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Antimicrobial Resistance - guide

17 November 2011
by eub2 -- last modified 17 November 2011

With about 25,000 patients dying per year in the EU from infections caused by drug resistant bacteria and related costs of over 1.5 billion euros in healthcare expenses and productivity losses , antimicrobial resistance is a growing health problem in the EU. Today, on the eve of European Antibiotic Awareness Day, the European Commission tabled a comprehensive Action Plan on Antimicrobial resistance (AMR) which unveils12 concrete actions to be implemented in close cooperation with the EU Member States.


What are antimicrobial agents and antibiotics?

Antimicrobial agents are substances produced synthetically and also naturally by bacteria, fungi or plants. They are used to kill or inhibit the growth of micro-organisms, including bacteria, viruses, fungi, and parasites. They can be used for a variety of purposes: to treat or prevent infections in humans and animals, to disinfect, to maintain hygiene, to preserve products, etc.

Antibiotics are probably the best known antimicrobial agents. They are medicines used to treat bacterial infections. There are more than 15 different classes of antibiotics that differ in their chemical structure and their action against bacteria. An antibiotic may be effective against only one or multiple types of bacteria.

What is antimicrobial resistance (AMR)?

Antimicrobial resistance (AMR) occurs when micro-organisms develop mechanisms that render antimicrobials less effective or ineffective.

Specific antibiotics are no longer able to kill or prevent the growth of certain bacteria. These bacteria have become resistant as a result of genetic changes. Other bacteria are naturally resistant to certain antibiotics.

Over the past few decades, irresponsible and incorrect use of antibiotics in human and veterinary medicines and the lack of new effective medicines have accelerated this trend.

Why is the Action Plan on AMR important?

AMR is a serious, worldwide, public health concern for both humans and animals. Of particular concern is antibiotic resistance. When commonly used antibiotics are no longer effective, doctors have to choose others which may lead to delays in getting the right treatment to patients. More worryingly, it may result in complications such as hospitalisation, and even death. AMR undermines the ability of health systems to treat and cure patients.

AMR is also a serious economic burden for EU countries. The European Centre for Disease Prevention and Control (ECDC) estimates that AMR costs €1.5 billion per year in the EU, for additional healthcare and loss of productivity. Inappropriate use of antimicrobial agents, such as treating viral infections with antibiotics, adds to this financial burden as it leads to reimbursement for medicines that should not have been taken in the first place.

The threat of AMR is becoming more serious. New EU-wide surveillance data from the European Antimicrobial Resistance Surveillance Network (EARS-Net), coordinated by ECDC, shows that resistance to last-line antibiotics is increasing in Europe. For example, resistance to pathogens which frequently cause pneumonia and urinary tract infections in hospitals is increasing across the EU and is now established in several countries.

In the EU, measures have been taken in many different sectors to address the problem. However, a coordinated, comprehensive approach involving all sectors will be beneficial to ensure the best results in effectively addressing the threat of AMR in human and animal healthcare systems and settings.

What is the aim of the Action Plan?

The Action Plan aims to substantially reinforce the measures currently in place and to introduce a new set of rigorous measures to prevent the further spread of resistance and preserve the ability to combat microbial infections.

Using a holistic approach and involving many different sectors (for example: medicine, veterinary medicine, animal husbandry, agriculture, environment and trade), the new concrete actions put forward in the Plan aim to:

    Minimise the risk of developing AMR in humans from the use of antimicrobials both in humans and animals by ensuring appropriate use

    Introduce effective measures to prevent microbial infections and their spread

    Develop effective antimicrobials or alternatives for treatment of human and animal infections

    Join forces with international partners to contain the risks of spreading AMR from international trade and travel and via the environment.

    Reinforce research to develop the scientific basis and innovative means to combat AMR

All EU Member States and stakeholders are called to implement the12 concrete actions set out in the Plan. The Commission shall monitor the use of antibiotics and AMR, and where appropriate shall ask follow up reports on the implementation and actions taken at national level.

What has been done so far?

Over the past decade the Commission has developed a series of EU-wide policy and legislative initiatives for the prevention and control of AMR, for example:

    In human medicine, the 2001 Community Strategy against AMR called for EU initiatives in the fields of surveillance, research, prevention and international cooperation. This led to the adoption of EU-wide recommendations and guidelines against AMR to be implemented by EU countries

    In animal husbandry, a ban on the use of antimicrobials for growth promotion was introduced in 2006

    In the veterinary field, EU law calls for the monitoring of zoonotic AMR (resistance transmissible between animals and humans). Focus is also given to monitoring the use of antimicrobials in animals

    Authorisation requirements for human and veterinary medicines and other products, such as food enzymes, probiotics and decontamination agents, with possible effects on the development of AMR have also been focus areas.

    Risk assessment by the EU's independent agencies and scientific committees

    EU-funded research: For example, almost €600 million has been channelled to research on AMR through the Research Framework Programmes

    The Seventh Framework Programme contributes to the Innovative Medicines Initiative (IMI) which is Europe's largest public-private partnership. It aims to improve the drug development process by supporting efficient discovery and development of better and safer medicines for patients. With a €2 billion budget, IMI supports collaborative research projects and builds networks of industrial and academic experts in Europe that will boost innovation in healthcare.

What next in AMR research?

At the end of 2011 the European Commission issued a Recommendation to encourage EU countries to develop a common vision, and coordinate their activities in the field of AMR research via a Joint Programming initiative (JPI). The aim of the JPI, named "The Microbial Challenge - An Emerging Threat to Human Health" is to coordinate national research activities related to AMR in EU countries. The initiative is expected to become operational in 2012. The JPI will focus on three main areas: understanding the biology and dynamics of resistance, which is of prime importance for controlling the emergence and spread of resistant infectious organisms; improving disease prevention through supporting development of novel antimicrobials and refined treatments, alternative treatments, and rapid diagnosis of pathogens and their resistance

AMR will be taken into account in the final years of the 7th Framework Programme for Research and Technological Development (2007-2013) and this commitment will continue under Horizon 2020, the future funding programme for research and innovation (2014-2020).

Source: European Commission

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