Jesús Rodriguez-Baño
ESCMID President
Nobody doubts today that antimicrobial resistance is a very serious public health problem that may jeopardise the development of modern medicine.
New treatments must be developed for AMR
To fight antimicrobial resistance (AMR), we must see a significant reduction in the consumption of antibiotics in agriculture, animals and humans. Currently, transmission of resistant bacteria through water, food and contact, is high and must be drastically reduced, and we must see a reduction in the occurrence of infection through vaccination and preventive measures. New rapid diagnostic tools and treatments must be developed, including new antibiotics and non-antibiotic approaches.
The economic situation in many countries has had an important impact in the resources dedicated to this problem.
We can achieve all of these measures by prioritising AMR in the political agenda and dedicating funds for research. Such research will allow us to better understand the molecular and epidemiological variables influencing the problem, and discover new tools. It is vital that we do so in order that microbes – such as those causing common infections like pneumonia, pyelonephritis or intraabdominal abscesses – do not outpace us with their resistance to our antibiotics. The results to society would be catastrophic.
We need to education both the general population and healthcare professionals to the dangers of AMR, and effectively fight the antivaccines movement, which puts so many at risk. We can help prevent the need for antibiotic prescription by investing in sanitary solutions in mid- and low-income countries, by improving hand hygiene and other transmission preventive measures, and we can lower the opportunity for resistance by implementing interventions in antibiotic use and infection prevention.
What are the barriers?
The problem of AMR is so complex, that it is difficult to identify priorities. The numerous actors that need to be involved pose some organisational difficulties. The economic situation in many countries has had an important impact in the resources dedicated to this problem, for example, the economic impact of some measures in the agriculture and food industry must be considered and addressed. There is an increasing complexity of modern medicine in terms of antibiotic use and infection prevention which must be taken into account also.
Countries’ economic situations impact the resources dedicated to the AMR problem.
What is ESCMID doing about AMR?
The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) has AMR among its priorities. In fact, we have a committee dedicated to antimicrobial susceptibility testing (EUCAST) and another to infection control (EUCIC); we also have several study groups developing activities in the field. ESCMID dedicates important efforts to educational activities in antimicrobial resistance, both as technical workshops, postgraduate courses and an international master’s degree, provides grants for observerships in hospitals with advanced programmes in antibiotic stewardship and infection control, and for research projects. We develop guidelines to help in the use of antibiotics and prevention of transmission of resistant organisms and disseminate relevant information for the fight of resistance.
Can we be optimistic about the future of AMR?
We can, partially. The problem of antimicrobial resistance is now present in the health political agenda, but it may not be high enough in some countries or institutions. Some countries have taken actions and put forward resources, but the situation is very heterogeneous, and a global and comprehensive policy is needed. The level of awareness of the population and professionals is higher than a few years ago, but a much more important change in behaviour and culture is still needed.
Antimicrobial resistance is more present in the education and training of professionals. Important measures related to the use of antibiotics in non-human environments are being implemented in many countries. Many hospitals in the world are implementing or improving their antibiotic stewardship and infections control programmes, but again there is a huge heterogeneity. Despite the insufficient number of (and innovation in) solutions, new antimicrobials and non-antimicrobial approaches are being developed.