Ten tips on how to win the war against resistance to antibiotics

Excerpt

Antibiotic resistance has increased dramatically in the past few years and nowadays represents a serious threat to public health [1‐3]. Reasons are multiple, the excess in antibiotic consumption being the most important one. Therefore, antibiotic prescription must be carefully discussed for each patient. Unfortunately, antibiotic prescription is still considered as a trivial act in both humans and animals, in both the hospitals and community. Antibiotic resistance is a worldwide issue. The prevalence of Enterobacteriaceae resistant to third generation cephalosporins reaches 70–80 % in several countries, the prevalence of carbapenemases in Klebsiella pneumoniae being more than 50 % in many countries [4, 5] (Fig. 1). In the ESAC network in Europe [6], antibiotic consumption in the community ranges from 11 to 32 DDDs per 1,000 inhabitants per day. Similar differences are seen in other continents. Between 2000 and 2010, consumption of antibiotics increased in 71 countries by 36 %, Brazil, Russia, India, China and South Africa accounting for 76 % of this increase [7]. Animal consumption represents 80 % of total antibiotic consumption. Large differences are seen in the consumption in animals [8]. In Europe, France and The Netherlands were the highest consumers. The Netherlands has been able to reduce its consumption by more than 60 % and France by 35 % in the last 5 years.

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