6.4.5. Antimicrobial resistance.

A Council Recommendation (2002/77/EC) was adopted on 15 November 2001 on the prudent use of antimicrobial agents in human medicine. The European strategy to control antimicrobial resistance comprises actions in four priority areas, and takes into consideration that exposure to antimicrobial agents may occur not only through medicinal products but also through:

·          food surveillance with the aim of monitoring resistance to antimicrobial agents and evaluate the effects of interventions. The following priorities have been set up: a) develop a European network for the surveillance of the occurrence of resistant strains; b) put in place and improve the collection of data on consumption of antimicrobial agents in all sectors. These surveillance systems must co-operate closely with the Network on epidemiological surveillance and control of communicable diseases (Decision 2119/98/EC). Such cooperation will favour the analysis of combined information on the spread of communicable diseases, on the occurrence of resistant strains and on consumption of antimicrobial agents for the evaluation of policy effectiveness and for the policy design.

·          preventive actions to avert the occurrence of outbreaks of communicable diseases, to reduce the need for antimicrobial agents and to promote the prudent use of such agents. These include: a) increase the importance of this phenomenon in the dossier requested for any authorization to market antibiotics; b) support, at Community level, educational campaigns directed at professionals (such as optimising the choice of medicament, dose and duration of the treatment and training on hygiene and infection control standards) and the general public to avoid overuse and misuse of antimicrobial agents; c) make sure that antibacterial substances are available by prescription only in human and veterinary medicine, and distributed in a controlled way in agriculture; d) reinforce and promote infection prevention programmes, in particular immunization programmes; e) reinforce the food monitoring system as regards methods of analysis, sanctions and reporting systems; f) phase out and replace antimicrobial agents used with different purposes in feed and food; g) give particular attention to GMOs which contain genes expressing resistance to antibiotics;

·          research and development of alternative products: a) encourage the development of new antimicrobial agents, alternative treatments and vaccines; b) support the development of rapid and reliable diagnostic and susceptibility tests. A need has also been identified for research focused mainly on the mechanisms of emergence and spreading of antimicrobial resistance, development of new means of preventing and treating infections, and on the development of alternatives to antimicrobial agents.

·          international cooperation: the expansion in global trade and travel makes the international dimension of these measures a major pillar that must be specifically addressed. Among the aims of this programme there is, therefore, the development of cooperation, co-ordination and partnership with the Euro-Med, the Northern Dimension and the Candidate Countries and with a number of international organizations, including the WHO.