One of the biggest global health threats is the loss of the healing effects of antibiotics. According to some predictions, it may be responsible for more deaths than cancer by 2050. One of the key ways to preserve the effectiveness of antibiotics is through information campaigns that raise public awareness about antibiotic stewardship. A joint survey by Engage Hill and Remmark in February 2022 shows how the knowledge of the Czech population has been influenced by the Prevent Antibiotic Resistance campaign, which has been running in the Czech Republic since autumn 2021.
„The Preventing Antibiotic Resistance project focuses on preventing the misuse or unnecessary use of antibiotics in the Czech population. The effort to preserve the effectiveness of antibiotics requires a comprehensive approach to the issue, respecting the principle of One Health, which is the umbrella of the National Antibiotic Programme. This is done both by linking activities within the Department of Health, targeting the public and professionals, and by close cooperation with other departments, especially veterinary medicine. Only the joint implementation of preventive measures and infection control will allow us to limit the spread of resistant microbes in healthcare facilities and in the general population,“ says Barbora Macková, M.D., Director of the State Health Institute.
Prestigious global research published in the Lancet shows that antibiotic resistance is already one of the most common causes of death. The number of victims is approximately one million lives lost worldwide each year. In 2019, for example, one and a quarter million patients succumbed to such diseases.
Antibiotic resistance has been perceived as a serious public health problem since 1998, when the Microbial Threat Conference was held in Copenhagen, Denmark. This was the first step on the road to counter the weakening effects of antibiotics against increasingly resistant batteries. This was followed by awareness-raising projects in individual EU countries, including a project by the National Institute of Health (NIH) called Prevention of Antibiotic Resistance. Launched in November 2021, it used advertising, PR articles and social media activity to raise awareness of the seriousness of the problem of microbial resistance to antibiotic treatment of infections. It also included a joint survey by Remmark and Engage Hill monitoring our population’s knowledge of antibiotic use. The first part of the survey was conducted before the campaign began (7/2021), and the second after the first phase of the campaign ended (2/2022).
„The survey provided us with interesting feedback. It showed that almost two-thirds of the population (62.5%) had already encountered the topic of antibiotic resistance, which is 19% more than before the campaign started. The highest increase was observed in the group with primary education and also in the age group under 35. We consider this a success because the data from August 2021 showed that the gaps in knowledge about antibiotic use were mainly in the younger generation,“ explains Assoc. MUDr. Helena Žemličková, Ph.D., Head of the National Reference Laboratory for Antibiotics of the National Institute for Health Research and expert guarantor of the project.
The biggest benefits of the survey in practice
The key finding of the survey is that 82% of people in the Czech Republic already know that antibiotics are not effective against viruses.
„This knowledge is crucial. I believe that patients will be aware that there is no point in trying to get a doctor to prescribe antibiotics in case of viruses. The survey also showed that 65% of the Czech population understands that the correct model of behaviour is to leave the prescription of antibiotics to the discretion of the doctor,“ explains Associate Professor Žemličková. „Although the statistics of the February survey show significantly more positive data than in July 2021, we still have room for improvement. This is confirmed, for example, by the contradiction that the survey revealed: only 6% of respondents mistakenly believe that antibiotics work against colds, but a full 35% of respondents incorrectly state that antibiotics shorten the treatment of colds,“ adds the expert guarantor of the project.
Recommendations for doctors on how to indicate antibiotics
The Antibiotic Resistance Project does not just spread awareness among the general population, but supports doctors in their decision-making process on whether or not to indicate antibiotics for a particular patient. Indeed, the increase in antibiotic resistance due to the prescription of mainly broad-spectrum antibiotics is leading to the devaluation of all antibiotics. That is why the website antibiotickaresistence.cz also offers a ‚Recommendations for physicians‘ section.
„We have tried to make the issue of antibiotic resistance prevention as comprehensive as possible. Therefore, we have also targeted general practitioners to facilitate their decision-making regarding the indication of antibiotics, the choice of a specific drug, the dosage and the duration of treatment of the most common infectious diseases in primary health care. The aim of the recommendations is to maintain the effectiveness of antibiotics used in the treatment of community infections. For this reason, unnecessary use of antibiotics should be avoided and the duration of their administration should be optimally reduced. The recommendations therefore address two levels of assessment: whether it is relevant to prescribe antibiotics and, if so, which ones to choose. Our recommendations should lead to a reduction in the overall consumption of antibiotics and a preference for narrow-spectrum ones. And this is the way to preserve the curative effects of antibiotics,“ adds Helena Žemličková.
The recommendations are based on our own data on the prevalence and status of antibiotic resistance of bacterial community infections in the Czech Republic. They take into account the latest expert knowledge (Cochrane database, Micromedex) and are supported by similar recommendations from European countries (Norway, Sweden and the UK). The State Institute of Health in cooperation with the Subcommittee for Antibiotic Policy of the Czech Medical Association, representatives of professional societies and associations of the Czech Medical Association, primary care physicians and specialists in individual clinical areas have contributed to their development.
A new tool for monitoring ATB prescription also helps physicians
As the structure of antibiotic prescriptions in our country is steadily deteriorating, the Health Insurance Office (HIO) is also offering assistance to doctors in the decision-making process for antibiotic prescribing.
„We are fully aware of the dangers of antibiotic resistance, which is why we have prepared and developed a set of antibiotic prescription indicators for physicians, which are available on our website. For the first time, adult and paediatric practitioners have the opportunity to compare their practice not only with the recommended thresholds, but also with aggregate benchmarks in their region and across the country. This information will allow them to adjust their antibiotic prescribing in line with recommended practices,“ explains Ing. Ladislav Wagner, MHA.
The results of the measurements are published on the KZP Indicators Portal (puk.kzp.cz). They have been developed in cooperation with health insurance companies, sponsors from the field of general medicine, infectology and representatives of professional societies. The KZP also cooperates with the National Antibiotic Programme to improve the situation and disseminate information to both doctors and the general public.
The project Prevention of Antibiotic Resistance is implemented by the National Institute of Health. The project Prevention of Antibiotic Resistance (ZD-PDP2-001) was supported by a grant from the EEA Grants 2014-2021 under the Health Programme. www.eeagrants.cz