Survey in eastern European and central Asian countries finds further control of antibiotics use needed

A WHO survey carried out in 18 countries and areas of eastern Europe and central Asia reports that legislative frameworks are already in place to govern the distribution, quality, prescription and dispensing of antibiotics.

Survey respondents suggested that legislation and regulations governing the marketing authorization of antimicrobials, their distribution, quality, prescription and dispensing are mostly enforced. Respondents from 6 countries and areas indicated that antibiotics were “regularly” sold over the counter without prescription, and respondents from a further 8 said this occurred “occasionally”. The responses seem at odds with other evidence that suggests widespread availability of over-the-counter antibiotics in a number of the countries and areas.

Many, but not all, of the countries and areas confirmed that officially endorsed clinical guidelines or treatment protocols for some common infections were in place in hospitals and for primary health settings, but acceptance and use of the guidelines in practice is less clear.

Survey respondents also reported a wide range of activities in support of appropriate use of antimicrobials that targeted the general public, doctors and pharmacists.

Greater enforcement needed

Priority actions identified by survey respondents for improving the responsible use of antibiotics were greater enforcement of prescription-only access to antibiotics, educating health-care professionals about antimicrobial resistance (AMR) and appropriate use of these medicines, improving public awareness on rational use of antibiotics, and establishing and implementing standard treatment guidelines for use in clinical practice.

The survey additionally suggests that opportunities exist to enhance the role of pharmacists to support responsible use of medicines. The results highlight limited collaboration between pharmacists and doctors in most of the participating countries and areas.

The 18 countries and areas surveyed are members of the WHO Regional Office for Europe Antimicrobial Medicines Consumption Network.

The growing threat of AMR

AMR, and resistance to antibiotics in particular, is a serious threat to public health in the Region. The human and financial costs of AMR are recognized worldwide, with estimates of 700 000 deaths each year globally due to drug-resistant infections, and projected annual reduction in gross domestic product of 3.8% by 2050.

AMR also poses substantial risks to the achievement of the Sustainable Development Goals. Progress to address AMR relies on coordinated responses across the human and animal health sectors, as well as the environment, trade, intellectual property and innovation sectors.