European Antibiotic Awareness Day on 18 November 2021 and World Antimicrobial Awareness Week from 18-24 November 2021
Experts have been warning for a long time that we could be facing a post-antibiotic age in the future, in which humanity can no longer count on the effectiveness of antibiotics. This would be a disaster for global health, because even everyday infections could suddenly become life-threatening. Already, about 700.000 deaths worldwide each year are due to resistant organisms, and this number could rise dramatically. However, whether and when this horror scenario will occur depends on many factors. How prudently will people use antibiotics in the future? How quickly will resistant germs spread? How quickly will the development of new active substances progress? Every year in November, the World Antimicrobial Awareness Week (WAAW) and the European Antibiotic Awareness Day (EAAD) raise awareness of this problem and call for the prudent use of antimicrobial agents – and this year is no exception.
Europe and the world: two campaigns – one goal
In principle, both the EEAD, launched in 2008 by the European Centre for Disease Prevention and Control (ECDC), and the WAAW, initiated in 2015 by the World Health Organization (WHO), have a common goal: to promote the prudent use of antibiotics through education and thereby prevent antimicrobial resistance. However, while the EAAD still focuses on antibiotics - i.e. medicines against bacterial infections - the WAAW has expanded its message since last year to include medicines against viruses, fungi and parasites (so-called antimicrobials).
Resistance affects not only bacteria, but also viruses, fungi and parasites
Bacteria, viruses, fungi, parasites – they are all capable of becoming resistant to antimicrobial drugs. This process is natural, but it is mainly driven by the misuse of medicines. In addition, poor hygiene contributes to the spread of resistant pathogens in the first place. In terms of bacteria, pathogenic E. coli, Klebsiella and MRSA, but also the pathogens of tuberculosis and gonorrhoea are of worldwide concern. Bacteria can either be insensitive to certain antibiotics in the first place because they do not possess the necessary target structure (e.g. the cell wall) or become resistant because they are suddenly able to degrade the active substances enzymatically (e.g. through β-lactamases) due to mutations or the exchange of genetic material with other pathogens . According to a WHO report,E. coli, the most frequent cause of bloodstream infections worldwide, is already almost 60% resistant to so-called reserve antibiotics in poorer countries . However, there are also numerous examples of resistance to antiviral medicines among viruses, as the case of HIV and Influenza  clearly shows. Resistant parasites of the Plasmodium genus are also of great importance for tropical and subtropical regions, making treatments against malaria significantly more difficult . Among the fungi, against which only a few antifungal medicine classes exist, increasing azole resistance in Candida and Aspergillus is clinically problematic .
A more conscious use of antimicrobials is essential
In order to prevent the further increase in antimicrobial resistance and its dramatic consequences in the future, a correct and prudent use (in German language) of these medicines is essential. For example, the dosage, beginning and duration of the treatment must be correct and the spectrum of action must be appropriate for the pathogen in question. In addition, it is of course important to avoid infections in general in order to prevent the spread of resistant pathogens - e.g. through hygienic measures and vaccinations. The extent to which the COVID-19 pandemic will have an impact on resistance in the long term is also currently being discussed , but can only be assessed conclusively. The WHO fears at least a pandemic-related increase in the use of antimicrobial drugs and thus a higher risk of resistance development. At least one community-based British study, which observed a sustained reduction in antibiotic prescriptions from the first lockdown until the end of 2020 , gives hope - even if the reasons for this remain unclear. In addition, in the year 2020 fewer cases of drug-resistant bacteria than expected were reported (in German language)to the Robert Koch Institute (RKI), which – if not due to a missed transmission – could indicate fewer nosocomial infections during this period. But there is no reason to breathe a sigh of relief when it comes to resistance, because researchers in Germany have just found bacteria that are already resistant to a new combination of two antimicrobial substances that is not yet routinely used (in German language).
The fight against MDROs can only succeed if we work together
In any case, it is clear that the fight against multidrug-resistant pathogens (MDROs) can only succeed if we work together. You too can help to raise awareness. Join us in supporting EAAD and WAAW and share your posts under #stopresistance, #missioninfectionprevention, #antibioticawareness, #antimicrobialawareness!
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