Why is antibiotic resistance an important public health problem?

Treating infections due to antibiotic-resistant bacteria is a challenge: commonly used antibiotics are no longer effective and doctors must choose other antibiotics to treat infected patients. This may delay getting the right treatment to patients and may result in complications, including sometimes death. Also, a patient may need more care as well as alternative and more expensive antibiotics, which may have more severe side effects.

The European Centre for Disease Prevention and Control (ECDC) places a great emphasis on prevention of self- medication with antibiotics. Why is this such an important case for your organisation?

Several factors have been identified as being associated with the development of antibiotic resistance, and these include self-medication with antibiotics i.e. without consulting a doctor and getting a medical prescription.
Taking antibiotics when they are not necessary, for the wrong reason, possibly without the correct dose and dose intervals and for the wrong duration – all are factors that will contribute to the development of antibiotic-resistant bacteria and will compromise the activity of the same antibiotic later, for another infection.

According to ECDC, what are the main actions to prevent self-medication and antibiotic resistance?

ECDC has identified three main strategies to address antibiotic resistance: first: prudent use of antibiotics, second: good practices of infection prevention and control, and third: development of new antibiotics with novel mechanisms of action is essential, as resistance inevitably builds over time.

Proper use of antibiotics is the focus of the European Antibiotic Awareness Day (EAAD), a European health initiative coordinated by ECDC. Each year on 18 November, it provides an opportunity to raise awareness about the threat to public health posed by antimicrobial-resistant bacteria and to communicate about the importance of proper use of antibiotics.

This year, WHO organises its first World Antibiotic Awareness Week that will take place on 16-22 November. EAAD will partner with this global initiative by promoting proper antibiotic use across Europe, with a European event on 16 November in Brussels and by raising awareness through social media. Join us with #EAAD and #AntibioticResistance.
In your opinion, how patients and patients’ organisations can be involved in prevention of self-medication and antibiotic resistance?

We should all be involved, because we are all responsible. We or our children sometimes suffer infections and therefore we are potential users of antibiotics even though they are not always needed. For example, colds and flu are caused by viruses against which antibiotics are not active: therefore the EAAD slogan “Cold? Flu? Take care, not antibiotics”.

What would you recommend patients with chronic and long-term conditions to do in order to avoid self-medication and prevent antibiotic resistance?

National authorities have specific recommendations for patients with chronic and long-term conditions and these should be followed. For example, if the infection is severe, such as bacterial pneumonia, or necessitated by the patient´s condition, the doctor will prescribe antibiotics.
Certain patients should seek help of a doctor more quickly than other people. If in doubt, always consult a doctor, but do not self-medicate with antibiotics.

I have Juvenile Idiopathic Arthritis (JIA) and I was diagnosed when I was seven years old. JIA is an autoimmune inflammatory joint disease and it affects approximately 1 in 1.000 children every year. Although, with proper therapy some patients are able to lead normal lives, it is considered to be a lifelong disease.

In my case, the disease affects all the large joints and few smaller joints in my body. My symptoms are joint pain and stiffness, fatigue and also occasionally inflammation. This means that I have to consider carefully before doing things like going out with friends or travelling, because my body is constantly battling itself and this takes up a lot of energy.

Here is an example of the tough process that I go through every time I am asked to go out. It was the beginning of September and I had just started my first year at The University of Tartu. The freshers’ week was in full swing and I was asked to go to a party, to meet the people from my course. The day of the party I had to decide: should I go or should I stay in? I chose to go simply because I felt that if I missed it, I will forever be a social recluse. The party was starting at 11 pm and I already felt the need to take a yearlong nap. My knees and ankles were hurting me and made it difficult for me to move. I really should not go but I was really determined so I made myself a strong cup of coffee, took some painkillers, and got dressed.

When I finally got there, I was still exhausted and in pain. I managed to stay there for an hour, but then I decided to leave. I was home just before 1 am. I did not make any new friends, I just chatted with some acquaintances from high school. Furthermore, later I found out that no one from my course was there.

It’s not easy for people with chronic conditions to do everything they would like to, whenever they want to. Their daily schedule is very dependent on how they are feeling at the moment so it is difficult to make promises to attend an event or just simply meet up. It is very important to be supportive of a friend with a chronic condition. We want to socialise, but our bodies often hinder our ability to do so.