Tackling Antimicrobial Resistance

  Published: 14.06.05 Updated: 16.06.2005 11:15:27

P. Aavitsland
Norwegian Institute of Public Health, Oslo, Norway

Three articles addressing antimicrobial resistance are presented in this issue of EpiNorth. This is an important topic for communicable disease control because resistant microbes cause infections that:

- require more expensive treatment, both in terms of direct antibiotic costs and length of hospital stay
- have more serious outcomes for the patients
- last longer thus increasing the possibility for spread

Pujate and co-workers report the results of a prevalence survey of antimicrobial use in seven hospitals in Latvia. They found that 27.1% of hospitalised patients on a given day received antimicrobials. This is a very high figure. Of even greater concern is that almost half of the patients had no clinical infection. They received antimicrobials for prophylaxis or for unclear reasons.

The Latvian group should be congratulated on this very important study. It shows the value of the prevalence survey as a tool for identifying problems and forming a basis for improvement.

Improvement is probably on its way. Dumpis and co-workers report from an international seminar where Russian and Baltic experts met to discuss the challenges of antimicrobial resistance. Through workshops they identified key strategies to confront the problem, in particular to improve infection control in hospitals and encourage rational prescribing of antibiotics.

Surveillance of antimicrobial resistance was also deemed important and participants acknowledged the European Antimicrobial Resistance Surveillance System (EARSS) as a good model. The EU funded EARSS is presented in a separate article by Nienke Bruinsma. 

The Council of the European Union has recommended four measures to improve the use of antimicrobial agents in Europe (1):

- establish or strengthen surveillance systems on antimicrobial resistance and the use of antimicrobial agents
- implement control and preventive measures to support the prudent use of antimicrobial agents
- promote education and training of health professionals concerning antimicrobial resistance
- inform the general public of the importance of prudent use of antimicrobials

These measures are still lacking many places in Europe and therefore we all have a job to do.


1. Council recommendation of 15 November 2001 on the prudent use of  antimicrobial agents in human medicine (2002/77/EC).