Abstract
Unnecessary and inappropriate use of antibiotics in human healthcare is a major driver for the development and spread of antimicrobial resistance; many countries are implementing measures to limit the overuse and misuse of antibiotics e.g. through the establishment of antimicrobial use reduction targets. We performed a review of antimicrobial use reduction goals in human medicine in Transatlantic Taskforce on Antimicrobial Resistance partner countries. On 31 March 2017, the European Centre for Disease Prevention and Control sent a questionnaire to National Focal Points for Antimicrobial Consumption and the National Focal Points for Antimicrobial Resistance in 28 European Union countries, Iceland and Norway. The same questionnaire was sent to the TATFAR implementers in Canada and the United States. Thirty of 32 countries replied. Only nine countries indicated that they have established targets to reduce antimicrobial use in humans. Twenty-one countries replied that no target had been established. However, 17 of these 21 countries indicated that work to establish such targets is currently underway, often in the context of developing a national action plan against antimicrobial resistance. The reported targets varied greatly between countries and can be a useful resource for countries willing to engage in the reduction of antibiotic use in humans.
Highlights
Inappropriate and unnecessary use of antibiotics in human healthcare—i.e. ambulatory, hospital and long-term care—is a major driver for the development and spread of antimicrobial resistance
According to data collected by the Organisation for Economic Co-operation and Development (OECD), inappropriate use of antibiotics may account for up to 50% of all antimicrobials used in human healthcare and may be as high as 90% in long-term care facilities and ambulatory care [1]
In this Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) survey, we collected data from official contacts in European Union (EU) countries, Norway, Iceland, Canada and the United States (US) on such targets—either implemented or under development—with an aim to reduce the use of antibiotics in humans in ambulatory, hospital and long-term care, independently from their link to financial incentives
Summary
Inappropriate and unnecessary use of antibiotics in human healthcare—i.e. ambulatory, hospital and long-term care—is a major driver for the development and spread of antimicrobial resistance. The 2015–20 multisectoral strategy against antimicrobial resistance includes specific targets for the reduction of antibiotic use in humans [17] For ambulatory care, it aims: (i) to reduce antibiotic consumption by 30% (measured as DDD per 1,000 inhabitants per day) by 2020 compared with 2012 consumption, (ii) to reach, by 2020, an average of 250 prescriptions of antibiotics per 1,000 inhabitants per year, and (iii) to reduce the number of prescriptions of antibiotics to treat respiratory infections by 20% (measured in DDD per 1,000 inhabitants per day) by 2020 compared with 2012. According to the Swedish antimicrobial resistance strategy, the total number of antibiotic prescriptions in Swedish ambulatory care (sales of all antibiotics within ATC group J01, except methenamine, dispensed by all Swedish pharmacies) should not exceed 250 per 1,000 inhabitants per year (long-term goal). The remaining 21 countries indicated that they have not established such targets; 17 of them indicated that work to establish such targets is underway, often in the context of developing a national action plan against antimicrobial resistance (Table 2)
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