European Antibiotic Awareness Day, 18th November 2013

Introduction

European Antibiotic Awareness Day, 18th November 2013

Existing evidence confirms that the more we use antibiotics the more selection of resistant organisms occur and this alongside a scarcity in development of new antibiotics means our expectations for future healthcare will require new approaches and changes in attitudes, behaviours and beliefs about antibiotic use.

We have built a healthcare system on the expectation that antibiotics will prevent or control infection but with increasing AMR this is no longer the case and with a need to conserve existing antibiotics we will need to concentrate on embedding best infection prevention and control practice and antibiotic stewardship in both human and animal healthcare.

There is also a need to educate the general public globally, that antibiotics are not necessary for most simple self limiting infections which can also be prevented from spreading by simple self help actions and hygiene discipline

Publication of the “UK Five Year Antimicrobial Resistance Strategy (AMR) 2013 to 2018” with the UK devolved administrations identifies many of the priorities to be addressed and includes a call to action in an effort to address the increasing problem of AMR

The strategy acknowledges that AMR is a global problem and that international partnerships need to be strengthened if the threat is to be understood and reduced.

The overarching goal of the strategy is to slow the development and spread of AMR and has three strategic aims: -

  • 1. To improve knowledge and understanding of AMR
  • 2. To conserve and steward the effectiveness of existing treatments
  • 3. To stimulate the development of new antibiotics, diagnostics and novel therapies

These three aims will be underpinned by seven key areas informed by the 2011 EU AMR Strategic Action Plan and recommendations set out in the Chief Medical Officers Annual report 2012

The organisations who will lead the work programmes are the Department of Health, Department for the Environment, Food and Rural Affairs (DEFRA) and Public Health England

The UK’s commitment to tackle AMR will focus on 7 key areas for future action: -

  • 1. Improving infection prevention and control practices in human and animal health, both through enhanced dissemination and implementation of best practice and better use of surveillance data and diagnostics
  • 2. Optimising prescribing practice through implementation of antimicrobial stewardship programmes that promote rational prescribing and better us of existing and new rapid diagnostics
  • 3. Improving professional education, training and public engagement to improve clinical practice and promote wider understanding of the need for more sustainable use of antibiotics
  • 4. Developing new drugs, treatments and diagnostics through better collaboration between research councils, academia, industry and others; and by encouraging greater public-private investment in the discovery and development of a sustainable supply of effective new antimicrobials, rapid diagnostics, and complementary tools for use in health, social care, and veterinary systems
  • 5. Better access to and use of surveillance data in human and animal sectors through new arrangements that facilitate greater consistency and standardisation of the data collected across the system and encourage improved data linkage
  • 6. Better identification and prioritisation of AMR research needs to focus activity and inform our understanding of AMR. This may identify alternative treatments to new drugs as well as new or improved rapid or point-of-care diagnostic tests for humans and animals
  • 7. Strengthened international collaboration working with and through a wide range of governmental and non-governmental organisations, international regulatory bodies and others to influence opinion, galvanise support, and mobilise action to deliver the scale of change needed globally


To meet the challenges ahead the programme will require a wide range of public and private sector bodies to help deliver this integrated programme to safeguard human and animal health. It will also require co-operation and re-education of the general public to change behaviour and expectations in antibiotic customs, locally, nationally and internationally

Useful References

UK Five Year Antimicrobial Resistance Strategy 2013 to 2018

Annual Report of the Chief Medical Officer Volume Two, 2011 Infections and the rise of antimicrobial resistance

TARGET Antibiotics toolkit

European Antibiotic Awareness Day is marked annually on 18 November.

EU AMR Strategic Action Plan

The chain of infection transmission in the home and everyday life settings, and the role of hygiene in reducing the risk of infection

ESBLs – A threat to human and animal health? Report by the Joint Working Group of DARC and ARHAI.

AMR Factsheet for experts – ECDC

Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins. de Kraker ME, et al J Antimicrob Chemother. 2011 Feb;66(2):398 - 407. Epub 2010 Nov 23

Strategy for Tackling Antimicrobial Resistance (STAR) 2012 – 2017

Antimicrobial Resistance Programme in Wales

WHO’s European strategic action plan on antibiotic resistance, 2011.

The Path of Least Resistance Main Report Standing Medical Advisory Committee (SMAC). Sub-group on Antimicrobial Resistance. 1998.

Antimicrobial stewardship: Start smart - then focus

The World Organisation for Animal Health (OIE)strategy/Terrestrial Animal Health Code 2013

Edugame4all

e-bug EU

Showcase Hospitals Local Technology Review Report number 6 - Smartphone application for antibiotic prescribing

ESBL’s – A threat to human and animal health?

The Urgent Need: Regenerating antibacterial drug discovery development - Report of the British Society for Antimicrobial Chemotherapy Initiative

NDM-1 — A Cause for Worldwide Concern

The English antibiotic awareness campaigns: did they change the public's knowledge of and attitudes to antibiotic use?

Code of Professional Conduct for Veterinary Surgeons, 2012, Royal College of Veterinary Surgeons.

Defra Antimicrobial Resistance in Animals Policy Statement

The true cost of antimicrobial resistance. BMJ 2013;346:f1493. Smith R, Coast J.

Responsible Use of Medicines in Agriculture Alliance (RUMA)

G8 science ministers written statement from their UK meeting on international issues that need global cooperation June 2013.

Expectation for consultations and antibiotics for respiratory tract infection in primary care; the RTI clinical iceberg. (Cliodna AM McNulty, Tom Nichols, David P French, Puja Joshi and Chris C Butler).BJGP July 2013 Vol 63 No 612.

Stemming the Tide of Antibiotic Resistance, STAR - Visiting the STAR Educational Program.