EU needs patient-centred approach to tackling AMR
Educating patients is essential in the fight against antimicrobial resistance, but the pharmaceutical industry also has a role to play, writes Piernicola Pedicini.
Each year in the EU, 25,000 people die of infections caused by antibiotic-resistant bacteria. According to a recently published study, "drug resistant infections will kill an extra 10 million people a year worldwide - more than currently die from cancer - by 2050, unless action is taken".
A major reason for this is that all around the world, people incorrectly - and often excessively use antibiotics. Additionally, drug development in the field of antimicrobial medicines is stagnant.
Therefore, globally effective measures are urgently required. One such measure is an investment on the part of the pharmaceutical industry into the 'real development' of new antimicrobial drugs, alongside investments in alternative, natural methods to fight antibiotic resistance.
- Richard Bergström: Industry to work together to fight antimicrobial resistance
- Andrea Ammon & Dominique Monnet: More needs to be done to tackle the spread of antimicrobial resistance
- Dutch presidency: 'One health' approach crucial to fighting antimicrobial resistance
- Christel Shaldemose, Annicka Engblom and Christina Gestrin: Antibiotic resistance 'threat to human health'
In my report, 'Safer healthcare in Europe: improving patient safety and fighting antimicrobial resistance', adopted by Parliament last May, I addressed this grave topic, as well as the serious need for increased healthcare safety throughout Europe.
In this respect, I believe it is crucial to stress the importance of a 'patient-centred' approach, coupled with innovative interdisciplinary strategies, so that doctors are educated and trained to deliver the best medical treatments currently available.
The implementation of disease prevention measures is paramount in reducing healthcare associated infections and antibiotic resistance.
One of my proposed measures included the need to regulate the prescription of antibiotics for treatment or prophylaxis, so that an appropriate use of antibiotic medicines is assured.
Additionally, antibiotics should be used only for the correct indications, at the correct dose and for the shortest duration possible, as recommended by evidence-based guidelines.
Also, regulations and restrictions are required on the sale of antibiotics, so that patients can only purchase antibiotics that have been prescribed for them by a medical doctor.
This strategy will help save money for patients (antibiotics do not work against viral or fungal infections) and ultimately, help reduce the growing prevalence of antibiotic resistance in countries where antibiotics are available without a medical prescription.
In some countries like Italy, patients buying antibiotics are allowed to purchase a complete packet of tablets, which usually contains more than the exact number of pills prescribed by their doctor.
This means that patients may use antibiotics unnecessarily, or may store leftover antibiotics for future use without a medical prescription. It is essential for patients to adhere to 'best prescribing practices' when using antibiotics and comply with the advice given to them by medical professionals.
Importantly, both medical professionals and patients should be made aware of the limitations and correct use of antibiotics, possibly via healthcare awareness campaigns aimed at the rational use of antibiotics and explaining the serious risks involved in increasing worldwide antibiotic resistance.
Such campaigns should particularly target the parents and carers of young children, as well as elderly people, and data should be collected regarding the outcomes of these campaigns.
With respect to international and cross-border perspectives, an increased and intensified screening process for patients during their transfer from a country, region or hospital known for its high prevalence of multidrug-resistant (MDR) bacteria, to a country, region or hospital of low prevalence of MDR bacteria, would allow effective, international, infection control measures to be implemented.
In my report, I also expressed my strong concern about the budget cuts in the healthcare systems of some member states following the recent economic crisis. Instead, we should be investing in educating and training medical personnel and the general public.
Many healthcare associated infections, including those caused by MDR bacteria, are due to the bad management of healthcare facilities.
Managers should be appointed on the basis of their merits and professional experience and not on the basis of their political affiliations.
Another very important aspect for defeating antibiotic resistance is the monitoring and control of the use of antibiotics in animals, especially the use of antibiotics as growth promoters or as prophylactic drugs to prevent infections. There is growing evidence relating antibiotic use in animals to antibiotic resistance in humans.
I am strongly committed to the fight against antimicrobial resistance and, within the framework of the European Parliament's STOA MEP-scientist pairing scheme, recently invited John Hays (who has been involved in six European funded projects related to antibiotic resistance) from the Erasmus University Medical Centre Rotterdam in the Netherlands, to update me on the latest trends relating to the fight against antibiotic resistance.
The scheme allows MEPs to receive expert scientific support during the development of a wide range of European policies relating to the health and future prosperity of European citizens.
There is a weak correlation between animal consumption of antibiotics and human resistance, argues Rick Clayton.
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