The outbreak of Covid 19 (the coronavirus) has put the health care sector in the Netherlands under extreme pressure. Many more people were admitted to intensive care, and the regular care activities were downscaled. Nevertheless, it does not seem that more bacteria developed resistance to antibiotics in 2020. For some types of bacteria, resistance even seems to have diminished in comparison to previous years. In addition, the number of bacteria that are resistant to various antibiotics at the same time, making it more difficult to treat them, remained the same. The long-term effects of the corona outbreak on antibiotic resistance are not yet clear.
Over the entire world, we are seeing increasing numbers of infections caused by bacteria with resistance to antibiotics. This problem is less severe in the Netherlands than in many other countries. However, due to the global situation, it remains important to be on the alert in the Netherlands. If the problem of resistance does increase, it will then be easier to detect it in time.
To prevent antibiotic resistance from developing, it is important to use antibiotics properly and only when necessary. General practitioners prescribed approximately 10% fewer courses of antibiotics in the past year compared to previous years. Due to the Covid 19 measures, such as social distancing and working from home, many infectious diseases that are spread by social contacts occurred less frequently. In addition, fewer people visited their general practitioner. The total quantity of antibiotics used in hospitals in 2019 remained fairly stable. The data on their use in hospitals in 2020 is not yet available.
The scope of the measures implemented in the Netherlands to combat antibiotic resistance extend further than the health care sector. After all, resistant bacteria also occur in animals, food and in the environment (One Health approach).
Over the last decade, the intestinal bacteria in pigs, cows, and chickens kept for food production (farm animals) have become less resistant. The level of antibiotic resistance in the various animal sectors remained approximately the same in comparison to 2019. ESBL producing intestinal bacteria in broiler chickens and on chicken meat were less prevalent in 2020. In the other animal sectors, the prevalence of these resistant bacteria was the same as in 2019. ESBLs are enzymes that can break down commonly used antibiotics such as penicillins. The quantity of antibiotics sold in 2020 for farm animals increased somewhat compared to 2019. In comparison to 2009, the reference year, the sale of antibiotics decreased by almost 70%. Almost no antibiotics that are crucial for treating infections in humans have been used for farm animals in recent years.
This is shown in the annual report NethMap/MARAN 2021, in which various organisations jointly present data on antibiotic use and resistance in the Netherlands, for both humans and animals.
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.