AMR

What is AMR?

Antimicrobial resistance is the broader term for resistance in different types of microorganisms and encompasses resistance to antibacterial, antiviral, antiparasitic and antifungal drugs.

Antimicrobial resistance occurs naturally but is facilitated by the inappropriate use of medicines, for example using antibiotics for viral infections such as cold or flu, or sharing antibiotics.

The burden of AMR

Resistance to antimicrobials (AMR) is a complex and growing, international public health problem. [1, 2] Globally, infections with resistant microorganisms are estimated to kill hundreds of thousands of people every year. An often cited but also criticized scenario suggests that by 2050 that figure could be more than 10 million. The economic cost will also be significant, with the world economy being hit by up to $100 trillion by 2050 if we do not take action. [1]

Policies on AMR

Formal policies on the global, regional and national level most often use six strategies to reduce antibiotic use:

  1. Infection prevention and control of resistant bacteria;
  2. Monitoring of both infection prevention and control of resistant bacteria;
  3. Research on antibiotic resistance and antibiotic use;
  4. Appropriate use of antibiotics (e.g. not for viral infections);
  5. Less antibiotic use (e.g. delayed prescription and alternatives); and
  6. Development of new antibiotics. [3]

However, currently these strategies appear to be insufficient, as for example demonstrated by the unchanged average European consumption rates of antibiotics during the years 2011 – 2014. [4] European statistics also show that there are significant differences between European countries which are not related to geographic or natural conditions and can only be explained by socio-economic factors (policies, values, competencies, …). [5] For example, in the UK in 2015, for the first time fewer antibiotics were being prescribed by GPs and clinicians across all healthcare settings than in 2014. [6] Nevertheless, the latest “EARS-Net data for 2016 show that antimicrobial resistance remains a serious threat to public health in Europe”. [7]

References

[1] O’Neill, J., Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance 2016. Publications. html.

[2] EMA. Antimicrobial resistance. 2017; Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/special_topics/general/general_content_000439.jsp.

[3] World Health Organization, Global action plan on antimicrobial resistance. 2015. ISBN, 2017. 978(92): p. 4.

[4] Smith, E., et al., Evaluation of the EC action plan against the rising threats from antimicrobial resistance. 2016.

[5] Gaygısız, Ü., T. Lajunen, and E. Gaygısız, Socio-economic factors, cultural values, national personality and antibiotics use: A cross-cultural study among European countries. Journal of infection and public health, 2017. 10(6): p. 755-760.

[6] Hopkins, S. and A. Johnson, English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) 2016. 2016.

[7] ECDC. Summary of the latest data on antibiotic resistance in the European Union. 2017; Available from: https://ecdc.europa.eu/en/publications-data/summary-latest-data-antibiotic-resistance-european-union