Health officials around the world agree that our one of the best steps to reducing the problem of antimicrobial resistance is scaling back on unnecessary overprescribing of these medications. As doctors in many countries work to implement these efforts, a new report out of the United Kingdom shows some progress in the fight against drug-resistant “superbugs,” along with plenty of work to still be done.
Health officials around the world agree that one of the best steps to reducing the problem of antimicrobial resistance (AMR) is scaling back on unnecessary overprescribing of these medications. As doctors in many countries work to implement these efforts, a new report out of the United Kingdom shows some progress in the fight against drug-resistant “superbugs,” along with plenty of work to still be done.
The new report comes from the UK’s Department of Health and Department for Environmental, Food & Rural Affairs, and was prepared by their AMR Strategy High Level Steering Group. It’s their second annual progress report, outlining progress made in 2015 to slow the spread of superbugs in England, Scotland, Wales, and Northern Ireland and detailing their five-year antimicrobial resistance strategy for 2013 to 2018. This report’s release came as the United Nations General Assembly was set to gather for a meeting to discuss the international problem of drug-resistant bacteria, a common global enemy.
Quite simply, antimicrobial resistance is the ability of bacteria, viruses, and parasites to develop immunity to the antibiotic, antiviral, and antimalarial drugs humans have created to fight off dangerous infections. As pathogens have adapted over recent decades, they’ve become stronger and are increasingly able to defy medical treatment. Infections that were once easily treatable can today become life threatening, and around the world people are experiencing more illnesses, hospitalizations, medical expenses, and deaths due to these superbugs. In many cases, doctors are now treating patients with infections that are resistant to even last-line antibiotics, drugs typically given as a last resort when nothing else has worked to clear an infection.
If we’ve prescribed ourselves into a corner, the UK’s new report demonstrates local and national efforts taken to tackle this global threat. Their first such report included an ambitious “One Health” strategy to tackle AMR in people, animals, agriculture, and the wider environment, and the new report delves into how they’ve implemented that approach. Ensuring that their regulatory and operational infrastructure is ready to drive real progress, the UK officials have been working closely with the World Health Organization, largely driving the international effort on AMR. “We made considerable progress at a national level putting the building blocks for success in place including better data, guidance and a strengthened framework for antimicrobial stewardship,” say the report’s authors. “However, we were acutely aware that we had yet to see unequivocal evidence that we are making a difference, although, at the end of 2015, early signs suggested that initiatives begun earlier in the year were having good results. The challenge now is to shift focus from the development of national tools and guidance to local delivery.”
Highlighting the amount of progress still to be made, the report notes that prescriptions of antibiotics continue to increase, with total consumption going up by by 2.4% between 2013 and 2014. England had the lowest use of antibiotic drugs, while Northern Ireland had the highest. As for rates of drug resistance, isolates of Neisseria gonorrhea, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, and Pseudomonas from human samples collected in the UK still show mostly stable levels of antimicrobial resistance, rather than a desired drop. In the Pseudomonas isolates collected, researchers found a statistically significant increase in resistance. The news on isolates collected from animal samples showed much more promising results. A comparison of pig, turkey, and chicken isolates tested proved more susceptible to the antibiotic drugs ciprofloxacin, cefotaxime, and erythromycin. In a comparison with a number of European countries, the UK isolates showed the lowest levels of resistance in six of the 16 drug-bug combinations, with the UK coming in second in five combinations and in third in two combinations.
From 2010 to 2014, the UK showed an increase in the occurrence of bacteremia, a rise not linked to population growth but which could be at least partially attributed to better reporting. However, infection prevention control measures in hospitals has shown more favorable results, with the proportion of bloodstream infections from methicillin-resistant Staphylococcus aureus (MRSA) in England falling from 15% in 2010 to 8% in 2014. In those same years, rates of Streptococcus pneumoniae bacteremia dropped some 23%.
With tighter regulations and a revised health care code of practice adopted in 2015, along with a new range of guidance and tool kits produced to support healthcare staff in hospitals and doctors’ offices, health officials in England, Scotland, Wales, and Northern Ireland hope to show some improvements in time for their next report on AMR. “We have begun to empower and support local leaders to drive change and hold them to account for delivery,” states the report. “To support local action, we will continue to work to change behaviours around the demand for, and prescribing of, antibiotics by increasing the understanding of AMR among the public, and by supporting professionals to reduce prescribing for both humans and animals.”