Joint European report calls for more action on antimicrobial resistance
A new joint report on antimicrobial resistance (AMR) in European Union/European Economic Activity (EU/EEA) countries is calling for concerted action to address the problem from a One Health perspective.
The report from the European Centre for Disease Prevention and Control (ECDC), the European Food Safety Agency (EFSA), the European Medicines Agency (EMA), and the Organisation for Economic Co-operation and Development (OECD) notes that there have been encouraging trends in human and animal antibiotic use across Europe over the past decade. From 2011 through 2020, antibiotic consumption in humans in EU/EEA countries fell by 23%, while animal antibiotic consumption fell by 43% in 25 European nations with consistent reporting.
In addition, EU/EEA countries have made major strides in developing and implementing national AMR action plans.
Resistance to commonly used antibiotics in bacteria from food-producing animals, however, remains high (>20% to 50%) or very high (>50% to 70%), with significant variation across the continent, while resistance to critically important antibiotics in healthcare-associated pathogens continues to climb. And the declines in human and animal antibiotic use vary widely as well. In addition, the evidence that AMR can spread between humans, animals, and the environment continues to mount, and significant gaps remain in implementation of national AMR action plans.
"AMR cannot be contained within borders or regions, underlining the need for concerted action throughout the EU/EEA," the report states.
To continue making progress, the report urges EU/EEA countries to prioritize monitoring and evaluation of national action plan implementation, integrate and expand surveillance of drug-resistant bacteria in humans, animals, and the environment, and invest in antimicrobial stewardship and infection prevention and control programs.
The report also recommends that a forthcoming EU policy initiative to boost implementation of the EU One Health Action Plan against AMR should promote innovative economic models and incentives for new antibiotics, diagnostics, and vaccines; target antibiotic consumption in nursing homes; and establish a system to promote implementation of best practices to tackle AMR.
Mar 7 ECDC/EFSA/EMA/OECD joint report
Canadian hospital surveys show rise, stabilization of antimicrobial use
Point-prevalence surveys of sentinel acute-care hospitals in Canada suggest that antimicrobial use over a 15-year period stabilized following a sharp increase, Canadian researchers reported today in Infection Control & Hospital Epidemiology.
The surveys were conducted by the Canadian Nosocomial Infection Surveillance Program in 2002, 2009, and 2017 during a 24-hour period in February of each year to identify trends in antimicrobial use in acute care. Patients were eligible if they were admitted for 48 hours or more or if they had been admitted to the hospital within a month. Twenty-eight to 47 hospitals participated in each survey.
In 2002, 2,460 of 6,747 patients (36.5%) at surveyed hospitals received one or more antimicrobials. In 2009, the proportion of patients receiving one or more antimicrobial climbed to 3,566 of 8,902 patients (40.1%). In 2017, 3,936 of 9,929 patients (39.6%) received one or more antimicrobial. Overall, the prevalence of antimicrobial use increased 9.9% from 2002 to 2009 but remained stable (a 1.1% decrease) from 2009 to 2017. In a secondary analysis of the 18 hospitals that participated in all three surveys, the prevalence of antimicrobial use was similar to the primary analysis.
Among patients who received one or more antimicrobials, penicillin use increased 36.8% from 2002 to 2017 and third-generation cephalosporin use increased from 13.9% to 18.1%. Over the same period, fluoroquinolone use declined by 36.5% and clindamycin use decreased by 62.5%. Carbapenem use increased by 57.6% from 2002 to 2009, then by 4.8% from 2009 to 2017.
The authors say the stabilization of antimicrobial use coincided with an increased focus on antimicrobial stewardship in Canadian hospitals since the mid-2000s.
"Further studies are needed to examine the appropriateness of antimicrobial use, as part of a coordinated approach to prevent the emergence and spread of antimicrobial resistance," the authors write.
Mar 7 Infect Control Hosp Epidemiol study