Audit finds EU efforts to fight antibiotic resistance are lacking
A new report from the European Court of Auditors (ECA) argues that while some progress has been made, European Union (EU) leaders need to do more to address the health burden of antibiotic resistance.
In their assessment of the European Commission and European Centre for Disease Prevention and Control’s management of key antibiotic resistance activities and resources, the auditors found that support for the “one health” approach was having some positive impacts, including more prudent use of veterinary antibiotics in most member states. But they also noted that there are big differences between the member states, that veterinary antibiotics use overall is still too high, and that gaps in collecting data and monitoring resistance in food animals and food remain. Incomplete surveillance data on hospital infections and insufficient knowledge of antibiotic-resistant pathogens in the environment were also cited as issues.
In addition, the auditors pointed out that while 99% of the EU’s antibiotic-resistance budget is devoted to research, there has not yet been any breakthrough in the development of new antibiotic classes, and the specific market challenges for new antibiotics have not been addressed.
“Antimicrobial resistance is a serious threat to public health,” ECA member Nikolaos Milionis said in a press release. “While there has been some progress on veterinary issues, the European Commission, together with the Member States, need to further step up their efforts to tackle this growing threat.”
The report calls on the European Commission to provide more support for member state national action plans, promote better monitoring and use of veterinary antibiotics, and strengthen strategies for boosting antibiotic-resistance research.
Nov 15 ECA report
Nov 15 ECA press release
New guidance on drug-resistant TB prioritizes oral antibiotics
The American Thoracic Society (ATS), US Centers for Disease Control and Prevention (CDC), European Respiratory Society, and Infectious Diseases Society of America have published a practice guideline on treating drug-resistant tuberculosis (TB) that includes new recommendations for the choice and number of drugs in a regimen and duration of therapy, as well as the role of injectable drugs in multidrug-resistant TB (MDR-TB).
Writing in the American Journal of Respiratory and Critical Care Medicine, experts from the four organizations note that they analyzed data from 50 studies involving 12,030 patients total across 25 countries to develop the guideline.
The guideline makes clear that treatment should be tailored based on drug-susceptibility testing, and that patients should not receive medicines to which the Mycobacterium tuberculosis strain is resistant. It also prioritizes the use of oral medications.
The guideline recommends treatment with a later-generation fluoroquinolone for all infected contacts of patients who have MDR-TB, rather than watchful observation, and it provides evidence-based guidance for treating pregnant women who have MDR-TB. The experts also spell out the role of surgery in treating MDR-TB and advice for treating isoniazid-resistant TB.
“Having the participation of committee members from multiple medical societies and the CDC, as well as patient advocate perspectives, was absolutely critical to discussing the balance between desirable and undesirable health effects of interventions, making certain they were favorable for MDR-TB patients, including for children and pregnant women,” said Payam Nahid, MD, MPH, chair of the guideline committee, in an ATS news release.
Nov 15 Am J Respir Crit Care Med guideline
Nov 18 ATS news release
