Antibiotic use is declining rapidly in Spain

Spain is among the countries that have reduced their use antibioticswith a fall of 6.7 percent compared to 2.5 percent overall European Union in the period 2019-2022. However, it ranks seventh in the ranking of countries with the highest consumption of these drugs. While the latest available European average for 2022 was 19.4 prescribed daily doses per thousand inhabitants per day (DHD), in Spain it reached 23.2 DHD. These are the main conclusions of the report Review of microbial resistance and new antibiotics which was prepared General Council of Colleges of Pharmacy (Cgcof) to coincide with the celebration next Monday, November 18th, European Day for the Wise Use of Antibiotics.

The Cgcof document reviews the current situation with microbial resistance and availability of new antibiotics. Although progress has been made in addressing these issues, as evidenced by the reduction in consumption rates following the implementation of the National Plan to Combat Antibiotic Resistance (PRAN), for pharmacists it continues to be “one of the greatest threats to global public health in the 21st century.” century.”

In this scenario, the development of new antibiotics is not yet sufficient to compensate for the increasing emergence of resistance. Over the past five years – since January 1, 2020 – only five new companies have been registered in Spain. antibiotics – oritavancin, delafloxacin, cefiderocol and the combinations of meropenem/vaborbactam and imipenem/cilastatin/relebactam – from the last seven approved in the European Union, which also include lefamulin and cefepime/enmetazobactam.

Among the strategies to avoid the problem of antimicrobial resistance, we must emphasize the importance vaccination and innovative pharmacotherapeutic approaches, such as those using monoclonal antibodies or phage therapy or phage therapy, a therapeutic approach that uses bacteriophages, which are viruses that infect and kill bacteria, to treat bacterial infections.

Regarding vaccines, the report emphasizes that they are another fundamental element in the fight against infectious diseasesas they go far beyond their primary function of individual prevention and also promote herd immunity by reducing the transmission of pathogens within a community.

Moreover, beyond the health aspect, vaccines are an extremely cost-effective strategy. A recent study in Spain cited by Cgcof estimated that every euro invested in General vaccination schedule reports range from 2.91 to 4.58 euros, and the total economic benefit is approximately 800 million euros.

The role of the pharmacist in the use of antibiotics

He pharmacistIn all its many areas of activity – from research to distribution and optimizing the use of medicines – Cgcof has “a clear responsibility and capacity for action in the fight against antimicrobial resistance”, according to Cgcof.

Rita de la PlazaTreasurer of the General Council and Director of the Journal Current Drug Review (PAM), which will publish the report, highlights that pharmacists are in a “privileged position” to directly influence the appropriate use and monitoring of antibiotic treatment. “This role goes beyond drug dispensing and extends to aspects such as public health education, participation in multidisciplinary medical teams or innovation in the development of new antibiotics,” he adds.

Recommendations for dispensing antibiotics

For Cgcof, one of the fundamental roles of pharmacists within the development Professional pharmaceutical servicesThis is health education. In this sense community pharmacy is a “specialty health care facility” that offers a number of basic guidelines regarding the dispensing of antibiotics, including:

• Contact a doctor if a symptom appears that is identified with any infectious disease. They warn about the dangers of self-diagnosis, which can lead to erroneous self-medication.
• Refusal to dispense an antibiotic without appropriate permission. medical prescriptionfor both legal and medical reasons.
• Insist to the public that many common microbial diseases, such as flu
  or colds, are not produced by bacteria, but by viruses, or at least by microorganisms other than bacteria, and, therefore, the use of antibiotics is completely useless, and also contributes to the inadequate selection and proliferation of bacteria resistant to the antibiotic. used.
• Inform that the use of leftovers antibiotic treatment the previous ones pose a serious health hazard, both due to their improper use and the possibility of their deterioration – expired or damaged when stored in inappropriate conditions. Therefore, such remains must be taken to a pharmacy so that they can be collected at CIGRE points under appropriate environmental conditions.
• Insist on completing the full course of treatment, even if symptoms improve sooner. If treatment is stopped early, there is a risk pathogenic bacteria multiply again and develop mechanisms of resistance to the antibiotic used, thereby causing a potentially more serious infection and facilitating the spread of resistant strains.
• Remember that antibiotics are generally safe drugs, although, like all drugs, they can cause side effects In some cases: allergy to some antibiotics (especially beta-lactams) is one of the most well-known and frequent side effects, and therefore the patient must be informed if he has an allergy; In addition, persistence of diarrhea for more than two days in a row during or immediately after antibiotic treatment requires consultation with a doctor.

Moreover, since European pharmaceutical group A number of government measures have been proposed at European level to strengthen the role of pharmacy in the face of antimicrobial resistance.