Status of Resistance
The most urgent antibiotic resistance problems identified by APUA-Spain members are:
- Lack of surveillance of antibiotic use and resistance
- Lack of continuing medical education on antibiotic use for prescribers
- Streptococcus pneumoniae, resistance to penicillin (~45%)
APUA-Spain was founded in 1996. APUA Spain members have participated in the Task Force of the Spanish Ministry of Health on Antibiotic Resistance in Spain: "What can be done?" Participation in WHO Task Forces at the Directory of Public Health of the European Commission on meetings or at a national level, APUA Spain members have been working since then for the surveillance and control of antimicrobial resistance and for a prudent use of antibiotics.
In October 19, 2006 the Spanish Ministry of Health, started a national campaign in order to stop the misuse of antibiotics in Spain. The slogan: "Keep antibiotics working: do not misuse them". The Spanish Minister of Health at that moment, Elena Salgado, said "Antibiotic consumption overuse is a big problem of public health in Spain. The misuse of antibiotics on viral infections, the high antibiotic resistance and the important amount of antibiotics acquired at the pharmacy offices as self medication (about 30%), are the cause of this campaign", the most important one in the last years, with a total cost of 6.4 million Euros, and directed to both, health related professionals and to the general public. You will find this information at: http://www.antibioticos.msc.es
Fortunately, during 2006 national authorities began to sponsor this educational challenge of public health lowering self medication and leading to a better and judicious consciousness. Future trends on antibiotic surveillance and resistance control should be developed.
Future, interventions directed towards slowing emergence of resistance and controlling spread of resistant strains have to be followed in Spain by means of:
- Surveillance of the evolution on antibiotic resistance and antibiotic consumption monitoring (EARSS and ESAC).
- Approach to veterinary antibiotic use, legislation and regulation.
- Improve new guidelines with recommendations to antibiotic use on adults and children, with the sponsorship of the Scientific Societies and the Public Health Department of the Ministry of Health.
- Antibiotics as only prescription based drugs. Enforce the law (just physicians and veterinaries may prescribe antibiotics), and stop antibiotic self medication.
- National Co-operation of the Health Authorities with international organizations as: WHO, EC , ECDC, APUA, EMEA, DANMAP, etc
2006 Campaign "Keep antibiotics working: do not misuse them".
Chapter Objectives and Priorities
- Prudent use of antimicrobial agents: not just for humans
- Consumer and patient education
- Prescriber training
- Prescriber information
- Facilitation of collaboration between experts
- Conference or poster sessions
Beatriz Perez-Gorricho, M.D., PhD., University Hospital
Rafael Canton Moreno, M.D., PhD., University Hospital
Carmen Torres Manrique, M.D., PhD., University of La Rioja