Facing up to the urgent reality of AMR: perspectives from across the Region
Antimicrobial resistance (AMR) is one of the top global public health threats, contributing to nearly 5 million deaths annually worldwide.
The rise of resistant infections undermines modern medicine and jeopardizes life-saving procedures like organ transplants, cancer therapy, surgery and intensive care.
In the WHO European Region, antimicrobial-resistant infections are directly responsible for 133 000 deaths each year and indirectly linked to 541 000 deaths, representing a substantial burden on individuals, societies and health-care systems.
Estimates show that AMR costs the European Union and European Economic Area around €11.7 billion each year due to increased health expenditure and workforce productivity losses.
Without concerted action, the rise of AMR is predicted to cause 10 million deaths a year globally by 2050.
Victoria Panzari, patient, Republic of Moldova
Experiencing the life-threatening effects of AMR first-hand
I was admitted to hospital where I was diagnosed with a severe form of pancreatitis and prescribed antibiotic treatment.
However, the treatment didn’t work and my condition worsened.
I was put in a drug-induced coma for 2 months and had 10 surgeries along the way. My chance of survival was slim.
After multiple investigations by the Laboratory of the National Agency for Public Health, the susceptible antibiotic was fortunately identified and targeted therapy with a more effective antibiotic was initiated.
My health slowly improved.
I owe my life to that second treatment, but tackling AMR is everyone’s responsibility. Preserving antimicrobials for their correct use is a vital part of this.
Olafur Gudlaugsson, medical doctor, Iceland
Reducing the burden of AMR on hospitals and society
In our hospital, we have seen an increase in infections caused by antibiotic-resistant organisms, be they life-threatening blood stream infections and pneumonia or more common infections.
Recently, we had a lady in her seventies who needed multiple admissions because of repeated urinary tract infections caused by bacteria resistant to most antibiotics. Instead of being treated at home with oral antibiotics, she needed intravenous antibiotics at our hospital for 5 days each time she was admitted.
Repeated admissions are a big burden to the individual and very costly to hospitals and society.
We need to limit the spread of antibiotic-resistant organisms to preserve the effectiveness of antibiotics.
Otherwise, we will see an increasing number of patients with simple infections being hospitalized or for whom no effective antibiotics are available.
The nursing team, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel
Working in unison to prevent and control antibiotic-resistant outbreaks in health-care settings
As nurses, we play a pivotal role in coordinating national efforts to prevent infectious diseases and combat antibiotic resistance in health-care settings.
Our responsibilities encompass developing and providing evidence-based guidelines for infection prevention and control, monitoring infections, implementing infection control practices, conducting education and training and managing outbreaks.
Through our work, we contribute to improving patient outcomes, preserving the effectiveness of antibiotics and safeguarding public health at the national level.
Muratbek Mhuhambetovsurgeon, Kyrgyzstan
Reducing the risk of post-operative infections and possible AMR
Over the years, I have witnessed challenges with the inappropriate use of antibiotics and increasing trends in AMR, which is very worrying for me as a surgeon.
In response to this, I am championing the prudent use of surgical antimicrobial prophylaxis (administering antimicrobials before an operation to prevent infections) and have advocated for updated guidelines to be implemented in hospital settings to help decrease the risk of post-operative infections.
These essential guidelines require regular monitoring and updates because wound infections change their resistance patterns over time.
I also strongly advocate for having proper infection prevention and control measures, in which we all have a role to play.
Margarita Melikyan, pharmacist, Armenia
Advocating and educating on the sensible use of antibiotics
Every day, I promote the rational use of antimicrobials, by explaining to patients the possible negative consequences of misusing antibiotics, especially through self-medication.
I also work with physicians to optimize the prescribing of antibiotics.
Through advocacy and education, health-care professionals, including pharmacists like me, can help prevent the further development and spread of resistance.
Claire Reading, midwife and sexual and reproductive health advisor,Doctors Without Borders, Belgium
Protecting maternal health through the correct and necessary use of antibiotics
The increasing global rates of sexually transmitted infections (STIs) is a major public health emergency.
I remember seeing newborns, born at home with no access to antibiotic eye ointment to prevent mother-to-child transmission of gonorrhoea. Left untreated, these infections can cause blindness.
The impact of not effectively treating STIs or reproductive tract infections with the correct antimicrobials can not only lead to early infertility or the inability to carry pregnancy but can also result in maternal death.
Midwives have an important role to play in educating women about STIs and ways to prevent these infections. By raising this awareness, we can help reserve antibiotics for their necessary and correct use.
Eimear Brannigan, medical doctor and infection, prevention and control leader, Ireland
Using frontline experience to develop a national response to AMR
I have seen the increasing challenges of managing and appropriately treating people with antibiotic-resistant infections, having worked to control outbreaks in hospital settings and in treating affected patients.
I support hospitals in the development of clinical guidelines for the management of sepsis, including guidance for the early administering of antibiotics in severe infections and collaborating with colleagues across our health system to understand the epidemiology of resistant infections.
I’m able to bring this frontline experience to the national programme in Ireland as we strive to improve antimicrobial stewardship and reduce health-care-associated infections.
Stine Mikkelsen, farmer and former nurse, Denmark
Reducing the use of antibiotics in food production to prevent AMR
Since we started raising pigs in 2015, we have worked according to the mantra, “as few antibiotics as possible but as much as necessary”.
Of course, we always treat sick animals, and we never compromise on animal welfare, but we make a big effort to limit the need for antibiotics and to prevent rather than treat diseases.
In my previous work as a nurse, I saw how antibiotic resistance can make the treatment of ill people very difficult and how it puts a strain on our hospital system.
Therefore, we use many of the same procedures on our farm when it comes to keeping our animals healthy: a focus on hygiene and measures to break the chains of infection to prevent disease.
Silva Gradovska, antimicrobial resistance researcher, Institute of Food Safety, Animal Health and Environment (BIOR), Latvia
Monitoring wastewater as an early warning system for the spread of AMR organisms
We collect and analyse wastewater samples to track resistant bacteria and AMR genes, providing crucial data for public health surveillance.
Our research has identified resistant bacteria in hospital wastewater, emphasizing the urgent need for stringent infection prevention and control measures.
By identifying these threats promptly, we can implement targeted measures to prevent disease outbreaks, protecting patients and the broader community.
I believe embracing a One Health approach, which encourages cross-sector collaboration, is vital for tackling this issue effectively.
Working together, we can make a difference.