The number of bacteria that are resistant to antibiotics is increasing worldwide. In the Netherlands, that number is basically remaining stable and it is not at such a high level as in many other countries. Nevertheless, there is reason to be concerned and alert. The resistance of some bacterial species to some antibiotics is increasing slowly. Particularly in the case of Klebsiella pneumoniae, a common intestinal bacterium, several antibiotics have been becoming less effective over the past five years. These bacteria can cause harmless infections, such as bladder infections, and resistance is making them more difficult to treat. Consequently, certain types of antibiotics that are considered a last resort are having to be used more often.
To prevent resistance, it is important to use antibiotics properly and only when necessary. General practitioners prescribed the same number of courses of antibiotics as in the previous years. The overall use of antibiotics in hospitals is continuing to increase, though.
Approximately the same amounts of antibiotics were prescribed for animals in 2018 as in 2017. With respect to 2009, the reference year, the use of antibiotics has dropped by over 63%. Almost no antibiotics that are important in treating infections in humans have been used for animals in recent years. The number of resistant bacteria in animals has remained roughly the same. However, the number of ESBL-producing intestinal bacteria has dropped further in almost all animal species that are used for food production. This number is only continuing to increase in veal calves. ESBLs are enzymes that can break down commonly used antibiotics such as penicillins.
This is shown in the annual report NethMap/MARAN 2019, in which various organisations jointly present data on antibiotic use and resistance in the Netherlands, for both humans and animals.
In recent years, extra measures have been taken in the Netherlands to combat antibiotic resistance. These measures go further than the healthcare system because resistant bacteria also occur in animals, in foodstuffs and in the environment (One Health). Among other things, 'regional care networks' have been set up to encourage cooperation between various care professionals and to minimize the risk of resistant bacteria being transferred.
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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