In the last nine years, since the launch of the National Plan against Antibiotic Resistance (PRAN) of the Spanish Agency for Medicines and Health Products (AEMPS) nine years ago, there has been a “gradual decrease” in the resistance to antibiotics, “reducing it by 27 percent”, but in the last three years there has been an increase in the use of antimicrobials, according to the PRAN coordinator, Antonio López.
“We are looking to see what the causes of this increase are, we have to influence certain messages, but hey, the reality is that. Despite the enormous success of the measures that are being implemented and the collaboration of everyone, it is seen which is not enough,” López pointed out during the POP Breakfasts on ‘Public health strategies against infections and antimicrobial resistance’ organized by Servimedia this Thursday.
Thus, he has highlighted the palpable differences between the countries of northern Europe, which “have been working on antimicrobial resistance for more than 20-30 years”, and the countries of southern Europe, mainly in the Mediterranean, which “have not begun to give it importance to this problem until 10 years ago.
“Reducing the use of antimicrobials costs time, but it not only costs time, reducing the use of antimicrobials and seeing an impact on the incidence of infections and resistant batteries costs people, and even all people, professionals and patients, understand the importance of this,” warned the PRAN coordinator.
In this sense, the expert has stressed the need to address antimicrobial resistance from a multidisciplinary approach that includes specialists and patients because “it is not possible to understand addressing this problem without multidisciplinarity and collaboration, putting the patient at the center. “.
This has also been pointed out by the president of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Federico García, pointing out that the change “absolutely has to come from cultural changes in which it is possible to understand that the way to move forward is to coordinate, and not work individually.
“The increase in antimicrobial resistance is something that is happening worldwide, it has to be considered an existing pandemic at this time, some call it a ‘silent pandemic’. All the measures that are being put in place to stop the increase in multidrug-resistant bacteria, although they are being effective because we are not seeing an increase, they have room for improvement, it is clear,” said Federico García.
In this regard, the specialist has pointed out that “in countries where they have been educating in prevention and public health for 25 years”, totally different results have been achieved in the field of antimicrobial resistance than in Spain.”
Likewise, the member of the semFYC Infectious Diseases Working Group, José María Molero García, has highlighted that “Spain is a country that consumes the most antibiotics in Europe” and that, “compared to a country like Holland, which is the one that consumes the least in Europe, in Spain three times more antibiotics are consumed”,
This situation happens “for multiple reasons” but, according to the semFYC member, the main one is “custom, the pressure exerted by society itself due to the beliefs that antibiotics cure a viral disease when that is not true.” “All this means that we are in an important problem and that we have to deal with in our consultations day by day,” he added.
PREVENTION THROUGH VACCINATION: KEY TO NOT USING SO MANY ANTIBIOTICS
In parallel with the increase in the use of antibiotics, experts have highlighted the increase in infectious diseases and emerging diseases that, due to climatic conditions, are already considered endemic diseases such as dengue in some territories. In this situation, experts point to prevention through vaccination as one of the keys to reducing the use of antibiotics.
“Emerging diseases such as dengue are becoming endemic, we already have them here and they are endemic in some countries and, if they are not already, they will soon be in Spain. We are also experiencing an increase in sexually transmitted diseases,” he said. warned the president of SEIMC
In this sense, the PRAN coordinator, Antonio López, has indicated that prevention is a “fundamental pillar”, it is a “clear measure to avoid infections and, therefore, the use of antimicrobials.”
“We have measures to fight some of these infections, such as vaccines against diphtheria or meningococcus. There are vaccines for viral infections, many of which have bacterial complications and vaccines will help. Respiratory viruses also have vaccines. But not only We need vaccines but rather to give those vaccines, to introduce those vaccines into the vaccination schedules,” indicated the Member of Relations with Scientific Societies of the Spanish Association of Vaccinology (AEV), Victoria Nartallo.
Thus, he has added that it is necessary to “take a comprehensive approach to the patient” by vaccinating not only him, but his cohabitants, especially when it comes to people at risk. “In addition, in adult vaccination we still have a lot of room for improvement. Just as childhood vaccination in Spain is wonderful and we have very high coverage, vaccination in adults is a field where we have a lot of room for improvement,” he pointed out.
Another key aspect that has been addressed during the day is the care of chronic patients since “they are a specific type of patient who has more infections due to their own pathology” and who, therefore, need “a comprehensive approach”, and an approach different in vaccination.
For this reason, the president of the Patient Organizations Platform (POP), Carina Escobar, has pointed out the need for vaccination schedules to have a specific indication for chronic patients.
“Many times we go to the signs or what is said and they say elderly, pregnant, but the chronic person does not know it. We tend to say fragile people or vulnerable people, but the people who are at home do not know if they are fragile or vulnerable. This must be explained better, because we ask that people be vaccinated, but we do not have it. We have to improve the communication channel, that there is sufficient coverage and that chronic patients be prioritized,” said Carina Escobar.
