Both initiatives were presented today during the Day of the European Day for the Prudent Use of Antibiotics 2019, which was held at the headquarters of the Ministry of Health, Consumption and Social Welfare with the collaboration of the Ministry of Agriculture, Fisheries and Food.

This meeting, organized by the Spanish Agency for Medicines and Health Products (AEMPS), has been assisted by more than 250 people. Experts from different fields have analyzed the current problem of resistance: Carl Suetens, specialist of the European Center for Disease Prevention and Control (ECDC); Christian de la Fe, researcher at the University of Murcia; María Jesús Lamas, director of the AEMPS; and José Luis Martínez, researcher at the National Biotechnology Center (CNB-CSIC), who has detailed for the first time on this day the relationship between resistance and the environment.

More training and information, better prescription

Among the priority initiatives of PRAN, María Jesús Lamas has highlighted the promotion of the training of Spanish health professionals in the field of resistance, a strategy that "will greatly contribute to reducing antibiotic consumption and improving its use." Thus, he has announced the creation of the Expert Diploma in Optimization Programs for the Use of Antibiotics (PROA), a degree developed in collaboration with the National University of Distance Education (UNED) and funded by this state agency. In the next four years, UNED will convene and award 188 annual seats for this course, which has 20 ECTS credits and is aimed at health professionals who work within the framework of PROA in the hospital field.

In the area of ​​Animal Health, the interactive map of clinical pathogens developed with the Grup de Sanejament Porcí de Lleida (GSP) will also help improve antibiotics, a tool that will provide veterinarians with all the information necessary to optimize the prescription. A network of laboratories will communicate data from isolated pathogens and antibiotic sensitivity patterns for constant map updating. This will allow the veterinarian to consult the specific pathogen that is most likely to cause infection in the treated species and in a specific geographical area, as well as its level of sensitivity to antibiotics.

This resource will reinforce the preparation of veterinarians to comply with the new European legislation on animal health, which will enter into force in January 2022. In addition to the surveillance of clinical pathogens in animals, the new regulations include the collection of data from veterinary prescriptions and better biosafety, management and welfare measures on farms. The MAP will lead this preparation with the ultimate goal of reducing the need for antibiotics.

According to the latest data collected under the PRAN, the total consumption of antibiotics in human health in Spain registered a decrease of 7.2% (2 DHD) between 2015 and 2018, while sales of veterinary antibiotics were reduced by 52.3% between 2014 and 2018. The Spanish average of antibiotic consumption in human health has gone from the 28 DHD registered in 2015 to the 26.1 DHD counted in 2018. In the case of veterinary antibiotic sales, with the 52.3% reduction Spain goes from 418.8 mg / PCU counted in 2014 to 199.2 mg / PCU in 2018. In the fall of the veterinary area, the drop in sales of antibiotics of critical importance for human health, which in 2014 was 12% of the total and in 2017, 4%. In any case, and waiting for the ESAC-Net database and the ESVAC project to update their figures, Spain remains above the European average for antibiotic use, both in human and veterinary medicine.

What do European healthcare professionals know about resistance?

According to the results of the online survey conducted by the ECDC of 18,365 health professionals throughout the European Union (EU) in the field of human health, the vast majority know the key concepts on resistance and know that antibiotics are not effective against infections viral (97%). 89% of health professionals know the connection between prescription, dispensing or administration of antibiotics and the spread of resistance, although only 58% recognize playing a key role in controlling this problem.

Nursing professionals are the group that best knows the recommendations of the World Health Organization (WHO) for proper hand hygiene (73%). In the case of prescribers, although most consider resistance as a prominent factor when deciding on treatment, fear of complications in the patient is the main factor in prescribing antibiotics in situations where they would have preferred not to. 43% say that this concern affected their prescriptions at least once in the last week.

The publication of guides and group training are the most decisive actions for changing attitudes, according to respondents, and more than 75% say they have easy access to guides for infection management. Spain is one of the countries that has contributed most to this analysis, with a total of 1,892 respondents. The ECDC recalls in this study that infections related to healthcare represent 75% of the total burden of the problem of resistance in the EU and more than half of these infections could be prevented.

PRAN Awards 2018

On this day, the PRAN 2018 Awards have been delivered. A total of 54 projects have attended the II edition of these awards, which reflects the enormous commitment of all the groups involved in our country to a problem that every year It causes 33,000 deaths throughout Europe and around 3,000 in Spain.

In the surveillance and research categories, the project "Evaluation of the sale of antibiotics for veterinary use through the Internet", presented by Juan Felipe García Sierra, and the study "New metagenomic and bioinformatics methodologies for the detection and quantification of bacteria and genes with antimicrobial resistance ", presented by the Foundation for Biomedical Research of the Ramón y Cajal University Hospital (FIBIO-HRC).

In the categories of best scientific publication, training and communication, the article "Whole genome sequencing, molecular typing and in vivo virulence of OXA-48-producing Escherichia coli isolates including ST131 H30-Rx, H22 and H41 subclones", presented by Javier Fernández Domínguez; the VetResponsable platform, presented by the Vet + i Foundation; and the Micro-combat card game, presented by the Barcelona Global Health Institute Foundation (ISGlobal).

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