2023-11-18 15:22:55
Toothache, cystitis and colds are the pathologies in which excessive consumption of antibiotics is observed in Spain, as revealed by the latest Cofares Trends Observatory: ‘Antibacterial resistance, a threat to public health?’
The study also confirms, as Cofares explains, that around 35,000 people die each year in Europe as a result of resistant infections, approximately 4,000 of them in Spain.
This Observatory is an initiative developed within the framework of the World Awareness Week on Antimicrobial Resistance, promoted by the World Health Organization (WHO) under the motto ‘Let’s prevent antimicrobial resistance together’, and which is celebrated from November 18 to 24.
To develop the Cofares Trends Observatory, we have analyzed, on the one hand, the evolution of demand in pharmacies for antibiotic medications in recent years, and documentary and bibliographic research to advance the knowledge of the pathologies where this type is most prescribed. of drugs.
Among its main conclusions, this work reveals an inappropriate magnitude in terms of prescription of this type of drugs in common pathologies, such as toothache, urinary tract infections and winter infections that affect the nose, ears. , and the throat.
Likewise, the results obtained also show that in dentistry, around 10% of the total antibiotics consumed are prescribed, of which it is estimated that in 70% of cases these prescriptions are not considered appropriate.
In parallel, it is observed that urinary tract infections (UTI) are the second most common cause of antibiotic prescription, after respiratory infections. In fact, one in four women receives inappropriate antibiotics as treatment. Regarding respiratory infections, it is concluded that most of the symptoms of winter illnesses can be alleviated with other medications that can be purchased without a prescription at the pharmacy.
In fact, between 44% and 98% of antibiotic prescriptions for respiratory tract infections are classified as inappropriate. In this sense, the role of the pharmacist is especially important, who can recommend and advise on the best medication to administer, thus avoiding excessive consumption of antibiotics.
Demand in pharmacies
The analysis shows that in the years prior to the outbreak of the covid-19 pandemic, there was a seasonal pattern of demand for antibiotics, which included significant volumes in six of the twelve months of the year and absolute and relative maximums in the seasons of autumn and winter. A pattern that was altered in the 2020-2021 season, when a significant decrease in demand was recorded. This is a consequence of the arrival of the pandemic and the corresponding protective measures established: home confinement, social distancing, the systematic use of the mask and hand hygiene.
After the relaxation of these restrictions, a pattern similar to the pre-pandemic reappears starting in autumn 2021, although without reaching the same levels of demand to date. This behavior is observed at the national level and is replicated in most communities.
Regarding the accumulated demand for antibiotic medications, an increase of 3% in unit volume has been observed compared to pre-pandemic levels. The autonomous communities with the greatest weight and growth in demand for this type of drugs are Madrid (weight 23%, +7%), Comunidad Valenciana (weight 14%, +8%) and Andalusia (weight 11%, +6%) .
A job for everyone
Reducing inappropriate antibiotic prescribing is crucial to combat the growing global threat of antimicrobial resistance, Cofares reiterates. To improve guideline adherence, it is essential to understand the barriers that hinder this goal. This understanding will allow effective interventions to be directed, both for doctors and patients, thus improving the implementation of more appropriate practices.
In parallel, it is necessary for the scientific community to design new antibiotics or innovative therapeutic approaches for the treatment of antibiotic-resistant infections, since pathogens have evolved and generated resistance to multiple antibiotics and their treatment is becoming problematic.
Community pharmacy
Antibiotherapy management programs are multidisciplinary strategies that, through the coordination of different healthcare agents, seek to optimize the therapeutic potential of antibiotics, by focusing on evidence-based practices, and minimizing the emergence and spread of antimicrobial resistance. Therefore, pharmacists, once again, can play a crucial role in such programs, both in the hospital and community settings.
Pilot programs in community pharmacies have yielded positive results in promoting and educating patients on the administration of antibacterial treatments. Specifically, they have shown benefits in reducing patients’ expectations to receive antibiotics in self-limited infections and in turn reducing the pressure on primary care physicians to prescribe them.
In addition, they have made it possible to collect relevant data about the infections themselves, risk factors, allergies and knowledge about antibiotics among the general population. Community pharmacies are well positioned to contribute significantly to the implementation of information and prevention programs in the use of antibiotics, as they can actively participate in patient education, promote the rational use of antibiotics and provide appropriate advice on adherence to the medication. medication and possible adverse effects.
Environment
The main cause of the spread of resistance in the environment is human activity. Resistances circulate freely through the different compartments, but the environments that have been modified or in some way influenced by human action are those that generate the greatest impact on the abundance and diversification of said resistances, putting the future of medicine at risk. human and animal.
The existence of antibiotic residues in soil, water, sediments and living beings has a determining role in the conservation, propagation and dissemination of resistance genes in the environment. Thoroughly understanding the environmental behavior of antibiotics is very useful in the battle against resistance to these drugs.
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