Global call to action to fight antibiotic resistance

The emergence of pan-resistant NDM-1 bacteria and epidemic of multidrug-resistant E. coli infections currently in Europe should be taken as a major public health warning, indicating that a new era of antimicrobial resistance has begun, according to industry experts, and this must lead to a global awakening: the protection of antibiotics has now entered the sphere of sustainable development.

More than 70 international experts in medicine, infectious diseases, microbiology and epidemiology, from every continent, gathered recently at the Fondation Merieux's Conference Center for the third edition of the World HAI Forum on healthcare-associated infections, a bioMerieux initiative. Forum participants called upon national and international health authorities and policy makers, the medical and veterinary communities, industry and the general public to take action to avoid an impending public health catastrophe caused by the emergence and spread of bacteria that are resistant to all antibiotics.

While research to discover novel antibiotics has slowed to a virtual standstill, bacterial resistance has increased due to the massive use and misuse of antibiotics, not only for human health, but also for animals. The treatment of certain common infections is becoming difficult and the success of immunosuppressive therapies and surgical interventions (organ transplants, cardiac surgery), which are associated with a high risk of bacterial infection, could be compromised.

The Forum participants identified priority action areas to fight bacterial resistance and recommended 12 concrete actions to be implemented in the short to mid-term.

Priority actions for policy makers and health authorities:

• For animals, stop the administration of antibiotics used in human medicine and limit antibiotics to therapeutic use only. It is imperative to reserve the most important classes of antibiotics for humans.
• Banish, in all countries, the use of antibiotics as growth promoters in animal feed.
• Regulate the sale of antibiotics for use in human medicine and prohibit over-the-counter sales worldwide.
• Have international organisations (WHO, European Union) develop a charter on good antibiotic stewardship and have all the ministries of health worldwide sign it and commit to respecting it.

Priority actions for the human and veterinary healthcare communities:

• Establish standardised, universal surveillance of antibiotic use and resistance and monitor the emergence and spread of new forms of bacterial resistance.
• Include, in the medical and veterinary school curricula, a solid training in bacterial resistance and the prudent use of antibiotics and establish on-the-job training programmes for healthcare workers, taking into account the cultural specificities of each country.

Priority actions for the general public:

• Develop culturally sensitive awareness campaigns, targeted to the general public, explaining the importance of protecting antibiotics and using them only when absolutely necessary.
• Provide education about fundamental hygiene, such as handwashing to prevent the spread of infection. It is imperative to improve sanitation systems to eliminate resistant bacteria in wastewater.
• Include consumers in the development and implementation of action plans. Priority actions for industry:
• Develop point-of-care and rapid diagnostic tests that can be used at the patient's bedside or the doctor's office to guide the prescription of antibiotics and avoid their prescription for viral infections.
• Stimulate research and development of novel antibiotics.
• Find new economic models that reconcile public health interests with industry needs for profitability.