European Antibiotics Awareness Day: 18 November 2008

The European Centre for Disease Control (ECDC) is coordinating this day in partnership with the European Commission; National AMR focal points; the World Health Organisation (WHO); the European Society of Clinical Microbiology and infectious diseases (ESCMID) and the Standing Committee of European Doctors (CPME).

Antibiotic resistance is widespread in Europe and is an issue of the utmost importance.

The European Antibiotics Awareness Day follows the publication of the first annual epidemiological report on communicable diseases in Europe, which shows a sharp upward trend in antibiotic resistance across Europe.

Antibiotic Resistance

What is it? When microbes and bacteria are treated with an antibiotic they will be killed. However this bacteria or microbe may have acquired resistance or may have an inherited resistance to the drug that is being used to kill it. Bacteria and microbes divide and multiply very quickly (in perfect growing conditions some can divide every 20 minutes). This rapid division leads to rapid evolution and adaptation to the environment. If there is a large quantity of an antibiotic circulating in a population, the adaptation to this high antibiotic environment will happen very quickly. If an antibiotic or antimicrobial is over used, it will lead to more resistance and the drugs will become less effective.

Why is it a problem? As antibiotics are produced, they have a certain effectiveness period before resistance takes hold and the drugs become more-or-less ineffective. The more an antibiotic is used, the shorter this effectiveness period is. Drug development is on the decrease and antibiotic resistance is on the increase - this paradox increases the morbidity and mortality from previously treatable illness.

Antibiotics and antimicrobials are used in almost every type of medicine carried out in hospital today - from hip replacements to chemotherapy and from organ transplants to post-trauma intensive care. Antibiotics are used more in hospitals than anywhere else. The increase of healthcare-associated infections (HCAI) is largely attributable to antibiotic resistance, approximately 4 million per year - more than 35 000 deaths (EU-25). It does not stop at drug resistant bacteria: multidrug-resistant bacteria account for half of the HCAI attributable deaths. MDR bacteria such as methicillin-resistent staphylococcus aureus (MRSA) are resistant to all but a handful of still-effective antibiotics such as Vancomycin.

Bacteria have, in some cases, acquired even more resistance. There are now cases of extensively drug resistant bacteria (XDR). XDR tuberculosis (TB), first described in 2006, has been growing in frequency in the last few years across the world, now several cases have been reported in Europe. There is no antibiotic that can cure XDR-TB. With drug development dropping off, and only a few drugs undergoing clinical trials a disease that we thought we had destroyed in the 1950s is now more virulent than ever due to over use of antibiotics.

What can be done? Inappropriate use of antibiotics has caused this problem and not just doctors over-prescribing drugs, but the general public over-using drugs. Antibiotic resistance is everyone’s problem so it is everyone’s responsibility to keep antibiotics effective. Creating new drugs to combat the growth of resistant, MDR and XDR bacteria is only one side of the problem, if these drugs are not prescribed responsibly or taken with due consideration, then this problem only worsen.

The European Antibiotics Awareness Day

The aim of the European Antibiotics Awareness Day, as part of a year long campaign, is to ensure that the general public are aware of the issues. The general public need to be informed about:
 When to take antibiotics
 How to take antibiotics
 Why responsible use is important

There will be a major press event in the European Parliament on 18 November 2008 and the ECDC will continue to coordinate actions on national campaigns with national focal points on antimicrobial resistance and national chief medical officers. Measures have been taken with the European institutions to ensure antibacterial resistance is high on the political agenda.

The day and campaign has three key messages:
 Keeping antibiotics effective is everybody’s responsibility
 Cold? Flu? Get well without antibiotics!
 Take antibiotics responsibly!

Antibiotic Resistance is an issue that is underestimated and needs to be taken more seriously. The ECDC’s initiative is an excellent opportunity to raise awareness and force people to take stock of the rapidly emerging problem.

For more information

Visit the Antibiotics awareness website

To read the WHO’s opinions and comment on drug resistance please click here

For WHO Europe’s Drug resistance pages click here

For the EPHA Press release please click here

EPHA related articles

 European Parliament addresses antibiotic resistance
 Deadly new form of MRSA emerges
 Tackling antimicrobial resistance: EU Member States must do more