Antibiotic stewardship: A crucial task to counter multidrug-resistant bacteria

Mon, 11 Dec 2017 • Dr. Andrea Ammon

For decades, antibiotics have been our primary weapon to treat bacterial infections. Today, we face one of the biggest challenges of our times: we are having difficulties curing infections caused by bacteria, which were once susceptible to the action of antibiotics, because they have become resistant to these medicines.

The situation is even more complex, since only few new antibiotics have been discovered and marketed in recent years. The emergence of multidrug-resistant bacteria, as well as of bacteria resistant to last-line antibiotics, is a major problem especially in hospitals and other healthcare settings.

European Centre for Disease Prevention and Control (ECDC) data on antibiotic resistance and antibiotic consumption, which are released every year in November, show that antibiotic resistance continues to increase for most bacteria and antibiotics under surveillance. Nevertheless, the progress and success of some European Union (EU) Member States in tackling this problem are encouraging, and are an indication that there is still time to turn the tide of antimicrobial resistance and ensure that antibiotics will remain effective in the future.

A point prevalence survey coordinated by ECDC in 2011-2012 showed that, overall, 59% of patients in European urology wards received at least one antimicrobial agent on a given day [1]. This high proportion of patients exposed to antimicrobials – one of the highest among all specialties in participating European hospitals – highlights the responsibility of urologists to take a key role in antibiotic stewardship and to implement interventions to reduce unnecessary antibiotic use.

In a Dutch urology ward, case audits to reassess antibiotic use after 48 hours reduced antibiotic consumption and length of stay, and also had a positive direct return on investment [2, 3], thus showing that antibiotic stewardship interventions in urology can be successful and cost-effective.

Since 2008, the ECDC has coordinated the European Antibiotic Awareness Day (EAAD), a European health initiative. EAAD provides a platform for the development and support of national campaigns in Europe, to raise awareness about antibiotic resistance and advocate a more prudent use of antibiotics. EAAD is marked every year on 18 November, with campaigns and activities undertaken by national governments and professional organisations with an interest in antibiotics and antimicrobial resistance.

This year, ECDC is launching a social media initiative called #KeepAntibioticsWorking, which aims at highlighting that everyone has a role in ensuring that these medicines remain effective. Individuals, as potential users of antibiotics when facing bacterial infections, need to know how to use these medicines prudently. Healthcare professionals such as urologists and other medical doctors, pharmacists, nurses as well as veterinarians and farmers, have an additional responsibility to use antibiotics wisely.

With the #KeepAntibioticsWorking social media initiative, ECDC is asking policymakers, governmental institutions, professional and patient organisations, as well as health professionals and the general public to show the actions that they are taking to address the problem of antibiotic resistance. Anyone can take part by sharing messages, pictures or videos during the week 13-19 November 2017 on different social media channels, using the hashtag #KeepAntibioticsWorking.

Finally, in 2017, the European Commission published EU guidelines for the prudent use of antimicrobials in human medicine and ECDC released evidence-based key messages for professionals in hospitals and other healthcare settings that are available from the EAAD website [4]. The EU guidelines and the key messages have been translated and are available in all EU official languages.

Joint action can lead to concrete results in the fight against antibiotic resistance. ECDC is committed to continue its efforts, together with EU Member States, health professionals and the EU institutions, to keep antibiotics working.

Note: References in this article can be provided upon request by sending an email to: