“Break the Chain of Antimicrobial Resistance” in the community and hospitals, call the State, the scientific community and citizens, experts, sounding the alarm for Greece’s sad first place in the overconsumption of antibiotics and in antimicrobial resistance.

At the scientific Forum, organized by the Hellenic Intermunicipal Network of Healthy Cities of the WHO and the Hellenic Society of Chemotherapy, with the support of the Medical Association of Athens, on the occasion of the completion of 10 years of the “Panhellenic Information Campaign for the Correct Use of Antibiotics and the Value of Vaccines” “, the participating scientists warned that the fight against microbes is at a critical point worldwide. They pointed to the growing risk of superbugs – which feed on antibiotics and pose an immediate threat of another deadly pandemic. The event took place as part of WHO’s Global Antibiotic and Antimicrobial Resistance Awareness Week (November 18-24).

The figures for Greece continue to be pessimistic. For the 14th year, our country continues to have the sad lead in the overconsumption of antibiotics, as well as in antimicrobial resistance, both in the community and in hospitals, among all European countries. Typically, the experts reported that 16% of citizens obtain antibiotics from the pharmacy without a prescription, while 50% of hospital infections can be prevented by the systematic application of preventive measures.

The Greeks pay dearly for this record, as our country is also first in losses, with 2000 deaths from multi-resistant microbes for 2020, in contrast to Sweden, where with the same population, the corresponding number is 300 deaths and demonstrates that it has overcome the limit beyond which antibiotics, from a weapon in the hands of science, can be fatal to human life, losing the their activity.

The danger from the misuse of antibiotics was emphasized by the President of ISA and EDDIPYY Giorgos Patoulis, who, in fact, referred to a publication in the prestigious medical journal Lancet, according to which, if we do not take our measures from now until 2050, more than 39 million people will die from infections due to multi-resistant – to antibiotics – microbes and about 169 million people will die from infections caused by multidrug-resistant bacteria.

Mr. Patoulis spoke about the formation of a new culture for the proper management of antibiotics, stressing that in this way we will manage to change “the negative championship of our country”.

He added that “in this war with germs, coordinated interventions in antibiotic policy are needed, both by the State and by the medical world and the pharmaceutical industry. The aim is to minimize the impact on Health, the Economy and to make citizens understand that the most effective weapon against the fight against antimicrobial resistance is to reduce the reckless use of antibiotics, since it has been proven that in this way microbes become sensitive again antibiotics, as well as the application of hand hygiene”.

The internationally renowned Infectious Disease specialist in the fight against Antimicrobial Resistance, Professor at the University of Uppsala, Otto Cars, emphasized that “antimicrobial resistance is now a visible global threat and we need to use a ‘new language’ to convince the community to change their mindset” . The Swedish professor underlined that a national action plan with stable financial support for Antibiotic Surveillance is required, under the responsibility of the State.

On her part, Ms. Professor of Pathology-Infectious Diseases, EKPA, etc. President of the Hellenic Society of Chemotherapy, Ms. Eleni Giamarellou pointed out that the resistance of hospital microbes to the strongest antibiotics to date, such as carbapenems, has exceeded 50% for Klebsiella in our country, according to the Whonet system, and exceeds 90% for Acinetobacter in ICUs. The professor also emphasized that, according to the WHO, hand hygiene – with an antiseptic containing 70% alcohol – is the simplest and most important measure to prevent hospital-acquired infections and the spread of multi-resistant microbes, and she emphasized that continuous education is required, both in the community and in health professionals, for infections and Antimicrobial Therapy, at least every three years.

Mrs. Giammarellou also presented a network of proposals and immediately applicable solutions, which have been tested and have yielded significant results at the global level, among which the following are predominant:

1. The Restrictive Prescription, for antibiotics whose administration requires approval by the Infectious Diseases Specialist.

2. The strategic method of “HANDSHAKE STEWARDSHIP”, with a spectacular reduction in stamina exceeding 50%. It is an innovative action plan for the management of antibiotics in hospitals, consisting of a full-time infectious disease specialist (as Leader), a full-time Clinical Pharmacist and an Infection Control Nurse.

The scientists described Microbial Resistance as a “new Armageddon” and expressed their concern because, despite the mandatory prescription in the community, a percentage of 16% obtain antibiotics from the pharmacy without a prescription, while 32% still keep antibiotics at home for “time necessity”. In hospitals, consumption of antibiotics in ICUs is 10 times higher than in wards, and susceptibility to infections is 5 to 10 times higher than in the rest of the hospital and the community.

Scientists analyzed measures to prevent infections and antimicrobial resistance. They emphasized that vaccines save lives by preventing infections, morbidity, mortality and antibiotic use and reducing Antimicrobial Resistance. In contrast, viral infections remain one of the main causes of antibiotic misuse, and their use has been shown to be ineffective. Despite the high rates of Antimicrobial Resistance, compliance with the guidelines remains low. About 80% of antibiotics are prescribed at the primary level, increasing resistance to over 25% in the community.

The suggestions of scientists

The scientists stressed that we are all jointly responsible and the mind-set of mindless overuse of antibiotics, which is primarily responsible for antimicrobial resistance, must change.

For this purpose it is required:

• Informing Greek citizens about the rational use of antibiotics from the first grades of Primary School.

• Regular mandatory retraining of hospital and general practitioners.

• Interventions by the State, with the appointment of full-time and full-time infectious disease doctors in the 3rd level hospitals, in order to reduce the resistance by limiting the overconsumption of antibiotics, to reduce nosocomial infections.

• Intensification of vaccinations.

• Application of hand hygiene.