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Antimicrobial resistance: Prevention and not just treatment

18 November 2015

“We need to act with urgency.”

During World Antiobiotic Awareness Week, experts from the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO), and the University of Antwerp, all conveyed the clear message that antimicrobial resistance is a growing global problem with severe consequences for all of us if we do not act now.

The Health First Europe roundtable focused on how to prevent antimicrobial resistance and the role of various stakeholders to support prevention.  While there is great variation in the consumption and use of antibiotics throughout the Europe, what is clear is that changes to policy can have a significant impact on reduction.  Member of the European Parliament Renate Sommer (EPP, Germany), kicked off the discussions by highlighting  what the Parliament has been doing to tackle this growing problem, including calling for “the use of diagnostic tests that allow doctors to determine when and which antibiotics to be used, training of professionals on antibiotics and information to patients on the risks and their role in prevention.”

Prof. Herman Goossens from the Univeristy of Antwerp, discussed how Denmark set a policy which only allowed prescribing based on diagnosis, creating a large reduction in consumption.  Likewise, Belgium invested €4.9 million in public awareness campaigns on antibiotic use through media channels between 1999 and 2015 which equated to a decrease in reimbursement for antibiotics and a cumulative savings to the health system of €642.2 million in the same period of time.  For every euro invested in the campaign, there was a cumulative saving of €131. To encourage smarter prescribing and use, Prof. Goossens explained, “More and more countries are moving towards target setting” including Sweden, Norway and the United States.

Dr. Dominique Monnet from the ECDC pointed out the urgency for action given that the ECDC is seeing more and more resistance which changes rapidly from a sporadic occurrence to an endemic situation. Despite the fact that 5 countries reported decreasing use of antibiotics between 2010 and 2014, he emphasised that modern medicine (i.e. hip replacement, organ transplants, intensive care therapy, etc.) will not be possible without antibiotics.

Dr. Stéphane Vandam from the WHO, reiterated the urgency of action globally to fight antimicrobial resistance just as the world has done so with climate change.  He affirmed the need to prevent infections through infection control programmes such as via the “Saves Lives: Clean your hands” campaign.  Highlighting the tools the WHO has developed with other global organisations and countries to support prevention and surveillance of antimicrobial resistance, he encouraged participants to utilse the information available from the WHO to raise awareness at national levels.

From a Health First Europe perspective, Amanda Massey expressed that antimicrobial resistance is a patient safety issue for every single one of us. “Imagine a world where ourselves, our children or our parents could die because of a simple infection?” She strongly advised that the next steps at European level include minimum patient safety standards which include information to patients on antimicrobial resistance and healthcare associated infections (HAIs), as well as setting targets for reduction of antibiotic use and HAIs at national level to be monitored by the EU.

Participants also raised the importance of screening patients for infections before entering hospitals, changing the reimbursement structures for diagnostic tests that support improved antibiotic prescribing, as well as encouraging hospitals to publish data on infection and resistance rates so that patients can make more informed choices.

While it is clear that there are many great initiatives being undertaken by various organisations and Member States, the outcome of the debate showcased that there is still much more to be done. In particular, the next steps at European level could have a positive impact on the rates of consumption and resistance in the coming years if we can work together to get it right.

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