Avoiding over-use of antibiotics in the ICU
Antimicrobial Resistance (AMR) is a worldwide issue and patients in ICU are at risk. The WHO (World Health Organisation) has identified AMR as one of the top ten global health threats of 2019.
Giving antibiotics without diagnosing infection in patients, combined with general over-prescribing of antibiotics by physicians and over-consumption in the population, is a threat for health and decreases the chance of recovery. Patients in the ICU are vulnerable and AMR is one of the major causes of death for hospitalized patients.
A recently-published article in the official journal of ESCMID (European Society of Clinical Microbiology and Infectious Diseases), discusses “When not to start antibiotics: avoiding antibiotic overuse in the intensive care unit” and explores the diagnosis of infections in ICU patients.
ESICM and other stakeholders, led by EPHA (European Public Health Alliance), issued a joint statement on AMR in 2017, highlighting the different actions to be put forward in order to reduce the threat of AMR. These include actions to support and promote the use of rapid diagnostic tests, focus on a preventive rather than curative approach in healthcare, and the use of the ‘One Health Approach’.
The European Union has put forward a number of perspectives to tackle AMR, the first one being a ‘One Health approach’. The meaning of ‘one health’ is that “human and animal health are interconnected, that diseases are transmitted from humans to animals and vice versa and must therefore be tackled in both. The One Health approach also encompasses the environment – another link between humans and animals and likewise a potential source of new resistance microorganisms”.
In 2017, an EU One Health Action Plan against Antimicrobial Resistance was issued and reinforced in 2019 by a Ministerial conference on AMR convened by the EU Romanian Presidency of the Council of the EU.
ESICM continues to work on and to be involved in AMR projects, including that of the joint ESICM/ESCMID Task Force, which is currently preparing a Guideline on AMR in critically-ill patients in the ICU.
Click here for more information about the ESICM Infection (INF) Section.
1) K.J.Denny, J.De Wale, K.B.Laupland, P.N.A.Harris, J.Lipman(2019). When not to start antibiotics: avoiding antibiotic overuse in the intensive care unit. Clinical Microbiology and Infection. pii: S1198743X(19)30396-9.
2) J. O’Neill (2016). Tackling drug-resistant infections globally: final report and recommendations. Review on antimicrobial Resistance.