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Editorial, /

Patient safety is an essential metric when it comes to building resilient public healthcare systems both at the European and global level. It is also indispensable in the provision of health care in all settings including hospitals and long-term care facilities. The lack of proper adherence to patient safety manuals undermines public confidence and trust in health systems, increases mortality and morbidity due to unsafe care, and increases the burden on the public purse in terms of healthcare costs. Unfortunately, patient harm resulting from safety lapses, though avoidable in most cases, is a growing canker that threatens global public health. Safety lapses lead to healthcare-associated infections (HAIs), which result in prolonged hospital stays, long-term disability and high costs for patients, family and healthcare providers.

Health First Europe and the members of the European Patient Group on Antimicrobial Resistance (AMR Patient Group) are committed to raising awareness about the real-world impact of antimicrobial resistance and healthcare-associated infections (HAIs) that have become a bane for individual and public health. The HFE-led initiative’s overarching objectives are to help reduce the inappropriate use of existing antibiotics, promote antimicrobial stewardship and infection prevention and control measures across Europe, and develop novel antibiotics where needed. The AMR Patient Group empowers patients across Europe with the necessary knowledge about antimicrobial resistance so that everyone understands when it is appropriate to take antibiotics and how to take them responsibly by addressing the gap in awareness at the patient level about the danger of antibiotic misuse and the lack of effective infection prevention measures.

The European Centre for Disease Control (ECDC) estimates that a total of 8.9 million HAIs occur each year in European hospitals and long-term care facilities combined, with more than half of certain HAIs considered preventable.[1] HAIs represent a common pathway that often leads to sepsis, which in turn contributes to approximately 37,000 deaths directly resulting from HAIs. This is devasting for patients and caregivers alike.

HAI prevention and control is a core element in tackling AMR. HAIs are often caused by resistant bacteria, but the occurrence of an infection in the first place may also increase the risk of developing resistant strains. Even though antibiotics have played a central role in the treatment of human infections, the lack of awareness on the general health risk associated with the excessive and inappropriate use of antibiotics menaces public health and patient safety. Antimicrobial resistance alone is responsible for approximately 33,000 deaths per year in the EU and is estimated to cost the EU €1.5 billion annually in healthcare costs and productivity losses. These figures and the general trend paint a bleak picture of the public health system. The situation is dire.

AMR will likely increase through the heavy use of antibiotics in COVID-19 patient treatment. Hence, the importance of diagnosing and implementing digital technologies, encouraging behavioural compliance in hand hygiene, checklists and safety protocols, and promoting the optimal prescription and sustainable use of antibiotics. As a result, there should be stronger preparedness for our healthcare systems and timely responses to this public health challenge.

Going forward we face an urgent need to arm ourselves with effective tools to improve patient safety in all healthcare settings. “In order to effectively fight healthcare-associated infections and antimicrobial resistance, there is a need to not just raise awareness and promote education, but, rather, a new paradigm shift – one that is patient-centered. The genesis of the European Patient Group on Antimicrobial Resistance is in line with this patient-centered paradigm shift as it includes many active patient groups coming from all over Europe,” says Ms Laura Cigolot, coordinator of the AMR Patient Group.

On 7 April 2021, the group launched a Declaration on AMR, calling on European and national authorities to commit to a full range of interventions in the field of education, prevention and investment. Currently, the AMR Patient Group is undertaking a major pan-European survey to assess awareness and knowledge of antimicrobial resistance and HAIs among the general public in five European countries: France, Germany, Italy, Spain and the UK. The findings of this questionnaire will be collected in five national reports which will be used to identify best practices and address current gaps in the implementation of national action plans on AMR.

It is now more urgent than ever to step up actions to prevent HAIs and the related development of antimicrobial resistance throughout the patient journey.

[1] ECDC, 2018. “Infographic: Healthcare-associated infections – a threat to patient safety in Europe”.