Public misconceptions about antibiotic resistance are among the obstacles in battling the problem, according to a World Health Organization (WHO) survey released today, part of week-long coordinated global effort to raise awareness about the threat.
As part of a global action plan to address antibiotic resistance, passed by the World Health Assembly in May, the WHO launched the first World Antibiotic Awareness Week, with the theme "Antibiotics: Handle with Care." Several other countries and regions are also devoting this week to antibiotic resistance awareness. The European Union, the United States, Canada, Australia, New Zealand, and Japan are among the groups coordinating their campaigns.
The White House has proclaimed this week as "Get Smart About Antibiotics Week," one of several federal efforts over the last 2 years to address the issue. At a federal forum in June, 150 organizations pledged to improve antibiotic use and slow the spread of resistance to the drugs. Walmart, for example, created educational videos on antibiotic resistance that its customers see while waiting in checkout lines. And on Nov 18, a Pew Charitable Trust coalition called "Supermoms against Superbugs" will host a briefing on Capitol Hill.
Other groups have used this weeks' observance to release more hard data about the problem. The European Centre for Disease Prevention and Control (ECDC) today highlighted a new survey showing an increasing spread of carbapenemase-producing Enterbacteriaceae (CRE). Today is the eighth annual European Antibiotic Awareness Day.
Survey reveals communications gaps
In a statement today, the WHO said its survey will help the organization identify gaps in the public's understanding of the problem and address them in antibiotic resistance campaigns.
At a media briefing today to unveil the survey findings, Margaret Chan, MD, MPH, the WHO's director-general, said the world is danger of losing its first-line antibiotics. "Superbugs haunt hospitals and ICUs [intensive care units] all around the world, and even with the best care, only about 50% of multidrug-resistant tuberculosis cases can be cured."
She said if current antibiotic resistance trends continue, medical care could become more difficult and dangerous, spelling the end of modern medicine as we know it.
The WHO survey included a set of basic questions about antibiotic resistance, questioning 10,000 people from 12 different countries, reflecting all of the world's regions. In some countries such as Barbados, Egypt, Nigeria, and Serbia, the interviews were done fact-to-face. An online survey format was used for other countries, such as China, India, and Indonesia.
At the media briefing, Keiji Fukuda, MD, the director-general's special representative for antimicrobial resistance, said getting to the heart of people's knowledge about antibiotic resistance is important, because getting people to change their perceptions and behaviors is fundamental to solving the problem.
He said the good news is that about two thirds of the respondents know that antibiotic resistance could affect them or their families. Also, the survey found that 73% thought that farmers should give fewer antibiotics to food-producing animals.
He said, however, that the findings revealed several misconceptions. About three-quarters (76%) said they thought antibiotic resistance occurred when the body becomes resistant to the drugs, when in reality, it's the bacteria that become resistant and can cause infections that are hard to treat.
Survey results also showed that 64% of respondents thought antibiotics could be used to treat illnesses that they're not indicated for, and about a third said it's okay to stop taking their prescribed antibiotic once they start feeling better, Fukuda noted that taking the full course makes an individual's use least likely to contribute to resistance.
Another key misconception that the survey revealed was that 57% of participants didn't feel there was much they could do to help solve the problem. "This is very much not true," Fukuda said. "Everybody has a role." For example, he said patients can ask their doctors if they really need prescribed antibiotics, and if the answer is yes, then patients can help by taking the full course as prescribed.
"Antibiotics are a global good that we need to handle with care. We believe everybody has a critical role to play in turning this around," Fukuda said.
ECDC: Worrying CRE signals
In a survey on CRE patterns among EU hospitals, meanwhile, researchers learned that facilities in three countries are repeatedly seeing patients who can't be treated with capbapenems, the last-line antibiotic group. CRE are thought to pose a greater risk than methicillin-resistant Staphylococcus aureus (MRSA), are resistant to nearly all antibiotics, have a high mortality rate when linked to invasive infections, and can spread their resistance genes to other bacteria in the body.
The ECDC said in a press release that the CRE situation continues to worsen, now that eight countries are reporting interregional spread and three are reporting endemic spread—meaning hospitals there are repeatedly detecting it.
An encouraging finding, however, was that the national capacity for containing CRE spread is increasing in the EU.
Vytenis Andriukaitis, MD, European commissioner for health and food safety, said in the statement that the survey results show that the antibiotic resistance threat is growing day by day. "If left unchecked, it has the capacity to turn the clock back on medicine by a hundred years."
Alongside the CRE survey data, the ECDC also released the latest findings from its antibiotic resistance and consumption networks. Resistance levels continue to climb for most bacteria and antibiotics in the tracking system, except for MRSA, the agency said.
For the first time the data reveal a significant drop on antibiotic consumption in five countries: Denmark, Luxembourg, Slovenia, Spain, and Sweden. The ECDC noted, though, that overall carbapenem use in hospitals is still on the rise.
Nov 16 WHO press release
Nov 16 WHO antibiotic resistance survey
Nov 16 WHO press conference audio file
Nov 16 ECDC press release
Nov 16 US Centers for Disease Control and Prevention press release on antibiotic resistance week