), Soci&eacute;t&eacute; Fran&ccedil;aise de G&eacute;riatrie et G&eacute;rontologie (SFGG) (Genevi&egrave;ve Ruault), Soci&eacute;t&eacute; Fran&ccedil;aise de Greffe de Moelle et de Th&eacute;rapie Cellulaire (SFGM-TC) (Ibrahim Yacoub), Soci&eacute;t&eacute; Fran&ccedil;aise de M&eacute;decine G&eacute;n&eacute;rale (SFMG) (Pascale Arnould), Soci&eacute;t&eacute; Fran&ccedil;aise de M&eacute;dicine Interne (SFMI) (Loic Guillevin), Soci&eacute;t&eacute; Fran&ccedil;aise de Microbiologie (SFM) (Ren&eacute; Courcol), Soci&eacute;t&eacute; Fran&ccedil;aise de Pharmacie Clinique (SFPC) (Marie-Claude Saux, Remi Varin), Soci&eacute;t&eacute; Fran&ccedil;aise de Sant&eacute; Publique (SFSP) (Pierre Lombrail), Soci&eacute;t&eacute; Libanaise de M&eacute;decine Interne (SLMI) (Emile Zein), Soci&eacute;t&eacute; Marocaine d&#8217;Hygi&egrave;ne Hospitali&egrave;re (Ouahid Barouti), Soci&eacute;t&eacute; Marocaine de Maladies Infectieuses (SMMI), Soci&eacute;t&eacute; Nationale des Groupements Techniques V&eacute;t&eacute;rinaires (SNGTV) (Christophe Brard), Soci&eacute;t&eacute; Tunisienne de Pathologie Infectieuse (STPI), Society of Critical Care Medicine (SCCM) (Chris Farmer, David Martin), Society of Infectious Diseases of Singapore (Paul Anantharaja Tambyah), Soci&eacute;t&eacute; Suisse d&#8217;Infectiologie (Bernard Hirschel), Spanish Society of Anesthesiology and Critical Care (Fernando Gilsanz, Emilio Maseda), Spanish Society of Infectious Diseases and Clinical Microbiology (Jos&eacute; Miro, Rafael Canton), Standing Committee of European Doctors (Katrin Fjeldsted, Birgit Beger), Surgical Infection Society (SIS) (William Cheadle), The Infectious Diseases Society of America (IDSA) (John Billington, David Relman), The Mexican Society of Infectious Diseases and Clinical Microbiology (AMIMC) (Celia Alpuche Aranada), Thoracic Society of Australia and New Zealand (Matthew Peters, Peter Wark), United Kingdom Clinical Pharmacy Association (UKCPA) (Mark Borthwick), World Federation of Societies of Intensive Care and Critical Care Medicine (WFSICCM) (Jean-Louis Vincent).</p> <p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Other supporting groups</span></p> <p id="par0240" class="elsevierStylePara elsevierViewall">Antibiolor (C. Rabaud), Antimicrobial Stewardship Working Group of the International Society of Chemotherapy (ISC) (Gabriel Levy Hara), Arab Alliance for a Prudent Use of Antimicrobials (Ar-Apua) (Fatma Amer), Association de Lutte contre les Infections Associ&eacute;es aux Soins (ALIAS), Association des M&eacute;decins Coordonnateurs en EHPAD, Association des Victimes d&#8217;Infection Nosocomiale (ADVIN), Association Le CISS (Claude Rambaud), Association Le LIEN (Madeleine Mador&eacute;), Association Phagespoir (J&eacute;rome Larch&eacute;), Association pour la Chimioth&eacute;rapie Anti-infectieuse (ACAI), Association pour la Recherche en Microbiologie Exp&eacute;rimentale (Marie-Laure Joly-Guillou), Austrian Antibiotic Stewardship Group (Elisabeth Heisbourg), CCLIN Ouest (Martine Aup&eacute;e), Centre for Infection Control and the APIC-Saudi chapter (Hanan Balkhy), Chaire Recherche Infirmi&egrave;re, AP-HP EHESP (France, Monique Rothan-Tondeur), Coll&egrave;ge des Enseignants de Maladies Infectieuses (CMIT) (Christian Michelet), Coll&egrave;ge National de M&eacute;decine G&eacute;n&eacute;rale (CNMG), Coll&egrave;ge National des G&eacute;n&eacute;ralistes Enseignants (CNGE) (Pierre Louis Druais), Comit&eacute; de Pilotage des R&eacute;seaux de Surveillance ATB et BMR Sud Est, Doctors Without Borders/M&eacute;decins Sans Fronti&egrave;res (Arl&egrave;ne Chua, Richard Murphy), Egyptian Patient Safety Association (EPSA) (Ossama Rassla), ESGAP working group (ESCMID) (Jordi Rello), F&eacute;d&eacute;ration des Sp&eacute;cialit&eacute;s M&eacute;dicales (FSM), F&eacute;d&eacute;ration Fran&ccedil;aise d&#8217;Infectiologie (FFI) (Christian Perrone), F&eacute;d&eacute;ration Fran&ccedil;aise de Pneumologie (FFP) (Bruno Housset), Global Sepsis Alliance (Konrad Reinhart), Groupe de Pathologie Infectieuse en P&eacute;diatrie (GPIP) (Robert Cohen), Groupo de Infec&ccedil;ao e Sepsis (Joao Jaime Sa), Grupo de Trabajo de Enfermedades Infecciosas y Sepsis De la Sociedad Espa&ntilde;ola de Medicina Intensiva, Hellenic Sepsis Study Group (Gogos Charalambos, Evangelos Giamarelos-Bourboulis), Infection Control Directorate (Ministry of Health-Kuwait), Infection Prevention and Control African Network (IPCAN) (Shaheen Mehtar), Institut de Recherche en M&eacute;decine G&eacute;n&eacute;rale (IRMG), Institut Maurice Rapin (IMR) (Christian Brun-Buisson), International Forum for Acute Care Trialists (InFACT) (John Marshal), International Sepsis Forum (Tom Van Der Poll), Le Forum des Bio-hygi&eacute;nistes, Ligue Africaine des Associations pour la S&eacute;curit&eacute; des Patients (LIASEP), Medqual (F. Ballereau), National Committee for the Proper Use of Antimicrobials (Ministry of Health-Kuwait), Observatoire du Risque Infectieux en G&eacute;riatrie (ORIG) (Monique Rotha-Tondeur), Observatoire National d&#8217;Epid&eacute;miologie de la Resistance Bact&eacute;rienne aux antibiotiques (ONERBA) (Marie-H&eacute;l&egrave;ne Nicolas-Chanoine), Portuguese Intersectorial Alliance for the Preservation of the Antibiotics (APAPA) (Jose Arthur Paiva), Programme National de Lutte contre l&#8217;Infection Nosocomiale (PRONALIN), S&eacute;n&eacute;gal (Babacar N&#8217;Doye), R&eacute;seau International pour la Planification et l&#8217;Am&eacute;lioration de la Qualit&eacute; des Soins en Afrique (RIPAQS) (Bernard Chanfreau), R&eacute;seau Sud-Est de Surveillance et de Pr&eacute;vention des Bact&eacute;ries Multir&eacute;sistantes aux Antibiotiques, South African Antibiotic Stewardship programme (Adrian Brink), Spanish Network for Research in Infectious Diseases (REIPI) (Jesus Rodriguez-Bano), Safe Observer International (SOI) (Garance Upham), The Bekele Afessa Initiative to Improve Sepsis Care in Resource-Limited Areas (Joseph Christopher Farmer), The Canadian Antimicrobial Resistance Alliance (CARA), The Eastern Mediterranean Regional Network for Infection Control (EMRNI) (Ossama Rassla), The Gulf Cooperation council (GCC) (Hanan Balkhy).</p>"
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Special article
World alliance against antibiotic resistance: The WAAAR declaration against antibiotic resistance
Alianza Mundial contra la resistencia antibiótica. Declaración contra la resistencia antibiótica
Jean Carlet, on behalf of the members of the WAAAR 1
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Please, help us to act NOW, by supporting this declaration, to promote wiser use of antibiotics in animal and human health, and the necessary accompanying political actions to support better education, integrated surveillance for public health action, and research.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The increase in antibiotic resistant bacteria poses a major healthcare threat. In the face of an almost complete absence of new antimicrobial drugs in development, antibiotic resistance (ABR) has become one of the main public health problems of our time. Antibiotics are a unique class of medications because of their potential societal impact; use of an antibiotic in a single patient can select for ABR that can spread to other people, animals, and the environment, making an antibacterial used in one patient ineffective for many others. Bacterial resistance can evolve rapidly. As bacteria acquire resistance mechanisms, the altered bacterial genetic material coding for resistance mechanisms can be transmitted at times readily between bacteria, broadening the reach and extent of resistance. Treatment failures because of multidrug resistant (MDR) bacteria, once rare, notable, and limited to hospitals, now occur very commonly in hospitals and increasingly in the community as well. It is estimated that a minimum of 25,000 patients in Europe and 23,000 in the USA die each year from infections caused by resistant bacteria. The cost of antibiotic resistance is tremendous, whether measured as the personal and societal burden of illness, death rates, or healthcare costs.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although it is a never-ending phenomenon, antibiotic resistance is directly related to the volume of antibiotics used. We are using increasing amounts of antibiotics in health care and agriculture, and discharging these active drugs into the environment. The impact of widespread antibiotic use is enormous, promoting the development and dissemination of antimicrobial resistance.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Safeguarding antibiotics will require a concerted effort by citizens, patients and prescribers. The primary goal of WAAAR is to raise awareness about the urgency and magnitude of the threat and to promote an international dialogue to assist in effective responses. The Alliance, in particular through this declaration, is dedicated to actively promoting antibiotic preservation and to raising awareness among antibiotic prescribers, politicians and policy-makers, patient safety and advocacy groups, the pharmaceutical industry, international health organizations, and the general population. Individual actions, no matter how well intended, are doomed to failure unless there is an international dialogue, a common sense of purpose, and broad consensus on how best to proceed.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">WAAAR advocates for the following 10 actions</span><p id="par0030" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">1.</span></span><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Promotion of awareness of all the stakeholders &#8211; including the general public &#8211; of the threat represented by antibiotic resistance</span><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Strong cooperation among international political, economic and public health organizations, which, all together, must take the lead of this action against antibiotic resistance.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">2.</span></span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Organization, in each country, ideally by Ministries of Health or regulatory bodies, of a financed national plan for the containment of antibiotic resistance, with the participation of all stakeholders, including patient advocacy groups</span></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">3.</span></span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Continuous access to antibiotics of assured quality, especially in middle and low income countries</span></p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">4.</span></span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">WAAAR advocates for the following 10 actions Integrated Surveillance of antibiotic resistance (ABR) and antibiotic use</span><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8226;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Standardized monitoring of antibiotic use and resistance at institution, regional, and country (comprehensive national data instead) level (through a Centres for Diseases Control and Prevention model) to allow comparative statistics (benchmarking), to be updated preferably in real-time and at least every 12 months. This will require adequate laboratory capacity using international standardized methods that may be facilitated by a centralized technologic coordinating infrastructure and information technology</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">5.</span></span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Use of diagnostic tests</span><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8226;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Appropriate use of existing diagnostic tests and development and implementation of new rapid, cost-effective and accurate diagnostic tests, adapted to the local context, to aid in distinguishing bacterial and nonbacterial etiologies. Rapid diagnostics may help clinicians avoid unnecessary treatments, rapidly select appropriate targeted therapies and inform the duration of treatment</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">6.</span></span><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Antibiotic stewardship (prudent, controlled and monitored approaches to the use of antibiotics)</span><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8226;</span><p id="par0080" class="elsevierStylePara elsevierViewall">In humans (hospitals, long term care facilities and primary care).</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">&#8226;</span><p id="par0085" class="elsevierStylePara elsevierViewall">In animals (animal husbandry, agriculture, aquaculture and animal health/veterinary setting), in a &#8220;one health&#8221; philosophy.</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">&#8226;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Progressive elimination of the &#8220;over the counter&#8221; (i.e. available without a prescription) access to antibiotics (systemic and topicals) for humans or animals.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">&#8226;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Ban of the use of antibiotics as growth promotion in food animals, and exceptional use in prophylaxis.</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">&#8226;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Rational use of metaphylaxis (Prophylaxis when some animals in the livestock are sick, or at high risk to be sick), and of animal treatment.</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">&#8226;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Limitation of the use of critically important antibiotics in humans and animals (e.g., carbapenems).</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">7.</span></span><p id="par0110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Educational efforts for change</span><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">&#8226;</span><p id="par0115" class="elsevierStylePara elsevierViewall">Educational programmes directed at children/teenagers on antibiotics, bacterial resistance, and infection control (e-Bug model).</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">&#8226;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Development of large coordinated, effective information and awareness campaigns directed at the public on expectations about the rational/appropriate use of antibiotics.</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">&#8226;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Continuous education and training programmes in the curriculum for all health care professionals in all settings (veterinarians, medical, dental, nursing, pharmacy and allied health care schools) and continuing professional education programmes, on the rational use of antibiotics, including indications, dosing and duration of therapy. Education of farmers.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">8.</span></span><p id="par0130" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Containment of bacterial transmission and prevention of infection</span><ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">&#8226;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Promotion of universal hand hygiene and all infection control interventions that have been proven to reduce rates of resistance.</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">&#8226;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Relentless efforts to prevent transmission of MDR organisms in healthcare, food production and animal husbandry.</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">&#8226;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Programmes to limit the contamination of drinking water with MDR bacteria, as well as contamination of the environment.</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">&#8226;</span><p id="par0150" class="elsevierStylePara elsevierViewall">Promotion of the use of available vaccines, in humans and animals.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">9.</span></span><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Basic and applied research, and development of new antibiotics</span><ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">&#8226;</span><p id="par0160" class="elsevierStylePara elsevierViewall">Increased support for basic and applied research aiming at curbing bacterial resistance in human and veterinary medicine.</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">&#8226;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Use of the principles of orphan drugs for new antibiotics.</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">&#8226;</span><p id="par0170" class="elsevierStylePara elsevierViewall">Incentives to stimulate research of new drugs (antibiotics and novel compounds) and vaccines via regulatory pathways that allow for fast track development.</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">&#8226;</span><p id="par0175" class="elsevierStylePara elsevierViewall">New economic business models to support the cost of innovation while safeguarding public health interests.</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">10.</span></span><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Request for UNESCO to include the &#8220;concept of antibiotic&#8221; in the list of the intangible cultural heritage.</span></p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Funding</span><p id="par0185" class="elsevierStylePara elsevierViewall">No funding.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflict of interest</span><p id="par0200" class="elsevierStylePara elsevierViewall">No conflict of interest.</p></span></span>"
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            "apendice" => "<p id="par0245" class="elsevierStylePara elsevierViewall">WAAAR is a group of 700 individuals from 55 different countries representing all the key stakeholders (physicians, veterinarians, microbiologists, surgeons, pharmacists, nurses, evolutionary biologists, ecologists, environmentalists, patient advocacy groups). The Alliance receives support from more than 140 learned societies or professional groups throughout the world. WAAAR is a nonprofit organization open to professionals and consumers worldwide. WAAAR receives no funding from the pharmaceutical industry.</p> <p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Supporting individuals</span></p> <p id="par0210" class="elsevierStylePara elsevierViewall">Laurent Aaron (France), Mohamed Salah Abassi (Tunisia), Lilian Abbo (USA), Oladipo Aboderin (Nigeria), Edward Abraham (USA), Fekri Abroug (Tunisia), Jacques Acar (France), Wafa Achour (Tunisia), Javier Adachi (USA), Seif Al-Abri (Oman), Haifaa Al-Mousa (Kuwait), Antonio Albaya-Moreno (Spain), Corinne Alberti (France), Serge Alfandari (France), Amani Alnimr (Saudi Arabia), Celia Alpuche Aranda (Mexico), Francisco Alvarez de Lerma (Spain), Fatma Amer (Egypt), Antoine Andremont (France), Fran&ccedil;ois Angoulvant (France), Maryvonne Anguill (France), Massimo Antonelli (Italy), Eleni Antoniadou (Greece), Guillaume Arlet (France), Apostolos Armaganidis (Greece), Anne Arnera (France), Antonio Artigas (Spain), Claude Attali (France), Fr&eacute;deric Auber (France), Jean-Pierre Aubert (France), Bernard Augereau (France), Martine Aup&eacute;e (France), Olfa Bahri (Tunisia), Fran&ccedil;oise Ballereau (France), G&eacute;rard Bapt (France), Fernando Baquero (Spain), Timothy Barkhan (Singapore), Ouahid Barouti (Morocco), Marie-Anne Barthelemy (France), Greg Barton (UK), Davide Bastoni (Italy), Michel Baussier (France), Luis Bavestrello (Chile), Birgit Beger (Belgium), Samuel Benenson (Israel), Fethi Bensalem (France), Guillaume B&eacute;raud (France), Frederique Bergheau (France), Gordon Bernard (USA), Philippe Berthelot (France), Xavier Bertrand (France), Fr&eacute;d&eacute;rique Beuhorry-Sassus (France), Pascal Beuret (France), John Billington (USA), Jacques Birg&eacute; (France), Sandra Biscardi (France), Luis Blanch (Spain), Herv&eacute; Blanchard (France), Thomas Bleck (USA), Joseph Blondeau (Canada), Fran&ccedil;ois Blot (France), France Borgey (France), Alain Bousquet-M&eacute;lou (France), Jean Brami (France), Christophe Brard (France), St&eacute;phane Bretagne (France), C&eacute;dric Bretonni&egrave;re (France), Adrian Brink (South Africa), Sheldon Brown (USA), Catherine Bruant-Rodier (France), Christian Brun-Buisson (France), Fabrice Bruneel (France), Frederico Bruzzi de Carvalho (Brazil), Christophe Buhot (France), Huda Bukharie (Saudi Arabia), Andr&eacute; Cabi&eacute; (France), Thierry Calandra (Switzerland), Isabelle Caniaux (France), Manuela Cani&ccedil;a (Portugal), Rafael Canton (Spain), Philippe Carenco (France), Camille Carlet (France), Claude Carlet (France), Florian Carlet (France), Jean Carlet (France), Romain Carlet (France), Otto Cars (Sweden), Manuel Cassiano-Neves (Portugal), Bernard Castan (France), Vincent Castellan (France), France Cazenave-Roblot (France), Alain-Michel Ceretti (France), Jean-Charles Chakarian (France), Ludivine Chalumeau-Lemoine (France), John Chandy (USA), Bernard Chanfreau (France), Jean Chastre (France), Robert Chausset (France), Pascal Chavanet (France), William Cheadle (USA), Jean-Daniel Chiche (France), Christian Chidiac (France), Olivier Chosidow (France), Natalia Chueca (Spain), Jon Cohen (UK), Robert Cohen (France), Peter Collignon (Australia), Fr&eacute;d&eacute;ric Collot (France), Patrick Coloby (France), John Conly (Canada), Cruz Cordero (Brazil), Catherine Cordonnier (France), Alejandra Corso (Argentina), Sara Cosgrove (USA), Ren&eacute; Courcol (France), Steve Crane (USA), Donald Craven (USA), Adnida Crespin (France), Marces Cyrillo (Brazil), Pierre-Eric Danin (France), Jan De Waele (Belgium), Pierre Dellamonica (France), E. Patchen Dellinger (USA), Philip Dellinger (USA), Jean Delmont (France), Eric Denes (France), George Dimopoulos (Greece), Dimitri Drekonja (USA), Anahi Dreser Mansilla (Mexico), Pierre-Louis Druais (France), Sylvie Dufour-Pierrat (France), Catherine Dumartin (France), Martin D&uuml;nser (Austria), Michel Dupont (France), Ricardo Durlach (Argentina), Oliver Dyar (UK), Gabriela Echaniz (Mexico), Paul Edelstein (USA), Philippe Eggimann (Switzerland), Mohamed Elghonemi (Egypt), Naima Elmdaghri (Morocco), Rehab Elsaid (Egypt), Rehab Elsokari (Egypt), Dan Engelhard (Israel), Jacques Fabry (France), Christopher Farmer (USA), J. Fernandez (Spain), Simon Finfer (Australia), Patricia Finn (USA), Katrin Fjeldsted (Israel), Daniel Floret (France), Francesco Flozaro (Spain), Jacinthe Foegle (France), Xavier Forceville (France), Sandra Fournier (France), Ir&egrave;ne Frachon (France), Alexander Friedrich (The Netherlands), Pascal Funuel (France), Didier Gaillard (France), Jacques Gaillat (France), Tatiana Galperine (France), Karine Gambarotto (France), Bernard Garo (France), Mait&eacute; Garrouste-Orgeas (France), Petra Gastemeier (Germany), Jean-Yves Gauchot (France), Remy Gauzit (France), Ga&euml;tan Gavazzi (France), Louise Gazagne (France), Julie Gerberding (USA), Abdul Ghafur (India), Evangelos Giamarellos-Bourboulis (Greece), Eleni Giamarellou (Greece), Marine Giard (France), Mark Gilchrist (UK), Jacques Gilquin (France), Fernando Gilsanz (Spain), Marek Gniadkowski (Poland), Charalambos Gogos (Greece), Don Goldman (USA), Florence Gordon (France), Thomas Gottlieb (Australia), Ian Gould (UK), Joao Gouveia (Portugal), Jennifer Grant (Canada), Lindsay Grason (Australia), Alix Greder (France), Hajo Grundman (The Netherlands), Eric Guaguere (France), Gwena&euml;lle Gu&eacute;roult-Locher (France), Benoit Guery (France), Bertrand Guidet (France), Catherine Guignabert (France), Pradip Gupta (India), Sanjay Gupta (UK), Mohan Gurjar (India), Manuel Guzman (Venezuela), Joseph Hajjar (France), Noha Hammad (Egypt), Anette Hammerum (Denmark), Hakan Hanberger (Sweden), Regina Hanke (Germany), Stephan Harbarth (Switzerland), Anita Harel (France), Elisabeth Heisbourg (Austria), Isabelle Hermes (France), Jean-Pierre Hermet (France), Bernard Hirschel (Switzerland), Bruno Hoen (France), Aidan Hollis (Canada), Xiao Honghong (China), David Hooper (USA), Juan Pablo Horcajada (Spain), Bruno Housset (France), Waleria Hryniewicz (Poland), Li Yang Hsu (Singapore), Susan Huang (USA), James Hughes (USA), Jean-Louis Hunault (France), Lotte Jakobsen (Denmark), Nordiah Jalil (Malaysia), Hilde Jansens (Belgium), Vincent Jarlier (France), William Jarvis (USA), Dominique Jean (France), Matjaz Jereb (Slovenia), James Johnson (USA), Marie-Laure Joly-Guillou (France), Olivier Jonquet (France), Guillaume Kac (France), Deogracias Kaddu-Mulindwa (Uganda), Mitsuo Kaku (Japan), Badreddine Kilani (Tunisia), Eui-Chong Kim (South Korea), Doroth&eacute;e Kinde Gazard (Benin), Keith Klugman (USA), Stacey Klutts (USA), Jan Kluytmans (The Netherlands), Marin Kollef (USA), Despoina Koulenti (Greece), Michael Kresken (Germany), Fran&ccedil;ois Lacoin (France), Jean-Patrick Lajonch&egrave;re (France), Nathalie Landgraf (France), G&eacute;rard Larroussinie (France), Pierre-Fran&ccedil;ois Laterre (Belgium), Anne-Marie Lavenaire (France), Thierry Lavigne (France), Ramanan Laxminarayan (USA), Thi Anh Thu Le (Vietnam), Fran&ccedil;oise Leblanc-Jouffre (France), Nam Yong Lee (South Korea), Olivier Lehiani (France), Herv&eacute; Lelouet (France), Fr&eacute;d&eacute;rique Lemanach-Kergueris (France), Alain Lepape (France), Joel Leroy (France), Xavier Lescure (France), Mitchell Levy (USA), Gabriel Levy-Hara (Argentina), Ling Moi Lin (Singapore), Jeffrey Lipman (Australia), Joel Livartowski (France), David Looke (Australia), Fernando Luis Lopez Cardozo (Brazil), Francisco Lopez Medrano (Spain), Anne Lotth&eacute; (France), Jean Christophe Lucet (France), David Lupande (D. R. Congo), Jean-Yves Madec (France), Jean-Luc Mainardi (France), Sundaresan Maiylagan (Mauritius), Jordi Mancebo (Spain), Franck Mansour-Adeoti (France), Enrique Maravi (Spain), Bruno Marchou (France), Darcy Marciniuk (Canada), John Marshall (Canada), Claude Martin (France), David Martin (USA), Luis Martinez-Martinez (Spain), Alain Martinot (France), Emilio Maseda (Spain), Dimitrios Matamis (Greece), Sophie Matheron (France), Ricardo Matos (Portugal), Marie Matthews (UK), Thierry May (France), Thierry Mayet (France), John McGowan (USA), Shaheen Mehtar (South Africa), Jose Mario Meira Teles (Brazil), Marc Mendelson (South Africa), Christian Michelet (France), Albert Mifsud (UK), Magolia Mikaszewska-Sokolewicz (Poland), Jessica Minion (Canada), Christelle Miquel (France), Jean-Paul Mira (France), Jose Miro (Spain), Benoit Misset (France), Jean-Jacques Monot (France), Philippe Montravers (France), Joy Mootien (France), Rui Moreno (Portugal), Andrew Morris (USA), G&eacute;rard Moulin (France), C&eacute;cile Mourlan (France), Gilbert Mouthon (France), Wafaa Mowafy (Egypt), Elke Muhl (Germany), A. Muruganathan (India), Enani Mushira (Saudi Arabia), Babacar N&#8217;Doye (Senegal), Aburjania Nana (USA), Michael Niederman (USA), G&eacute;rard Nitenberg (France), Patrice Nordman (France), Assumpta Novira (Spain), Cyrille Nowak (France), Iruka Okeke (USA), Pedro Maria Olaechea (Spain), Abeer Omar (Kuwait), Steve Opal (USA), Carlos Ortiz Leyba (Spain), Bauke Oudega (The Netherlands), Eric Oziol (France), Bernard Page (France), Jose Arthur Paiva (Portugal), Lucy Palmer (USA), Mercedes Palomar-Martinez (Spain), Pierre Parneix (France), Didier Payen de la Garanderie (France), Eli Perencevich (USA), Trish Perl (USA), Christian Perronne (France), Georg Peters (Germany), Matthew Peters (Australia), Dominique Peyramond (France), Fran&ccedil;ois Philippart (France), Didier Pittet (Switzerland), Jean-Fran&ccedil;ois Pittet (USA), Patrick Pl&eacute;siat (France), Mathias Pletz (Germany), Marie-C&eacute;cile Ploy (France), Florence Pospisil (France), Pascal Pouedras (France), Garyphallia Poulakou (Greece), Anny Poursinoff (France), Peter Pronovost (USA), C&eacute;line Pulcini (France), Massimo Puoti (Italy), Shanmugan Puvanendiram (Sri Lanka), Michael Quintel (Germany), Christian Rabaud (France), Claude Rambaud (France), Helena Ramos (Portugal), Ossama Rassla (Egypt), Josette Raymond (France), Bernard Regnier (France), Konrad Reinhart (Germany), Jordi Rello Condomines (Spain), Jean-Claude Revil (Reveil?), (France), Agn&egrave;s Rich&eacute; (France), Paul Richman (USA), Rosana Richmann (Brasil), Viviana Rodriguez (Argentina), Jesus Rodriguez-Bano (Spain), Olivier Romain (France), Karine Romand (France), Elisabeth Rossines (France), MonIque Rothan-Tondeur (France), Jean-Fran&ccedil;ois Rousselot (France), Ethan Rubinstein (Canada), Vladimir Rudnov (Russia), Narender Saini (India), Dominique Salmon (France), Reinaldo Salomao (Brazil), Miguel Sanchez Garcia (Spain), Antonio Santos-Bouza (Spain), Marie-Caude Saux (France), Anne Savey (France), Lynora Saxinger (Canada), Benoit Schlemmer (France), Jean-Luc Schmit (France), Dietmar Schneider (Germany), Janet Schoemaker (USA), Sanjeev Singh (India), Jordi Sole-Violan (Spain), Sara Soto (France), Jean-Paul Stahl (France), Annabelle Stoclin (France), Alexis Tabah (Australia), Jean-Philippe Tabut (France), Paul Anamtharajah Tambyah (Singapore), Fabienne Tamion (France), Phillip Tarr (USA), Pierre Tattevin (France), Fred Tenover (USA), Nicolas Terzi (France), Marthe Than Lecompte (Switzerland), Jonathan Theodore (France), Didier Thevenin (France), Philippe Thevenot (France), Laurent Thiriet (France), Carol Thompson (USA), Joseph Thurn (USA), Glenn Tillotson (USA), Hanene Tiouiri (Tunisia), Antonio Torres (Spain), Fran&ccedil;ois Tr&eacute;moli&egrave;res (France), Michel Troadec (France), Rabiatu Umar (Nigeria), Garance Upham (France), Carl Urban (USA), Jan Vaarten (-), Dominique Valla (France), Nathalie Van Der Mee-Marquet (France), Jos Van der Meer (The Netherlands), Tom Van Der Poll (The Netherlands), Jacques Vancel (France), Philippe Vanhems (France), Remi Varin (France), Emmanuelle Varon (France), David Vaughan (USA), Marc Veilly (France), K. Vijayakumar (India), Alvaro Villanueva (Columbia), Jean-Louis Vincent (Belgium), Virginie Vitrat (France), Andreas Voss (The Netherlands), Robert Wachter (USA), Tim Walsh (UK), Peter Wark (Australia), Grant Waterer (Australia), Henrik Caspar Wegener (Denmark), Pierre Weinbreck (France), Robert Weinstein (USA), Scott Weissman (USA), Jeanine Wiener-Kronish (USA), Alexander Wilmer (Belgium), Benjamin Wyplosz (France), Ibrahim Yacoub-Agha (France), Melanie Young (USA), Ibrahim Yusuf (Nigeria), Emile Zein (Lebanon), George Zhanel (Canada), Stephen Zinner (USA), Jos&eacute;phine Zoungrana (Burkina Faso), Nadezhda Zubareva (Russia).</p> <p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Supporting national and international agencies</span></p> <p id="par0220" class="elsevierStylePara elsevierViewall">Centres for Disease Control and prevention (CDC).</p> <p id="par0225" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Supporting medical organizations</span></p> <p id="par0230" class="elsevierStylePara elsevierViewall">American College of Chest Physicians (ACCP) (Darcy Marciniuk), American Society of Microbiology (ASM) (Janet Schoemaker), American Thoracic Society (ATS) (Patricia Finn, Steve Crane), Analgesia and Intensive Care Medicine (SIAARTI) (Massimo Antonelli), Andalusian Infectious Diseases Society (Jesus Gomes Mateos), Asia Pacific Society of Infection Control (APSIC) (Ling Moi Lin), Associa&ccedil;&atilde;o de Medicina Intensiva Brasileira (AMIB) (Jose Mario Meira Teles), Association Fran&ccedil;aise d&#8217;Urologie (AFU) (Patrick Coloby), Association Fran&ccedil;aise de Chirurgie (Jean Pierre Arnaud), Association Fran&ccedil;aise des V&eacute;t&eacute;rinaires pour Animaux de Compagnie (AFVAC) (Eric Guagu&egrave;re, Jean-Fran&ccedil;ois Rousselot), Association of Physicians of India (Dr Muruganathan), Association Tunisienne de R&eacute;animation (ATR) (Fekri Abroug), Association V&eacute;t&eacute;rinaire Equine Fran&ccedil;aise (AVEF) (Jean-Yves Gauchot), Australasian Society for Infectious Diseases (ASID) (David Looke), Australian Society for Antimicrobials (ASA) (Thomas Gottlieb), Belgian Society of Intensive Care Medicine (SIZ) (Alexander Wilmer), Belgium Infection Control Society (BICS) (Hilde Jansens), Brazilian Society of Infectiology, British Infection Association (Albert Mifsud), British Society of Antimicrobial Chemotherapy (Nicholas Brown, Laura Piddock), Centre National de R&eacute;f&eacute;rence de la R&eacute;sistance aux Antibiotiques (Patrick Pl&eacute;siat), Sociedad Espa&ntilde;ola de Medicina Intensiva, Cr&iacute;tica y Unidades Coronarias (SEMICYUC) (Luis Blanch, Miguel Sanchez Garcia, Francisco Alvarez Lerma), Egyptian Society for Infection Control (ESIC) (Ossama Rasslan), European Federation of National Associations of Orthopaedics and Traumatology (Manuel Cassiano-Neves), European Society of Infectious Diseases and Clinical Microbiology (ESCMID) (Gunnar Kahlmeter, Murat Akova), European Society of Intensive Care Medicine (ESICM) (Jean Daniel Chiche), F&eacute;d&eacute;ration Fran&ccedil;aise de Pneumologie (Bruno Housset), Federation of European Microbiological Societies (FEMS) (Bauke Oudega), Federation of Infectious Diseases Societies of Southern Africa (Marc Mendelson), Federation V&eacute;t&eacute;rinaire Europ&eacute;enne (FVE) (Christophe Buhot, Jan Vaarten), German Interdisciplinary Association of Intensive and Emergency Medicine (Dietmar Schneider, Michael Quintel, Elke Muhl), Hellenic Society of Antimicrobial Chemotherapy (Helen Giamarellou), Hellenic Society of Intensive Care (Antonios Mavrommatis), Ho Chi Minh City Infection Control Society (Thi Anh Thu Le), Indian Medical Association (Narendra Saini, K. Vijayakumar), Infection Control Association of Singapore (ICAS) (Ling Moi Lin), Instituto Latino-Americano de Sepsis (ILAS) (Reinaldo Salomao), International Society of Chemotherapy (Ian Gould), International Society of Infectious Diseases (ISID) (Jon Cohen, Keith Klugman), Israel Society for Infectious Diseases, Italian Society of Anesthesiology, Korean Society of Clinical Microbiology (Nam Yong Lee), Lebanese Association for Medical Diagnosis and Auto-Immune Diseases (Lambda) (Georges Khalil), Pan American Society of Infectious Diseases (Luis Bavestrello), Paul-Ehrlich-Gesellschaft f&uuml;r Chemotherapie e.V. (Paul-Ehrlich-Society for Chemotherapy) (Achim Hoerauf), Polish Society of Anesthesiology and Intensive Care (Magolia Mikaszewska-Sokolewicz), Portuguese Society of Infectious Diseases and Clinical Microbiology (Helena Ramos), Portuguese Society of Intensive Care (Joao Gouveia, Ricardo Matos), Saudi Society of Medical Microbiology and Infectious Diseases (Huda Bukharie), Sociedad Espa&ntilde;ola de Enfermedades Infecciosas y Microbiologia Clinic (SEIMC) (Jose<span class="elsevierStyleHsp" style=""></span>M Miro), Sociedad Espa&ntilde;ola de Enfermedades Respiratorias (SEPAR) (Pilar de Lucas), Sociedad Espa&ntilde;ola de Medecina Intensiva, Cr&iacute;tica y Unidades Coronarias (SEMICYUC) (Luis Blanch, Miguel Sanchez Garcia, Francisco Alvarez Lerma, Pedro Maria Olaechea), Society for Healthcare Epidemiology of America (SHEA) (Melanie Young), Sociedale Paulista de Infectiologia-Brazil (Rosana Richman), Soci&eacute;t&eacute; Belge de Microbiologie Clinique (BVIKM/SBIMC) (Camelia Rossi), Soci&eacute;t&eacute; de Pathologie Exotique (Jean Delmont), Soci&eacute;t&eacute; de Pathologie Infectieuse de Langue Fran&ccedil;aise (SPILF) (Christian Rabaud), Soci&eacute;t&eacute; de Pneumologie de Langue Fran&ccedil;aise (SPLF) (Alain Didier), Soci&eacute;t&eacute; de R&eacute;animation de Langue Fran&ccedil;aise (SRLF) (Djillali Annane), Soci&eacute;t&eacute; Fran&ccedil;aise d&#8217;Anesth&eacute;sie R&eacute;animation (SFAR) (Claude Ecoffey), Soci&eacute;t&eacute; Fran&ccedil;aise d&#8217;Hygi&egrave;ne Hospitali&egrave;re (SF2H) (Philippe Berthelot), Soci&eacute;t&eacute; Fran&ccedil;aise de Chirurgie Orthop&eacute;dique et Traumatologique (Bernard Augereau), Soci&eacute;t&eacute; Fran&ccedil;aise de Dermatologie (SFD) (Olivier Chosidow), Soci&eacute;t&eacute; Fran&ccedil;aise de G&eacute;riatrie et G&eacute;rontologie (SFGG) (Genevi&egrave;ve Ruault), Soci&eacute;t&eacute; Fran&ccedil;aise de Greffe de Moelle et de Th&eacute;rapie Cellulaire (SFGM-TC) (Ibrahim Yacoub), Soci&eacute;t&eacute; Fran&ccedil;aise de M&eacute;decine G&eacute;n&eacute;rale (SFMG) (Pascale Arnould), Soci&eacute;t&eacute; Fran&ccedil;aise de M&eacute;dicine Interne (SFMI) (Loic Guillevin), Soci&eacute;t&eacute; Fran&ccedil;aise de Microbiologie (SFM) (Ren&eacute; Courcol), Soci&eacute;t&eacute; Fran&ccedil;aise de Pharmacie Clinique (SFPC) (Marie-Claude Saux, Remi Varin), Soci&eacute;t&eacute; Fran&ccedil;aise de Sant&eacute; Publique (SFSP) (Pierre Lombrail), Soci&eacute;t&eacute; Libanaise de M&eacute;decine Interne (SLMI) (Emile Zein), Soci&eacute;t&eacute; Marocaine d&#8217;Hygi&egrave;ne Hospitali&egrave;re (Ouahid Barouti), Soci&eacute;t&eacute; Marocaine de Maladies Infectieuses (SMMI), Soci&eacute;t&eacute; Nationale des Groupements Techniques V&eacute;t&eacute;rinaires (SNGTV) (Christophe Brard), Soci&eacute;t&eacute; Tunisienne de Pathologie Infectieuse (STPI), Society of Critical Care Medicine (SCCM) (Chris Farmer, David Martin), Society of Infectious Diseases of Singapore (Paul Anantharaja Tambyah), Soci&eacute;t&eacute; Suisse d&#8217;Infectiologie (Bernard Hirschel), Spanish Society of Anesthesiology and Critical Care (Fernando Gilsanz, Emilio Maseda), Spanish Society of Infectious Diseases and Clinical Microbiology (Jos&eacute; Miro, Rafael Canton), Standing Committee of European Doctors (Katrin Fjeldsted, Birgit Beger), Surgical Infection Society (SIS) (William Cheadle), The Infectious Diseases Society of America (IDSA) (John Billington, David Relman), The Mexican Society of Infectious Diseases and Clinical Microbiology (AMIMC) (Celia Alpuche Aranada), Thoracic Society of Australia and New Zealand (Matthew Peters, Peter Wark), United Kingdom Clinical Pharmacy Association (UKCPA) (Mark Borthwick), World Federation of Societies of Intensive Care and Critical Care Medicine (WFSICCM) (Jean-Louis Vincent).</p> <p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Other supporting groups</span></p> <p id="par0240" class="elsevierStylePara elsevierViewall">Antibiolor (C. Rabaud), Antimicrobial Stewardship Working Group of the International Society of Chemotherapy (ISC) (Gabriel Levy Hara), Arab Alliance for a Prudent Use of Antimicrobials (Ar-Apua) (Fatma Amer), Association de Lutte contre les Infections Associ&eacute;es aux Soins (ALIAS), Association des M&eacute;decins Coordonnateurs en EHPAD, Association des Victimes d&#8217;Infection Nosocomiale (ADVIN), Association Le CISS (Claude Rambaud), Association Le LIEN (Madeleine Mador&eacute;), Association Phagespoir (J&eacute;rome Larch&eacute;), Association pour la Chimioth&eacute;rapie Anti-infectieuse (ACAI), Association pour la Recherche en Microbiologie Exp&eacute;rimentale (Marie-Laure Joly-Guillou), Austrian Antibiotic Stewardship Group (Elisabeth Heisbourg), CCLIN Ouest (Martine Aup&eacute;e), Centre for Infection Control and the APIC-Saudi chapter (Hanan Balkhy), Chaire Recherche Infirmi&egrave;re, AP-HP EHESP (France, Monique Rothan-Tondeur), Coll&egrave;ge des Enseignants de Maladies Infectieuses (CMIT) (Christian Michelet), Coll&egrave;ge National de M&eacute;decine G&eacute;n&eacute;rale (CNMG), Coll&egrave;ge National des G&eacute;n&eacute;ralistes Enseignants (CNGE) (Pierre Louis Druais), Comit&eacute; de Pilotage des R&eacute;seaux de Surveillance ATB et BMR Sud Est, Doctors Without Borders/M&eacute;decins Sans Fronti&egrave;res (Arl&egrave;ne Chua, Richard Murphy), Egyptian Patient Safety Association (EPSA) (Ossama Rassla), ESGAP working group (ESCMID) (Jordi Rello), F&eacute;d&eacute;ration des Sp&eacute;cialit&eacute;s M&eacute;dicales (FSM), F&eacute;d&eacute;ration Fran&ccedil;aise d&#8217;Infectiologie (FFI) (Christian Perrone), F&eacute;d&eacute;ration Fran&ccedil;aise de Pneumologie (FFP) (Bruno Housset), Global Sepsis Alliance (Konrad Reinhart), Groupe de Pathologie Infectieuse en P&eacute;diatrie (GPIP) (Robert Cohen), Groupo de Infec&ccedil;ao e Sepsis (Joao Jaime Sa), Grupo de Trabajo de Enfermedades Infecciosas y Sepsis De la Sociedad Espa&ntilde;ola de Medicina Intensiva, Hellenic Sepsis Study Group (Gogos Charalambos, Evangelos Giamarelos-Bourboulis), Infection Control Directorate (Ministry of Health-Kuwait), Infection Prevention and Control African Network (IPCAN) (Shaheen Mehtar), Institut de Recherche en M&eacute;decine G&eacute;n&eacute;rale (IRMG), Institut Maurice Rapin (IMR) (Christian Brun-Buisson), International Forum for Acute Care Trialists (InFACT) (John Marshal), International Sepsis Forum (Tom Van Der Poll), Le Forum des Bio-hygi&eacute;nistes, Ligue Africaine des Associations pour la S&eacute;curit&eacute; des Patients (LIASEP), Medqual (F. Ballereau), National Committee for the Proper Use of Antimicrobials (Ministry of Health-Kuwait), Observatoire du Risque Infectieux en G&eacute;riatrie (ORIG) (Monique Rotha-Tondeur), Observatoire National d&#8217;Epid&eacute;miologie de la Resistance Bact&eacute;rienne aux antibiotiques (ONERBA) (Marie-H&eacute;l&egrave;ne Nicolas-Chanoine), Portuguese Intersectorial Alliance for the Preservation of the Antibiotics (APAPA) (Jose Arthur Paiva), Programme National de Lutte contre l&#8217;Infection Nosocomiale (PRONALIN), S&eacute;n&eacute;gal (Babacar N&#8217;Doye), R&eacute;seau International pour la Planification et l&#8217;Am&eacute;lioration de la Qualit&eacute; des Soins en Afrique (RIPAQS) (Bernard Chanfreau), R&eacute;seau Sud-Est de Surveillance et de Pr&eacute;vention des Bact&eacute;ries Multir&eacute;sistantes aux Antibiotiques, South African Antibiotic Stewardship programme (Adrian Brink), Spanish Network for Research in Infectious Diseases (REIPI) (Jesus Rodriguez-Bano), Safe Observer International (SOI) (Garance Upham), The Bekele Afessa Initiative to Improve Sepsis Care in Resource-Limited Areas (Joseph Christopher Farmer), The Canadian Antimicrobial Resistance Alliance (CARA), The Eastern Mediterranean Regional Network for Infection Control (EMRNI) (Ossama Rassla), The Gulf Cooperation council (GCC) (Hanan Balkhy).</p>"
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Article information
ISSN: 21735727
Original language: English
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2023 September 37 39 76
2023 August 41 20 61
2023 July 47 25 72
2023 June 50 23 73
2023 May 68 27 95
2023 April 45 26 71
2023 March 66 39 105
2023 February 75 45 120
2023 January 54 16 70
2022 December 85 38 123
2022 November 77 35 112
2022 October 99 42 141
2022 September 71 40 111
2022 August 68 48 116
2022 July 62 45 107
2022 June 78 24 102
2022 May 130 40 170
2022 April 65 47 112
2022 March 68 45 113
2022 February 60 33 93
2022 January 55 33 88
2021 December 82 44 126
2021 November 62 49 111
2021 October 59 70 129
2021 September 29 33 62
2021 August 43 32 75
2021 July 30 34 64
2021 June 34 30 64
2021 May 50 62 112
2021 April 169 97 266
2021 March 108 35 143
2021 February 65 36 101
2021 January 57 42 99
2020 December 30 23 53
2020 November 38 41 79
2020 October 43 33 76
2020 September 33 18 51
2020 August 46 23 69
2020 July 34 31 65
2020 June 45 34 79
2020 May 48 20 68
2020 April 45 24 69
2020 March 35 17 52
2020 February 81 41 122
2020 January 46 32 78
2019 December 48 35 83
2019 November 48 31 79
2019 October 57 21 78
2019 September 56 24 80
2019 August 48 13 61
2019 July 42 30 72
2019 June 44 19 63
2019 May 66 29 95
2019 April 41 21 62
2019 March 40 21 61
2019 February 44 33 77
2019 January 47 29 76
2018 December 80 26 106
2018 November 42 62 104
2018 October 34 23 57
2018 September 32 8 40
2018 August 28 9 37
2018 July 23 13 36
2018 June 32 16 48
2018 May 14 1 15
2018 April 32 10 42
2018 March 27 13 40
2018 February 27 10 37
2018 January 42 10 52
2017 December 21 15 36
2017 November 24 8 32
2017 October 24 12 36
2017 September 20 15 35
2017 August 20 6 26
2017 July 18 8 26
2017 June 25 19 44
2017 May 23 10 33
2017 April 24 24 48
2017 March 17 10 27
2017 February 16 12 28
2017 January 17 7 24
2016 December 34 4 38
2016 November 33 11 44
2016 October 44 13 57
2016 September 36 9 45
2016 August 32 13 45
2016 July 14 6 20
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