“A prudent use of antibiotics is a cornerstone of the battle against antimicrobial resistance”
Doctor Andrea Ammon, Director of ECDC
On 17th November 2016, in conjunction with the World Antibiotic Awareness Week, policy makers and health stakeholders met within the framework of the EP Interest Group on Innovation on health and social care to discuss how to tackle the global threat of antimicrobial resistance to improve patient safety.
As underlined by MEP Karin Kadenbach, co-chair of the EP Interest Group, “antibiotic resistance represents a sever health threat for everyone and a crucial challenge that needs to be addressed from a global perspective. The resistance to antibiotics not only threatens the lives of individuals who come in contact with drug resistant bacteria, but also presents significant costs to health systems when they can least afford it”. This threat can be stopped and prevented by diagnostic tests that allow doctors to determine when and which antibiotics should be used, training for professionals on antibiotics, preventing surgical site infection, information to patients on the risks and their role in preventing infections. Moreover, it is critical to raise awareness as half of Europeans do not know that antibiotics do not work for viruses. If there are potential tool for actions, why is AMR still a growing threat? And what should policy makers, healthcare professionals, stakeholders do to support collaborative efforts to tackle and raise awareness on AMR?
Doctor Andrea Ammon, Director of ECDC, focused on the importance of prevention of Healthcare Associated infections (HAIs) which represent an alarming concern in European hospitals. Indeed, of all patients, 6% are infected with at least one HAI. “HAIs account for twice the burden of 31 other infectious disease”, Dr Ammon stated. It is possible to reduce impact of HAIs by prudent use of antimicrobial agents (only when needed, correct dose, correct dose intervals, correct duration), infection prevention and control (active surveillance, hand hygiene, screening, isolation), and new antimicrobial agents (with a novel mechanism of action, research, development).
Ms Line Matthiessen, Head of Unit for Fighting Infectious Diseases and Advancing Public Health in the Directorate General for Research and Innovation, emphasised the role of research and innovation to tackle AMR and showcased several examples of the European Commission’s support to projects which have allowed to develop new diagnostic tests, novel antimicrobial therapies and new strategies for rational use of antibiotics in human medicine, food producing animals and aquaculture.
Professor David Leaper, Emeritus Professor of Surgery, University of Newcastle upon Tyne, pointed out the urgency to return to the use of antiseptics for prevention and treatment of surgical site infection. Definitions, surveillance and compliance are required to prevent surgical site infection. Antiseptics do offer an alternative in many areas and, therefore, research is needed. In his opinion “Using the right antimicrobial at the right time, dose and duration is fundamental to reduce the impact of bacteria and in infection treatment”.
Ms Marja Esveld, Senior Advisor Global Health and Innovation at the Department of International Affairs within the Ministry of Health of the Netherlands shared a tangible example of how AMR can be tackled at the national level. The Dutch National Plan aims at reducing avoidable healthcare-associated infections by 50% and incorrectly prescribed antibiotics across the entire healthcare chain by at least 50%. Already, several business cases showed cost-effectiveness of the antimicrobial policy. Either by improving adequate use of antimicrobials or by improving adherence to infection control measures. Antimicrobial policies needed initial investments. Nonetheless, all business cases showed high return of investment and short pay back circles (e.g. less use of restricted antimicrobials, shorter length of stay, less healthcare personnel needed). More importantly, patient health and patient safety improved considerably.
Participants also raised the importance of screening patients for infections before entering hospitals, investing in and incentivising diagnostic tests to prevent antibiotic misuse, investing in new vaccines 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 AMR has become a public health threat with a very high position in the national, European and international political agenda, there is still much more to be done. Antibiotic consumption has increased in several EU Member States since 2013 and half of the EU citizens are not aware that antibiotics are ineffective to treat cold and season flu.
It is critical to work together at a local, national, European and global level. Bacteria do not know borders. Infection prevention is a key element to reduce antibiotic consumption. It is important to encourage and support Member States to put in place and monitor national targets for the surveillance and reduction of AMR/HAIs through holistic action plans under a “One Health approach”. Last but not least, patient empowerment is a key challenge. It has been proven that antibiotic consumption decreases as knowledge increases.