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 decline” in antibiotic resistance“arriving to reduce 27 percent“, but, in the last three years there has been a rise in antimicrobial useas pointed out by the PRAN coordinator, Antonio Lopez.
“We are looking to see What are the causes of this increase? You have to emphasize certain messages, but hey, that’s the reality. Despite the enormous success of the measures that are being implemented and the collaboration of everyone, it is seen that it is not enough,” López pointed out during the POP breakfasts about Public health strategies against infections and antimicrobial resistance organized by Servimedia this Thursday.
Thus, it has highlighted the palpable differences between northern European countrieswhich “have been working on antimicrobial resistance for more than 20-30 years”, and the countries of southern Europe, mainly in the Mediterranean, which “They did not begin to give 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.
Need for a multidisciplinary approach
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 in the center“.
This has also been pointed out by the president of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Federico Garciapointing out that the change “has to absolutely start from cultural changes in which it is possible to understand that the way to move forward is to coordinateand not work individually”.
“The increase in antimicrobial resistance is something that is happening worldwide, it has to be considered a current pandemicsome 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 witnessing an increase, they have room for improvementit 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”, progress has been made in the field of antimicrobial resistance. totally different results from those of Spain“.
Likewise, the member of the semFYC Infectious Diseases Working Group, José María Molero Garcíahas highlighted that “Spain is a country of those who consume 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 it consumes three times more antibiotics“,
This situation happens “for multiple reasons” but, according to the semFYC member, the main one is “custom, the pressure that society itself puts on beliefs that antibiotics cure a viral disease when that is not true.” “All of 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 which, due to climatic conditions, are already considered in some territories endemic diseases such as dengue. Given this situation, experts point to the prevention through vaccination as one of the keys to reducing the use of antibiotics.
“Emerging diseases like 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 a increase in sexually transmitted diseases“, warned the president of SEIMC
In this sense, the PRAN coordinator, Antonio Lopezhas indicated that prevention is a “fundamental pillar“, 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 We not only need vaccines but to give those vaccinesintroduce these vaccines into the vaccination schedules”, indicated for her part 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 much room for improvement“, he pointed out.
Another key aspect that has been addressed during the day is the chronic patient care since “it is a specific type of patient who has more infections due to their own pathology” and, therefore, they need “a comprehensive approach”, and a different approach to vaccination.
For this reason, the president of the Patient Organizations Platform (POP), Carina Escobarhas pointed out the need for vaccination schedules to have a specific indication for chronic patients.
“Many times we go to the posters 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 people who are at home don’t know if they are fragile or vulnerable. This needs to be explained better, because we ask that people get vaccinated, but we don’t have it. We have to improve the communication channellet there be sufficient coverage and that prioritize chronic ones“said Carina Escobar.
