Europe's response to the problem of antibiotic shortage

Posted Feb 25, 2012 by Tim Sandle
The issues of antibiotic shortage and growing resistance of many microorganisms to antibiotics is a significant global health issue. Strategies to tackle this issue have varied worldwide.
European Union wide data published by the European Centre for Disease Prevention and Control (ECDC) on antibiotic resistance has shown that resistance to last-line antibiotics is increasing in Europe (last-line refers to the fact that many bacteria are now resistant to the older generation of antibacterials; last-line refers to the last set of effective antibiotics available). Resistance by pathogens which frequently cause pneumonia and urinary tract infections in hospitals is increasing across the EU and is now established in several countries. These are the 'super bugs' (or multidrug resistant bacteria).
Many bacteria have become resistant to antibiotics through the widespread (some would say overuse) of antibiotics. It is well established that exposing bacteria to the right antibiotics kills most of them. However, the antibiotics course often leaves a few mutants behind that happen to resist the drug better than the rest. These mutants go on to multiply, and, over the course of many years and between many people, eventually the whole strain evolves resistance. Scientists have got round this by developing new generations of antibiotics. The problem now facing the world is that the latest generation may be the last, at least it is becoming increasingly difficult to formulate new antibiotics.
With Europe, the European Centre for Disease Prevention and Control (ECDC) has recently announced a strategy to tackle this issue.
According to the ECDC director, Dr. Marc Sprenger:
"The goal of this Europe-wide health initiative is to support national campaigns on prudent use of antibiotics. Overuse of antibiotics, both in hospitals and in the community, is one of the major drivers of drug resistance in bacteria. ECDC collects EU-wide data on these resistant bacteria, mostly from laboratories testing blood samples taken in hospitals. New data, released by ECDC today, shows that antibiotic resistance is increasing across the EU."
This has lead to a five year plan to address antibiotic issues. The key steps of the plan, displayed on the European Commission website, are:
a) Improve awareness raising on the appropriate use of antimicrobials
b) Strengthen EU law on veterinary medicines and on medicated feed
c) Introduce recommendations for prudent use of antimicrobials in veterinary medicine
d) Strengthen infection prevention and control in hospitals, clinics, etc.
e) Introduce legal tools to tighten prevention and control of infections in animals in the new EU Animal Health Law
f) Promote unprecedented collaboration to bring new antimicrobials to patients
g) Promote efforts to analyse the need for new antibiotics in veterinary medicine
h) Develop and/or strengthen multilateral and bilateral commitments for the prevention and control of AMR
i) Strengthen surveillance systems on AMR and antimicrobial consumption in human medicines
j) Strengthen surveillance systems on AMR and antimicrobial consumption in animal medicines
k) Reinforce and co-ordinate research
l) Improve communication on AMR to the public.
The purpose of the ECDC's focused is summarized in a press release:
"For a large part, antibiotic resistance is being driven by misuse of antibiotics in humans and animals. According to the latest data released by ESAC (European Surveillance of Antimicrobial Consumption), the vast majority of human consumption of antibiotics occurs in the community. Resistance to last-line antibiotics like the carbapenems, however, cannot be explained only by the use of antibiotics outside hospitals. Studies show that 50% of all antibiotic use in hospitals can be inappropriate. Prudent use of antibiotics is paramount to prevent and control resistant bacteria. Additionally, compliance with good hand hygiene by healthcare workers is the most effective way to prevent the spread of infections in hospitals. Finally, there is a particular lack of new antibiotics with new targets of mechanisms of action, in particular against carbapenem-resistant Gram-negative bacteria."
Hopefully the strategy will be a success.