Spain occupies top positions in Europe in several of the key indicators that measure the inadequate use of antibiotics and the impact of infections among the population. It is the country where more residents in socio-health centers contract a bacterium. After Cyprus, it is the second state with increased consumption of antibiotics. And their health professionals are among those who tend to use these drugs in their broad spectrum presentations (useful against several groups of bacteria), when it is recommended to refine everything possible in the treatments.
These are some of the data included in three studies presented yesterday in Brussels by the European Center for Disease Control and Prevention (ECDC) on the occasion of the Day for the Prudent Use of Antibiotics. The day comes at a key moment for the European authorities, who believe that the time has come to place resistance to antimicrobials (AMR, in its acronym in English) at the top of the agenda.
"The number of Europeans who get sick and die due to infections that are partly avoidable is growing," warned European Health Commissioner, the Lithuanian Vytenis Andriukaitis. "We can not delay more, it is necessary that all those who have a role in the treatment and prevention of these infections redouble their efforts," he said in a message also addressed to governments.
The publication of these investigations (which include some thirty EU countries and other neighbors such as Serbia and Norway) comes only 10 days after the ECDC will report another work that estimates 33,000 annual deaths caused on the continent by multi-resistant bacteria. All the studies reveal great differences between states, which illustrates the need to "join forces in the face of a global problem that requires coordinated solutions at all levels", according to Francesca Colombo, head of the OCDC Health Area.
One of the studies focuses on the use of antibiotics in acute hospitals, where one third of patients take antibiotics. Of these, 10% are not to treat infections, but to prevent them, such as those administered before surgery. The study reveals that almost half of these treatments last for several days in Europe, when "a single dose a day is sufficient for surgical prophylaxis." "Lengthening these treatments is an unnecessary practice that needs to be redirected," the authors say.
Although there is still a wide margin for improvement, Spain is well off in this index, 10 points below the European average. On the other hand, it presents worse data than the average number of patients in infected hospitals during their stay, 7.8%, only behind Cyprus, Portugal, Italy, Finland and Greece. The study has been done with a sample of 310,000 patients from 1,275 hospitals, 95 of them in Spain.
The ECDC also warns against the practice of administering antibiotics in a preventive way to residents in social care centers, mostly elderly people who want to avoid a urine infection. 30% of antibiotics prescribed in these centers is for this reason, which except in specific cases "is not supported by evidence and promotes the development of resistance," the report concludes.
Although the residents in these facilities in Spain take more antibiotics than the European average (10.5% against 4.9% on any given day), the ECDC has not detected a worse use of these drugs in our country for this reason . This seems to explain a striking fact: Spain is long the country where more patients of sociosanitary acquire an infection: 8.5%. The second country is Greece (6.3%) and the European average is reduced to 3.6%. This study is done with a sample of 102,000 residents of 1,788 centers throughout Europe, 46 of them in Spain.
Spain is also in the top positions in the study that analyzes the antibiotics consumed by the general population. On any given day, Spaniards take 32 DDD (daily defined doses, the most commonly used indicator to measure consumption), well above the European average (21.8) and only behind Cyprus (33.6). The Netherlands (10.1), Estonia (11.5) and Sweden (10.6) are the countries with the lowest consumption.
The experts consulted coincide in showing their remarkable "concern" for the data of the ECDC, although they agree in highlighting the improvements obtained in some variables and set them as an example to follow. "These advances should allow us to face the problem, with all its seriousness, but with optimism," says Joaquín López-Contreras, director of the Nosocomial and Antibiotic Infections Program of the Sant Pau Hospital in Barcelona. "Eight countries have managed to reduce the consumption of antibiotics and those that have applied coordinated policies have managed to lower the incidence of multiresistant bacteria such as Staphyloccus aureus. This teaches us that, with the right decisions, there is a way forward, "says López-Contreras.
For Bruno González Zorn, professor at the Faculty of Veterinary Medicine of the Complutense University, "it is good that the ECDC also places special emphasis on socio-health centers, which was very necessary". These centers, according to López-Contreras, should "implement the same control measures as acute hospitals", something that is not currently considered "viable in nursing homes" José Antonio López Trillo, president of the Spanish Geriatrics Society and Gerontology. "They can not have the laboratories and means of a hospital, and it would be desirable to create rapid channels so that the samples taken in them were taken and analyzed in acute hospitals with the same priority they give to their patients," he says.
On the measures to be adopted, the message of "more means and more coordination" is unanimous. "The antibiotic, unlike the other drugs, has an effect that goes beyond the specific patient, which requires the involvement of all prescribers, from doctors to veterinarians in the case of livestock, and also from the population. that to advance more in the lines already marked by the National Plan of Fight against the Resistance to the Antibióticos, that already has given some fruits ", considers González Zorn.
Jordi Vila, leader of the Antibiotic Resistance Initiative of the ISGlobal Institute in Barcelona, calls on the World Health Organization (WHO) to lead the fight against the problem. "Measures should be adopted globally and WHO should coordinate that strategy," he argues. "In Spain we can do everything within our reach, but if in another country like India the problem is not controlled, we will not succeed, any traveler will be able to acquire a multiresistant bacterium there and incorporate it into the Spanish bacterial ecosystem upon its return", concludes .