New findings have been released and make it clear that antimicrobial resistance (AMR) is progressing faster than the previous worst-case scenario numbers. As previously suggested, AMR could cause 10 million deaths per year by 2050. This would overtake cancer as a leading cause of death worldwide. However recent estimates could make this figure higher.
In the most comprehensive study on the global burden of bacterial drug-resistant infections ever conducted, published in January 2022 in the Lancet, titled ‘Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis’, a team of researchers looked at data from 471 million individual patient records in 204 different countries around the world, and were able to estimate the impact of AMR on the number of deaths due to and associated with AMR. They observed that AMR was directly responsible for an estimated 1.27 million deaths worldwide and was associated with an estimated 4.95 million deaths. This exceeds the number of deaths due to COVID-19 so far. One in five of the deaths occurred in children under the age of five, with low- and middle-income countries bearing the highest burden, mainly in the Sub-Saharan Africa and South-East Asia. A previous European report considered more than 25,000 deaths due to AMR but this estimate was underestimated as well. As expected, respiratory tract infections accounted for most of the infections caused by multi-resistant micro-organisms. Importantly, drug resistance in only six types of bacteria contributed to 3.57 million deaths, with the top microorganisms being Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, and Klebsiella pneumoniae.
New antimicrobials are lacking and the number of weapons to fight against these multi-resistant infections is dwindling. The best way to curb this increase in the AMR is optimizing existing antibiotic use. One of the most successful ways of doing that is by reducing the inappropriate use of antimicrobials, as the rate of over-diagnosis of suspected bacterial infections and antimicrobial over-prescribing is widely reported. Taking antibiotics unnecessarily can help bacteria to evolve resistance to antibiotics faster. Therefore, it’s so important not to take antibiotics unless they are prescribed, and to only use them for the infection they are prescribed for. Healthcare professionals and patients need to work together towards the appropriate use of antibiotics.
HAPPY PATIENT is tackling the problem of antibiotic inappropriateness consumption in four different settings: general practice, out of hours services, nursing homes and community pharmacies, which are the ones closer to the patient when infection symptoms start. HAPPY PATIENT aims at reducing the antibiotic over-prescribing and over-dispensing by educating patients and healthcare professionals in the appropriate antibiotic use for the most common acute infections, mainly respiratory and urinary tract infections.
The first year of HAPPY PATIENT has passed and the consortium has been busy laying the groundwork towards a successful intervention: a clinical audit before and after a multifaceted intervention. Context and co-design analysis have been performed and misconceptions and knowledge gaps related to infection management and antibiotic consumption in the four settings. We are now ready to start the first part of the clinical audit, with over 500 healthcare professionals involved in the 5 countries participating: France, Greece, Lithuania, Poland and Spain.
The consortium wants to thank all the healthcare professionals that have been involved in the project so far, together we will help curbing the AMR problem, one of the first healthcare priorities.
Carl Llor
HAPPY PATIENT’s Project Coordinator