Members of the European Parliament yesterday adopted a resolution to help tackle antimicrobial resistance (AMR).

The resolution, which was passed with 525 votes in favor, 2 against, and 33 abstentions, calls on European Union (EU) nations to implement and regularly update National Action Plans against AMR and to improve data collection on drug-resistant pathogens and antibiotic consumption. The resolution recommends a 20% cut in human antibiotic consumption by 2030, with at least 70% of the antibiotics consumed in human healthcare belonging to the "Access" group as defined by the World Health Organization (WHO) AWaRE (Access, Watch, and Reserve) classification system.

The resolution also asks EU member states and the European Commission to support prudent use of antibiotics in animals, good infection prevention and control measures, more research into the development of novel antibiotics and antibiotic alternatives, and sharing of research data.

Parliament members agreed that if the recommended measures prove insufficient to address AMR, which the EU has labeled a top three priority health threat, further legislative would be needed.

Surveillance data released in April by the European Centre for Disease Prevention and Control and the WHO showed high resistance to last-line antibiotics, particularly in countries in southern and eastern Europe. Previous EU estimates suggest 670,000 infections each year on the continent are caused by resistant bacteria, and 33,000 people die as a result of those infections.

A team of US researchers reported benchmarking data for outpatient prescribing in pediatric settings yesterday in the Journal of the Pediatric Infectious Diseases Society.

For the study, institutions from the Sharing Antimicrobial Reports for Pediatric Stewardship OutPatient (SHARPS-OP) Collaborative were invited to contribute quarterly aggregate reports on outpatient oral antibiotic prescriptions in patients under 20 years of age from January 2019 through June 2022. Outpatient settings included emergency departments (EDs), urgent care centers (UCCs), primary care clinics (PCCs), and telehealth encounters. Each institution then received a benchmark report comparing their institution with the others that provided data.

Benchmarking metrics included the percentages of all acute encounters resulting in an antibiotic prescription, acute respiratory infection (ARI) encounters resulting in an antibiotic prescription, encounters resulting in an amoxicillin prescription (the "amoxicillin index"), and encounters resulting in an azithromycin prescription (the "azithromycin index"). The researchers also collected rates of antibiotic courses that were 7 days or shorter and 10 days or shorter.

Overall, antibiotics were prescribed in less than one fifth of all acute encounters. Antibiotic prescribing for ARI varied between settings, with the highest rates observed in UCCs (40.2%) and the lowest in telehealth (19.1%), though there was substantial variation in prescribing for ARI encounters via telehealth. The amoxicillin index was highest for EDs (76.2%) and lowest for telehealth (55.8%), while the azithromycin index was similar for EDs, UCCs, and PCCs (3.8%, 3.7%, and 5.0% respectively). Antibiotic duration of 7 days or less also varied substantially (46.4% for EDs, 27.8% for UCCs, 23.7% for telehealth, and 16.4% for PCCs).

We will continue to collect and report quarterly antibiotic use to trend over time, with the goal of identifying high-performers and potential 'appropriate' levels for our metrics.

The study authors say they hope to use the benchmarking data to develop national standards for pediatric ARI prescribing.

"We will continue to collect and report quarterly antibiotic use to trend over time, with the goal of identifying high-performers and potential 'appropriate' levels for our metrics, and empowering institutions with data to develop approaches to reduce inappropriate antibiotic use in the patients cared for at their institutions," they wrote.

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