10 janvier 2024

Reducing antimicrobial resistance – Is the EU progressing towards the 2030 targets?

The European Centre for Disease Prevention and Control (ECDC) has previously raised the alarm on the increasing threat of antimicrobial resistance, estimating that over 35 000 people die annually from infections resistant to antibiotics in the European Union (EU), Iceland, and Norway. In a concerted effort to address this growing public health issue, the Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach was adopted on 13 June 2023, which included five targets to be achieved by 2030, building on a 2019 baseline. These targets encompass a reduction in overall antibiotic consumption, specific antibiotic group preferences, and the mitigation of bloodstream infections caused by pathogens that are often resistant to several antibiotics at the same time.

[…] The situation with carbapenem-resistant Klebsiella pneumoniae infections in the EU continues to deteriorate. The incidence of bloodstream infections with these bacteria has increased by almost 50% between 2019 and 2022. This goes against the goal of reducing these infections by 5% by 2030. This is a concerning trend because there are very few effective treatments available for patients with these infections.

Encouragingly, there have been notable improvements in two areas: the total incidence of bloodstream infections with methicillin-resistant Staphylococcus aureus (MRSA) declined by 12.2% between 2019 and 2022, which is close to the 15% reduction target. Similarly, the incidence of bloodstream infections with third-generation cephalosporin-resistant Escherichia coli decreased by 16.8% during the same period, indicating that the EU has already met the 10% reduction target. These developments reflect a positive trend in addressing antimicrobial resistance within the EU.

The total consumption of antibiotics in humans (community and hospital sectors combined) has decreased by 2.5% between 2019 and 2022, indicating slow progress towards the 20% reduction target by 2030. However, after unprecedented reductions in 2020 and 2021, consumption rebounded in 2022. This might indicate that the patterns of winter respiratory viruses, social contacts, hygiene habits and antibiotic-prescribing practices may now be similar to what they were before the Covid-19 pandemic.

Only nine EU Member States have met or exceeded the target of 65% antibiotic consumption being from the ‘Access’ group, as per WHO’s AWaRe classification of antibiotics, placing the EU overall at 59.8%. Antibiotics in this group should be the first choice for common infections, as they contribute to a lesser extent to the emergence of antimicrobial resistance. Continued efforts in this area are needed to align consumption patterns with the recommended target.

ECDC emphasises the need for stronger interventions and actions to address antimicrobial resistance in different areas such as prudent use of antibiotics, infection prevention and control, research and innovation, surveillance of antimicrobial resistance and antimicrobial consumption, and the implementation of One Health national action plans. Achieving the 2030 targets is an urgent and collective responsibility.

https://www.ecdc.europa.eu/en/news-events/eaad-2023-launch

https://www.ecdc.europa.eu/sites/default/files/documents/AER-antimicrobial-resistance.pdf