Scottish report shows 5-year decline in human antibiotic use
A report today from Scotland highlights reduced antibiotic use in the country since it adopted a One Health approach to combatting antimicrobial resistance (AMR).
The report, from Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, shows that total antibiotic use in people was 19.2 defined daily doses per 1,000 population per day in 2020, a 17.1% reduction since 2016. The report notes that the 11.8% reduction from 2019 to 2020 likely reflects the impact of the COVID-19 pandemic, which affected antibiotic use in all healthcare settings.
The vast majority of antibiotic use (84.2%) in Scotland in 2020 occurred in primary care settings, while acute care hospitals accounted for 13.2% and non-acute hospitals for 2.6%. Antibiotic use in primary care fell by 20.9% from 2016 to 2020, but rose by 2.3% in acute care settings, despite a decline in use during the pandemic.
"Access" antibiotics—the antibiotics classified by the World Health Organization (WHO) as first-line treatments for common infections—accounted for 61.2% of all antibiotics used in people in 2020, and 76.8% of all antibiotics dispensed in primary care. Use of Watch and Reserve antibiotics, which are broad-spectrum drugs that the WHO recommends should be restricted to more severe, drug-resistant infections, fell by 10.4% in acute care settings since 2016.
Surveillance data show that gram-negative bacteria continue to be a common cause of serious infections in both healthcare and community settings in Scotland, with Escherichia coli accounting for most drug-resistant infections. Nearly a quarter of E coli bacteremia cases in Scotland in 2020 were resistant to one or more key antibiotics.
On the animal side, the report shows that the percentage of companion animal veterinary consultations that resulted in an antibiotic prescription was 16.2% in 2020, down from 19.2% in 2016. Scotland is still in the process of developing systems to collect data on antibiotic use in livestock.
"Tackling AMR, which has been described as a slow burning pandemic, remains vitally important," the report states. "Sustained action to preserve antibiotics and reduce drug resistant infections is crucial to secure the future delivery of healthcare through and beyond the COVID-19 pandemic."
Nov 16 ARHAI Scotland report
Africa CDC issues antibiotic treatment guidelines for common infections
The Africa Centres for Disease Control and Prevention (Africa CDC) and the Center for Disease Dynamics, Economics & Policy (CDDEP), based in Washington, D.C., last week published the first edition of Africa-specific guidelines for antibiotic treatment of common bacterial infections.
Developed by an interdisciplinary panel of infectious disease clinicians, pharmacists, and public health experts, the guidelines aim to provide African healthcare workers with expert recommendations on antimicrobial selection, dosage, and duration of treatment for common bacterial infections and syndromes in African adults and children. They are designed to promote appropriate use of antimicrobials to limit the spread of drug-resistant pathogens.
They're based on a systematic review of existing national treatment guidelines, available AMR data, and expert opinion, and are intended to complement existing national and international clinical guidelines.
Africa CDC notes that the guidelines fill a long-existing gap. With the exception of infectious diseases like HIV, tuberculosis, and malaria, many countries in Africa lack guidelines that define appropriate treatment for common infections, and healthcare providers often have to rely on their own judgment or guidelines developed outside of Africa.
The agency says it hopes the guidelines serve as a standardized model for other jurisdictions or healthcare facilities in Africa to develop their own guidelines.
Nov 12 African Antibiotic Treatment Guidelines
Nov 12 CDDEP blog post
