Antibiotics are drugs that are very valuable in treating or preventing all sorts of infections caused by bacteria. Nevertheless, the more antibiotics are used, the more bacteria develop resistance to them. This is natural, and it is happening all over the world, particularly where antibiotics are used, overused and misused. Antibiotics use has to be balanced: they should be used only when they are needed for therapeutic reasons.

Did you know?

• Part of the reason for overuse of antibiotics is that people use them to treat influenza and colds. Viruses, not bacteria, cause influenza, colds, most sore throats and bronchitis, so taking antibiotics for them will not cure them and may do more harm than good, because it increases the risk of getting an infection later that resists antibiotic treatment. Further, antibiotic-resistant bacteria may infect other people and can spread from one place – or country – to another.
• Antibiotic resistance spreads. Resistant bacteria can be transmitted between human beings, between animals and between human beings, animals and the environment.
• Treatment of infections with resistant bacteria requires more expensive drugs, takes longer and may involve extended stays in hospital. For example, drugs used to treat multidrug-resistant tuberculosis can be significantly more expensive than the common anti-tuberculosis drugs that are normally used.
• Further, antibiotics are used to prevent bacterial infections, but only for specific reasons, for example, during and shortly after certain surgical operations and diagnostic tests such as when small scopes are inserted into the body. Such use usually lasts only 24 hours.
• Antibiotics are also used in the food-chain, especially as growth promoters in food-animal production. This is banned in the European union (EU), but not yet in other parts of the WHO European Region. Sometimes greater amounts of antibiotics are used in animals than in people. Resistance is occurring here, too, which makes the problem worse: resistant bacteria spread from the food-chain to people, including into hospitals and clinics.
• Unfortunately, new antibiotics are not going to be available for some time, as the research into and development of drugs require very high investments, which will only be made if future returns are considered profitable for drug companies.

Possible consequences

If the overuse and misuse of antibiotics are not stopped, antibiotics might not be effective any more when people need them. Imagine your doctor saying that there is no treatment for your child or your friend because he or she has a bacterial infection that antibiotics can no longer treat. Already, 25 000 people in the EU, Iceland and Norway die every year from bacterial infections that do not respond to antibiotics and mostly occur in hospitals. Society could return to a time before antibiotics were available, when simple infections could mean a death sentence.

Resistant bacteria are emerging and spreading rapidly. Today some bacteria are resistant to multiple agents, making life-threatening infections such as blood-stream infections or pneumonia potentially untreatable. Further, the loss of effective prevention through antibiotics could make a number of advanced medical interventions and diagnostic tests – such as arthroscopy, hip replacements and colon surgery – impossible because antibiotics would not protect against potential bacterial infections.

Antibiotic resistance is an urgent concern for everybody. To stop its increase, everyone has the responsibility to use antibiotics only when needed and prescribed by a doctor.

Many countries in the WHO European Region have public awareness campaigns to reduce antibiotic use, and these are making a difference. Everyone can help to tackle this problem.

What you can do

• Never buy antibiotics without prescription from a doctor.
• Do not expect a doctor to prescribe antibiotics for every infection. Viruses cause many respiratory infections, including colds and influenza. Antibiotics only cure bacterial infections; if they will not work for your illness, you do not need them, and they may make you more vulnerable in the future.
• If you are prescribed antibiotics, take them exactly as the doctor or pharmacist says. Complete the prescribed course of treatment, even if you are feeling better. If you do not, the infection may return.
• Do not use any medicine that has been prescribed for another person or condition.
• Try to prevent infections. Wash your hands regularly and encourage your family and colleagues to do the same.
• Preventing some bacterial infections through vaccination is another important step.
• Farmers should use antibiotics on their animals when prescribed, and not as growth promoters, as bacterial resistance can spread.

Points to remember

• Antibiotics are not always needed.
• Their overuse and misuse contribute to antibiotic resistance.
• Antibiotic resistance causes increased illness and unnecessary deaths.
• Antibiotic resistance can take society back to the pre-antibiotic era, when common infections could easily kill.
• No action today means no cure tomorrow!

Definitions: antibiotics and antibiotic resistance

Antibiotics are a subclass of antimicrobial agents that are active only against bacteria. They can either be naturally derived from bacteria or moulds (fungi) or produced synthetically. Scientifically, “antibiotic” refers only to naturally produced antimicrobial agents, but this text uses the term to mean all drugs or agents against bacterial infections.

The emergence of resistance to antibiotics is a natural biological phenomenon that occurs when antibiotics are used. Antibiotic resistance results from the ability of bacteria to withstand attack by antibiotics, which can develop either through mutation or by acquiring resistance genes from other bacteria that are already resistant.

The main drivers of antibiotic resistance are the use of antibiotics, especially overuse (but also misuse and underuse) and the transmission and spread of already resistant bacterial strains or genes that carry the information on resistance.

For further information on antibiotic resistance, please contact:

Dr Bernardus Ganter
Senior Adviser, Antimicrobial Resistance, Division of Communicable Diseases, Health Security and Environment
WHO Regional Office for Europe
Scherfigsvej 8
DK-2100 Copenhagen Ø
Denmark
Tel.: +45 39 17 14 23
E-mail: bga@euro.who.int

For further information and interview requests, please contact:

Ms Viv Taylor Gee
Regional Adviser, Communications
WHO Regional Office for Europe
Scherfigsvej 8
DK-2100 Copenhagen Ø
Denmark
Tel.: + 45 39 17 12 31
E-mail: VGE@euro.who.int