Antimikrobiyal Direncin (Sessiz Pandemi) İzlenmesi ve Entegre Çözümler

Antimicrobial resistance (AMR) is a global pandemic that is more devastating and progresses more silently than COVID-19. Globally, in 2019, it caused 1.27 million direct and 5 million indirect deaths; by 2050, it is expected to surpass cancer, causing 10 million deaths per year. Turkiye is facing a severe crisis, particularly due to high rates of multidrug antimicrobial resistance in Gram- negative bacteria (carbapenem resistance is 71% in Klebsiella pneumoniae and 93% in Acinetobacter baumannii). This situation carries the risk of an economic loss ranging from 220 billion to 1.4 trillion dollars by 2050. The problem is not limited to hospitals; it is also widely detected in community-acquired infections, in the environment (rivers, wastewater), and in the food chain. Although existing national surveillance systems are valuable, they are inadequate in covering community-acquired infections, have limited data presentation, and environmental monitoring is almost very limited. The solution is the ""One Health"" approach, which addresses human, animal, and environmental health as a whole. In this context: sentinel surveillance networks for community-acquired infections should be established; data quality, frequency, and molecular epidemiological analyses in healthcare-associated infection surveillance should be increased; and environmental monitoring (wastewater analyses, bio indicators such as honeybees) should be urgently implemented. All this data should be integrated with antibiotic consumption data and supported by artificial intelligence to develop early warning systems. Combating AMR requires an integrated strategy including leadership, dynamic surveillance, awareness, sanitation, vaccination, accountability, and a ""One Health"" approach. Ensuring adequate human resources and technical infrastructure under the leadership and coordination of the health authority, increasing awareness, facilitating vaccine access and combating vaccine hesitancy, effective sanitation, scientifically based antimicrobial stewardship programs in human and animal health are the fundamental building blocks of an effective fight. Transparency and accountability facilitate achieving program goals. Global analyses including Turkiye show that focusing resources specifically on infection prevention, surveillance, and antibiotic stewardship is the most effective way to reduce the AMR burden. For sustainable success, National Action Plans should be designed by blending technical infrastructure such as infection prevention and control, surveillance, and antibiotic stewardship with the sociological structure of society (education level, beliefs, social norms) and the psychological characteristics of individuals (risk perception, behavior change, doctor-patient dynamics). Institutional plans should be developed with an understanding that goes beyond hospital walls and extends into the public, cantering on communication, trust, and participation. The ultimate goal should be to create a human-cantered and integrated fight model that unites policymakers, healthcare workers, patient associations, pharmacists, veterinarians, farmers, and the media around a common purpose.