Antibiotic resistance: further efforts required despite progress made so far
Bern, 18.11.2024 - The new “Swiss Antibiotic Resistance Report 2024” (SARR 2024) shows that the use of antibiotics, particularly in veterinary medicine, continues to decline. At the same time, the report highlights the need for further efforts to ensure appropriate use of antibiotics and to combat resistance. Monitoring of antibiotic use and of the development of resistance in humans, farm and companion animals and the environment is a key tool for implementing the Swiss Strategy on Antibiotic Resistance (StAR) of the federal offices responsible for public health (FOPH), food safety and veterinary affairs (FSVO), agriculture (FOAG) and the environment (FOEN).
Antibiotics must be used sparingly and in a targeted manner in order to minimise the development of resistance and to preserve the effectiveness of these vital drugs over the long term. The analysis of data on the use of antibiotics in veterinary and human medicine up to 2023 shows that the positive trend in the use of so-called critically important antibiotics has been maintained. These antibiotics have a high potential for resistance and should therefore only be used for specific types of infection. For critical antibiotics in human medicine, an overall reduction of 26% has been achieved since 2014. Over the same period, a decline of 76% has been seen in the use of critical antibiotics in veterinary medicine. A significant reduction was also observed in the companion animal sector. The downward trend is attributable to greater awareness and thus more appropriate use of antibiotics among veterinarians. Compared to other European countries, Switzerland’s performance has been good to excellent.
Room for optimisation of prescribing practices
While the use of antibiotics in veterinary medicine is declining overall, in human medicine – after the Covid-19 pandemic – it has returned to levels similar to those seen in 2019. Around 20% of primary care prescriptions were for antibiotic classes which are not recommended under national guidelines. Likewise, regional differences persist – antibiotic use in German-speaking Switzerland is considerably lower than in the French- and Italian-speaking regions. There is thus room for improvement in physicians’ prescribing practices.
Good compliance with treatment guidelines in veterinary medicine
Since 2019, antibiotic use in animals has been recorded by veterinarians in the IS ABV database (information system on antibiotics in veterinary medicine). Analysis of this data shows that, for all animal species, the antibiotics primarily recommended are largely used, indicating good compliance with treatment guidelines. Among livestock species, cattle are most frequently treated with antibiotics (564 treatments per 1000 animals), followed by poultry, small ruminants (sheep, goats) and pigs, with less than 80 treatments per 1000 animals in each case.
Wastewater treatment plant upgrades under way
At present, around 15% of Switzerland’s wastewater is treated using an additional step that further reduces inputs of antibiotics to receiving waters – the proportion is to rise to 70% by 2040. According to contemporary scientific knowledge, the antibiotic concentrations currently observed in Swiss surface waters are unlikely to directly promote the development of resistance.
Cross-sectoral monitoring of problematic resistance
The resistance situation shows different developments in different areas. Overall, however, resistance rates have stabilised in recent years. Problematic pathogens continue to be closely monitored both in human medicine and in the veterinary sector. For this purpose, methods such as whole-genome sequencing are used to gain a better understanding of transmission pathways. To ensure that progress continues to be made with appropriate use and resistance control, and that Switzerland’s good current position is maintained over the long term, it is crucial that authorities, professionals and institutions continue to play an active role.
The trends observed in the monitoring programme helped to shape the One Health Action Plan for StAR 2024–2027, launched this summer by the Federal Council. This will strengthen the measures successfully implemented under StAR since 2016, with the One Health approach being further pursued, as human and animal health, agriculture and the environment are all affected by antibiotic resistance.
Additional legal foundations to be established
In addition, the ongoing partial revision of the Epidemics Act should create a legal basis for improving the monitoring, prevention and control of antibiotic resistance over the long term. This revision should also promote the development of new antibiotics and their availability in Switzerland.
Public survey on antibiotic resistance
Complementing the SARR 2024 report is a representative survey commissioned by the Federal Office of Public Health, which provides insights into the Swiss population’s knowledge of, attitudes to and use of antibiotics. The results of the survey show that the public consider health professionals to have a key role in diagnosis, prescription and the correct use of antibiotics, and see them as the most important source of information on the subject of antibiotic resistance.
International efforts and national initiatives on antibiotic resistance
The annual World AMR Awareness Week (WAAW), running from 18 to 24 November 2024, draws attention to the threat posed by antimicrobial resistance (AMR). WAAW aims to raise awareness – among professionals and the public – of the importance of prudent use of antibiotics in combating the spread of resistance. Events and educational campaigns are designed to highlight the need for action and to promote specific measures. The efforts of the World Health Organization (WHO), the World Organisation for Animal Health (WOAH), the Food and Agriculture Organization (FAO), and the United Nations Environment Programme (UNEP) are also being supported by Switzerland, with various stakeholders organising panel discussions, training events, site visits or information booths (WAAW 2024). At the SARR Webinar, StAR experts will present the findings of the Swiss Antibiotic Resistance Report 2024 and discuss planned responses to current challenges in the field of antibiotic resistance.
Address for enquiries
Federal Office of Public Health (FOPH), Communication, Tel. 058 462 95 05, media@bag.admin.ch
Federal Food Safety and Veterinary Office (FSVO), Media Office, Tel. 058 463 78 98, media@blv.admin.ch
Federal Office for Agriculture (FOAG), Communication, Tel. 058 461 14 41, media@blw.admin.ch
Federal Office for the Environment (FOEN), Communication, Tel. 058 462 90 00, medien@bafu.admin.ch
Documents
Publisher
Federal Office of Public Health
http://www.bag.admin.ch
Federal Food Safety and Veterinary Office
http://www.blv.admin.ch
Swiss Federal Office for Agriculture
http://www.blw.admin.ch
Federal Office for the Environment FOEN
https://www.bafu.admin.ch/en