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Data on antimicrobial resistance (AMR): use of antibiotics in the EU decreases but more needs to be done

On the eve of European Antibiotics Awareness Day (EAAD), a pan-European survey on antimicrobial resistance shows that half of Europeans still incorrectly believe that antibiotics kill viruses. At the same time, 23 % of respondents have taken antibiotics over the past year, the lowest figure since 2009 and clearly showing that the work of Member States and the Commission to help raise awareness among citizens on the risks of excessive use of antibiotics is paying off. Much more however needs to be done.

Antimicrobial resistance (AMR) is posing one of the greatest risks to human health and is one of the top 3 health threats identified by the Commission's Health Emergency Preparedness and Response Authority (HERA) that require coordination measures at EU level. New data published yesterday by the European Centre for Disease Prevention and Control (ECDC) estimates that, throughout the European Union, Iceland, and Norway, more than 35 000 people die each year due to antibiotic-resistant infections. Such infections cause an additional €1.5 billion in healthcare costs and productivity losses in the EU.

Eurobarometer survey: only 1 in 2 respondents know that antibiotics are not effective against viruses

A special Eurobarometer published yesterday offers an overview of the Europeans' attitudes towards antibiotics. The main results are:

  • Antibiotic use reached a record low: 23% of Europeans say they have taken antibiotics in oral form in the past year, the lowest since 2009. But this varies from 42% in Malta to 15% in Sweden and Germany.
  • Around 8% of antibiotics were taken without a prescription.
  • A very large proportion of Europeans have taken antibiotics without justification (i.e. for viral infections or symptoms only).

The survey also showed a worrying lack of awareness by citizens as to the appropriate use of antibiotics:

  • Only half (50%) of respondents know that antibiotics are ineffective against viruses.
  • Only 3 in 10 Europeans knew that the unnecessary use of antibiotics makes them become ineffective, that taking antibiotics should only stop after completing the whole treatment, that antibiotics often entail side effects, such as diarrhoea, and that antibiotics are not effective against colds.

ECDC Data: sharp increase of antimicrobial resistance

New data published by ECDC yesterday show that, overall, between 2016 and 2020, in the EU/EEA, the number of infections and deaths due to antibacterial resistance increased significantly. Between 2017 and 2021, there was also an increase in the number and proportion of reported Klebsiella pneumoniae and Acinetobacter spp., invasive infections that are resistant to carbapenems, a group of antibiotics that are often used as a last resort.

The total antimicrobial consumption in humans (in primary care and hospital sectors) decreased by 23% in 2012–2021. Although this demonstrates an important reduction of unnecessary use of these medicines, the consumption of the most widely effective antibiotics also very much increased, in particular in hospitals. For example, hospital consumption of carbapenems increased by 34% between 2012 and 2021.

What is the Commission doing to address this?

The growing threat underlines the need to tackle AMR through a One Health approach acknowledging the inter-links between human health, animal health and the environment. Earlier this year, new EU rules came into force to ensure that antimicrobials crucial for human medicine remain effective by prohibiting their use in veterinary medicine.

The Commission also published a review of Member States' AMR One Health National Action Plans. The review found that many Member States would benefit from a stronger One-Health approach towards AMR, taking on board the impact of antibiotics on the environment. The Commission also released an opinion by the Expert Panel on effective ways of investing in health to manage AMR across the health system.

In the first half of 2023, the Commission will step up its action on AMR in a proposed Council Recommendation and as part of a proposed revision of the EU Pharmaceutical legislation. Later in 2023, the EU will launch a € 50 million joint action with Member States, Norway, Iceland and Ukraine on AMR under the EU4Health Programme.

Under Horizon 2020, the EU's research program, over €690 million were mobilised to support research and innovation into AMR. In the first two years of Horizon Europe, € 32.5 million were committed for 13 research projects addressing antimicrobial resistance.

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