Antimicrobial stewardship in central Eastern European countries

In September 2019, European Commission President Ursula von der Leyen emphasized three priorities for health: e‑health and the creation of a European Health Data Space to promote health data exchange; advocacy to promote vaccination and tackle vaccine hesitancy; and implementation of the European One Health Action Plan against antimicrobial resistance (AMR) and cooperation at an international level on antimicrobials. The rise of antimicrobial resistance in recent times poses a serious threat to our ability to treat infectious diseases successfully. In 2018, the ECDC estimated that each year, 33,000 persons die from infections due to the resistance of bacteria to antibiotics, with more than 70% of these deaths being associated with healthcare. Selection pressure resulting from increasing antimicrobial use has been identified as the primary causal factor of AMR, which is strongly influenced by the behavior of individuals and of institutions. More specifically, this increase is blamed on overuse and misuse of antimicrobials by patients, physicians, and the farm animal industry. Antimicrobial resistance is also the result of the absence of sufficiently strong incentives for individuals, physicians, and drug manufacturers to consider the cost of resistance associated with successful antimicrobial use.