Covid cuts antibiotic use by 15% in Europe, but resistance worries

Antibiotic use dropped more than 15% between 2019 and 2020 —during the coronavirus pandemic — in Europe, show data recently released by the ECDC (European Center for Disease Control).

Despite this, antimicrobial resistance levels remain high for several important combinations of bacterial species and antimicrobial substances, mainly in countries in the south and east of the continent.

According to ECDC, more than 670,000 infections due to bacterial resistance occur each year in the 30 countries monitored by the organ, and around 33,000 people die from them. The number is comparable to flu, tuberculosis and AIDS combined.

“Lives are lost because the medicines no longer work and we urgently need to step up global action,” said Stella Kyriakides, EU health commissioner.

According to her, to fight drug resistance, the European bloc tightened legislation on veterinary medicines and medicated foods.

Andrea Ammon, director of ECDC, says there is also a need to improve infection prevention and control in hospitals and other medical settings.

“In the primary care sector, many infections are preventable through vaccination, respiratory etiquette, physical distance and hand hygiene, which reduces the need to use antibiotics,” she said.

According to ECDC, preventive measures to prevent the spread of Sars-Cov-2 also reduced the incidence of other respiratory tract infections in Europe in 2020, which shows the effectiveness of these methods, on the one hand, and explains part of the reduction in the consumption of medicines.

Hans Kluge, director for Europe at the WHO (World Health Organization), said an additional problem is that, especially in the east of the continent, the sale of these drugs without a prescription or control is still widespread.

“These antibiotics available are often associated with the highest risk of developing resistance. Covid is forcing us to fight a number of health threats, and resistance is one of the most serious,” Kluge said.

According to the ECDC, more than half of the reported strains were resistant to at least one antimicrobial group. Escherichia coli, one of the most frequent causes of intestinal and urinary infections worldwide.

In the case of Klebsiella pneumoniae, which can cause pneumonia, blood, urinary and postoperative infections, resistance was found in one third of the samples. Combined resistance to multiple antimicrobial groups was common, the report says.

species like Pseudomonas aeruginosa, one of the main causes of hospital infections, and Acinetobacter, which affects the lung, urinary tract, skin and soft tissue, showed common resistance to Carbapenen, a broad-spectrum antibiotic.

The percentage of isolates from Enterococcus faecium (which can cause neonatal meningitis) resistant to Vancomycin (a last-line drug) jumped from 11.6% in 2016 to 16.8% in 2020.

These pathogens can persist in the healthcare environment and are difficult to eradicate once established.

According to the ECDC, resistance to antibiotics such as Vancomycin and carbapenems is of concern because when they are no longer effective, treatment options are very limited and may not work, leading to death.

Resistance to these state-of-the-art drugs also compromises the effectiveness of cancer treatment and organ transplants.