The number of bacteria that are resistant to antibiotics is increasing worldwide. That number has generally remained fairly stable in the Netherlands. Nevertheless, there is cause for concern and caution. Certain resistant bacteria, the so-called ESBL-producing intestinal bacteria, have become more common among patients of GPs and in hospitals during the past 5 years. ESBL are enzymes that can break down commonly used antibiotics such as penicillins. These bacteria can cause harmless infections, such as bladder infections, that are more difficult to treat because of resistance. Moreover, more frequent use must be made of types of antibiotics that are only used as a last resort.
To prevent resistance it is important to use antibiotics properly and only when necessary. In recent years, GPs have been prescribing fewer antibiotics. In hospitals, on the other hand, total antibiotic use increased in 2016 compared to the previous year. On balance, total antibiotic use for animals in 2017 was comparable to 2016. Use declined in some animal sectors, while it increased slightly in other sectors. The antibiotics that are important to humans are only used to a limited extent in the animal sectors. The prevalence of ESBLs has declined further among almost all types of animals used for the food production, with the exception of veal calves where an increase was seen.
This is evident from the annual report NethMap/MARAN 2018, in which various organisations jointly present data on antibiotic use and resistance in the Netherlands, both for humans and animals.
In the past two years, extra measures have been taken in the Netherlands to combat antibiotic resistance. These measures go beyond healthcare. After all, resistant bacteria do not adhere to land borders and also occur in animals, food and in the environment (One Health). To support this approach, 'regional cooperative networks' were set up in 2017. They have the task of stimulating collaboration between different healthcare professionals in preventing and combating antibiotic resistance. In addition, there has been more attention to antibiotic resistance in nursing homes. For example, a new study investigates how many residents carry resistant bacteria. The results are expected at the end of 2018.
Collaboration
This report is published under the acronym NethMap by the SWAB, the Dutch Foundation of the Working Party on Antibiotic Policy, in collaboration with the Centre for Infectious disease control (CIb) of the RIVM, the National Institute for Public Health and the Environment of the Netherlands.
The major goal of the Dutch Working Party on Antibiotic Policy (Dutch acronym is SWAB) is to contribute to the containment of the development of antimicrobial resistance and of the expanding costs of the use of antibiotics. This is achieved by optimizing the use of antibiotics by means of guideline development, education and antibiotic resistance surveillance.
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