Between 2019 and 2023, antibiotic consumption in the European Union (EU) increased by 1%, a worrying trend that distances the region from its target of reducing antibiotic use by 20% by 2030.
This target, set by the Council of the European Union, is critical to combating the escalating problem of antimicrobial resistance (AMR).
While some progress has been achieved in specific areas, such as a decline in methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, there have been significant setbacks elsewhere.
Particularly alarming is the nearly 60% rise in carbapenem-resistant Klebsiella pneumoniae bloodstream infections over the same period. This increase poses a grave threat to patients, as treatment options for these infections are extremely limited.
Understanding antimicrobial resistance
Antimicrobial resistance occurs when microorganisms, such as bacteria, viruses, fungi, or parasites, evolve to resist the effects of drugs designed to kill them. This resistance renders treatments ineffective, making once-manageable infections difficult—or even impossible—to cure.
AMR develops primarily due to the misuse and overuse of antibiotics in both humans and animals. When antibiotics are used improperly, such as for viral infections or when not fully completing a prescribed course, bacteria are given opportunities to adapt and survive. Over time, this leads to the emergence of drug-resistant strains.
The consequences of AMR are profound and far-reaching. Common infections, surgeries, and medical treatments like chemotherapy rely on effective antibiotics to prevent and treat associated infections.
Without these drugs, routine procedures could become life-threatening. AMR also prolongs illnesses, increases healthcare costs, and results in higher mortality rates, posing a direct challenge to modern medicine and public health.
The EU’s response to AMR
Dr Pamela Rendi-Wagner, Director of the European Centre for Disease Prevention and Control (ECDC), has stressed the need for a unified, urgent response across the EU to combat AMR.
While some Member States have made significant strides toward reducing antibiotic use, the overall progress remains insufficient. Achieving the 2030 targets requires intensified, coordinated action across all countries.
To address this crisis, the ECDC has highlighted three critical areas for intervention: infection prevention and control (IPC), prudent use of antibiotics, and developing new, effective antimicrobials.
Strengthening infection prevention and control
Healthcare-associated infections account for 70% of the AMR-related health burden in the EU, making infection prevention a top priority. Hospitals must adopt comprehensive measures to combat the spread of resistant bacteria.
Improving hand hygiene practices, for example, is a fundamental step. Ensuring easy access to alcohol-based hand sanitisers in healthcare facilities can significantly reduce the transmission of resistant bacteria.
Screening for resistant bacteria, particularly carbapenem-resistant Klebsiella pneumoniae, is another critical intervention. By identifying carriers early, healthcare providers can take targeted actions to prevent outbreaks.
Hospitals also need to expand their capacity to isolate patients who test positive for resistant infections, which requires increasing the number of single rooms available for such cases.
Infection prevention efforts must also include investing in specialised staff and training programmes. Dedicated infection prevention teams equipped with the knowledge and resources to implement these measures can significantly reduce healthcare-associated infections and slow the spread of antimicrobial resistance.
Promoting prudent use of antibiotics
The misuse of antibiotics in community settings accounts for 90% of total antibiotic consumption in humans.
Addressing this requires widespread public awareness campaigns to educate people on the risks of unnecessary antibiotic use. Many individuals mistakenly believe antibiotics are effective against viral infections, leading to improper use.
Behavioural interventions can complement public information campaigns. Encouraging healthcare providers to prescribe antibiotics judiciously and promoting adherence to prescribed courses are essential strategies. In the long term, these efforts will help reduce antibiotic consumption and slow the development of resistance.
Developing novel antimicrobials
With resistance increasing against last-line antibiotics such as carbapenems, the development of new antimicrobials is critical. Innovative drugs that are both safe and effective against resistant infections can provide vital options for treating patients with otherwise untreatable infections.
The ECDC continues to advocate for increased investment in research and development to address this urgent need. Expanding access to alternative therapies and novel antimicrobial agents is a cornerstone of the broader strategy to combat AMR.
The consequences of inaction
Failure to meet the EU’s AMR targets by 2030 could lead to severe consequences. As drug-resistant infections become more common, treating them will become increasingly challenging and expensive. Patients will face prolonged illnesses, higher risks of complications, and, in some cases, untreatable conditions.
Healthcare systems across Europe will also bear the financial burden. Treating resistant infections often requires longer hospital stays and more expensive drugs, straining resources and limiting the ability to provide care for other patients.
Beyond the healthcare sector, AMR could have devastating societal impacts, including lost productivity and reduced economic growth.
A call to action
Antimicrobial resistance is not just a looming threat; it is an unfolding crisis that demands immediate action. Protecting the efficacy of antibiotics is essential to safeguarding modern medicine and public health.
To meet the 2030 targets, all sectors—healthcare providers, policymakers, and the public—must work together. Infection prevention, responsible antibiotic use, and investment in innovative treatments are vital strategies in the fight against AMR.
By acting decisively now, the EU can preserve the effectiveness of antibiotics for future generations and ensure that its healthcare systems remain resilient in the face of this growing challenge.
