Skip to main content
Top
Published in: Antimicrobial Resistance & Infection Control 1/2018

Open Access 01-12-2018 | Research

Antibiotic consumption and antimicrobial resistance in Poland; findings and implications

Authors: Jadwiga Wojkowska-Mach, Brian Godman, Amanda Glassman, Amanj Kurdi, Andrzej Pilc, Anna Rozanska, Szymon Skoczyński, Marta Wałaszek, Tomasz Bochenek

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2018

Login to get access

Abstract

Background

The problem of inappropriate use of antibiotics and the resulting growth in antimicrobial resistance (AMR) has implications for Poland and the world. The objective of this paper was to compare and contrast antibiotic resistance and antibiotic utilisation in Poland in recent years versus other European countries, including agreed quality indicators, alongside current AMR patterns and ongoing policies and initiatives in Poland to influence and improve antibiotic prescribing.

Methods

A quantitative ten-year analysis (2007–2016) of the use of antibiotics based on European Centre for Disease Prevention and Control (ECDC) data combined with a literature review on AMR rates and antimicrobial stewardship initiatives.

Results

The system of monitoring AMR and appropriate strategies to address AMR rates remain underdeveloped in Poland. The role of microbiological diagnostics and efforts to prevent infections is currently underestimated by physicians. Overall, Poland had one of the highest rates of total consumption of antibiotics in the analysed European countries. Total consumption of antibacterials for systemic use and relative consumption of beta-lactamase sensitive penicillins were characterized by small but statistically significant average annual increases between 2007 and 2016 (from 22.2 DIDs to 23.9 DIDs and from 0.8 to 1.3%, respectively).

Conclusions

The integrated activities around appropriate antibiotic prescribing in the pre- and post-graduate training of physicians and dentists seem to be particularly important, as well as changes in policies on prescribing antibiotics within ambulatory care. AMR and appropriate prescribing of antibiotics should be the focus of health policy actions in Poland.
Literature
2.
go back to reference Watanabe M, Iyobe S, Inoue M, et al. Transferable imipenem resistance in Pseudomonas aeruginosa. Antimicrob Agent Chemother. 1991;35:147–51. Watanabe M, Iyobe S, Inoue M, et al. Transferable imipenem resistance in Pseudomonas aeruginosa. Antimicrob Agent Chemother. 1991;35:147–51.
4.
go back to reference Caron WP, Mousa SA. Prevention strategies for antimicrobial resistance: a systemic review of the literature. Infect Drug Resist. 2010;3:25–33.PubMedPubMedCentral Caron WP, Mousa SA. Prevention strategies for antimicrobial resistance: a systemic review of the literature. Infect Drug Resist. 2010;3:25–33.PubMedPubMedCentral
7.
go back to reference Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. Pharmacy and Therapeutics. 2015;40(4):277–83.PubMedPubMedCentral Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. Pharmacy and Therapeutics. 2015;40(4):277–83.PubMedPubMedCentral
9.
go back to reference Harris AM, Hicks LA, Qaseem A. Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016;164(6):425–34. https://doi.org/10.7326/M15-1840.PubMed Harris AM, Hicks LA, Qaseem A. Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016;164(6):425–34. https://​doi.​org/​10.​7326/​M15-1840.PubMed
10.
go back to reference McCaig LF, Besser RE, Hughes JM. Trends in antimicrobial prescribing rates for children and adolescents. JAMA. 2002;287(23):3096–102.PubMed McCaig LF, Besser RE, Hughes JM. Trends in antimicrobial prescribing rates for children and adolescents. JAMA. 2002;287(23):3096–102.PubMed
24.
go back to reference Chlabicz M, Chlabicz S, Marcinowicz L, Rogowska-Szadkowska D, Pytel-Krolczuk B, Leszczyńska K. Outpatient use of systemic antibiotics in Poland: 2004-2008. Przegl Epidemiol. 2014;68(3):435–47.PubMed Chlabicz M, Chlabicz S, Marcinowicz L, Rogowska-Szadkowska D, Pytel-Krolczuk B, Leszczyńska K. Outpatient use of systemic antibiotics in Poland: 2004-2008. Przegl Epidemiol. 2014;68(3):435–47.PubMed
27.
go back to reference Walaszek M, Rozanska A, Bulanda M, Wojkowska-Mach J. Polish Society of Hospital Infections T. alarming results of nosocomial bloodstream infections surveillance in polish intensive care units. Przeg Epidemiol. 2018;72(1):33–44. Walaszek M, Rozanska A, Bulanda M, Wojkowska-Mach J. Polish Society of Hospital Infections T. alarming results of nosocomial bloodstream infections surveillance in polish intensive care units. Przeg Epidemiol. 2018;72(1):33–44.
31.
go back to reference Wójkowska-Mach J, Jaje E, Romaniszyn D, Kasparek M, Frańczuk B, Bulanda M, Heczko PB, et al. Comparison of SSI rate in endoarthoplasty of hip and knee in a Cracow patient population and the importance of postdischarge surveillance. Infection. 2008;36:36–40. https://doi.org/10.1007/s15010-007-6339-x.PubMed Wójkowska-Mach J, Jaje E, Romaniszyn D, Kasparek M, Frańczuk B, Bulanda M, Heczko PB, et al. Comparison of SSI rate in endoarthoplasty of hip and knee in a Cracow patient population and the importance of postdischarge surveillance. Infection. 2008;36:36–40. https://​doi.​org/​10.​1007/​s15010-007-6339-x.PubMed
32.
go back to reference Adriaenssens N, Coenen S, Tonkin-Crine S, Verheij TJ, Little P, Goossens H. European surveillance of antimicrobial consumption (ESAC): disease-specific quality indicators for outpatient antibiotic prescribing. BMJ Qual Saf. 2011;20(9):764–72.PubMed Adriaenssens N, Coenen S, Tonkin-Crine S, Verheij TJ, Little P, Goossens H. European surveillance of antimicrobial consumption (ESAC): disease-specific quality indicators for outpatient antibiotic prescribing. BMJ Qual Saf. 2011;20(9):764–72.PubMed
33.
go back to reference Adriaenssens N, Coenen S, Versporten A, Muller A, Vankerckhoven V, Goossens H. European Surveillance of Antimicrobial Consumption (ESAC): quality appraisal of antibiotic use in Europe. J Antimicrob Chemother. 2011;66 Suppl 6:vi71–7. doi: https://doi.org/10.1093/jac/dkr459.PubMed Adriaenssens N, Coenen S, Versporten A, Muller A, Vankerckhoven V, Goossens H. European Surveillance of Antimicrobial Consumption (ESAC): quality appraisal of antibiotic use in Europe. J Antimicrob Chemother. 2011;66 Suppl 6:vi71–7. doi: https://​doi.​org/​10.​1093/​jac/​dkr459.PubMed
36.
go back to reference Chmielarczyk A, Pilarczyk-Żurek M, Kamińska W, Pobiega M, Romaniszyn D, Ziółkowski G, et al. Molecular epidemiology and drug resistance of Acinetobacter baumannii isolated from hospitals in southern Poland: ICU as a risk factor for XDR strains. Microb Drug Resist. 2016;22(4):328–35. https://doi.org/10.1089/mdr.2015.0224.PubMed Chmielarczyk A, Pilarczyk-Żurek M, Kamińska W, Pobiega M, Romaniszyn D, Ziółkowski G, et al. Molecular epidemiology and drug resistance of Acinetobacter baumannii isolated from hospitals in southern Poland: ICU as a risk factor for XDR strains. Microb Drug Resist. 2016;22(4):328–35. https://​doi.​org/​10.​1089/​mdr.​2015.​0224.PubMed
37.
go back to reference Chmielarczyk A, Pomorska-Wesołowska M, Szczypta A, Romaniszyn D, Pobiega M. Molecular analysis of methicillin-resistant Staphylococcus aureus strains isolated from different types of infections from patients hospitalized in 12 regional, non-teaching hospitals in southern Poland. J Hosp Infect. 2017;95(3):259–67. https://doi.org/10.1016/j.jhin.2016.10.024.PubMed Chmielarczyk A, Pomorska-Wesołowska M, Szczypta A, Romaniszyn D, Pobiega M. Molecular analysis of methicillin-resistant Staphylococcus aureus strains isolated from different types of infections from patients hospitalized in 12 regional, non-teaching hospitals in southern Poland. J Hosp Infect. 2017;95(3):259–67. https://​doi.​org/​10.​1016/​j.​jhin.​2016.​10.​024.PubMed
45.
go back to reference Deschepper R, Grigoryan L, Lundborg CS, Hofstede G, Cohen J, Kelen GV, Deliens L, Haaijer-Ruskamp FM. Are Cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe? BMC Health Serv Res. 2008;6(8):123. Deschepper R, Grigoryan L, Lundborg CS, Hofstede G, Cohen J, Kelen GV, Deliens L, Haaijer-Ruskamp FM. Are Cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe? BMC Health Serv Res. 2008;6(8):123.
46.
go back to reference Schellack N, Bronkhorst E, Coetzee R, Godman B, Gous AGS, Kolman S, et al. SASOCP position statement on the pharmacist’s role in antibiotic stewardship. South Afr J Infect Dis. 2018;33(1):28–35. Schellack N, Bronkhorst E, Coetzee R, Godman B, Gous AGS, Kolman S, et al. SASOCP position statement on the pharmacist’s role in antibiotic stewardship. South Afr J Infect Dis. 2018;33(1):28–35.
47.
go back to reference McDonagh MS, Peterson K, Winthrop K, Cantor A, Lazur BH, Buckley DI. Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review. J Int Med Res. 2018;46(8):3337–57.PubMedPubMedCentral McDonagh MS, Peterson K, Winthrop K, Cantor A, Lazur BH, Buckley DI. Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review. J Int Med Res. 2018;46(8):3337–57.PubMedPubMedCentral
48.
go back to reference Formoso G, Paltrinieri B, Marata AM, Gagliotti C, Pan A, Moro ML, et al. Feasibility and effectiveness of a low-cost campaign on antibiotic prescribing in Italy: community level, controlled, non-randomised trial. BMJ. 2013;347:f5391.PubMedPubMedCentral Formoso G, Paltrinieri B, Marata AM, Gagliotti C, Pan A, Moro ML, et al. Feasibility and effectiveness of a low-cost campaign on antibiotic prescribing in Italy: community level, controlled, non-randomised trial. BMJ. 2013;347:f5391.PubMedPubMedCentral
49.
go back to reference Hallsworth M, Chadborn T, Sallis A, Sanders M, Berry D, Greaves F, et al. Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial. Lancet. 2016;387(10029):1743–52.PubMedPubMedCentral Hallsworth M, Chadborn T, Sallis A, Sanders M, Berry D, Greaves F, et al. Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial. Lancet. 2016;387(10029):1743–52.PubMedPubMedCentral
50.
go back to reference Köchling A, Löffler C, Reinsch S, Hornung A, Böhmer F, Altiner A, et al. Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review. Implement Sci. 2018;13(1):47.PubMedPubMedCentral Köchling A, Löffler C, Reinsch S, Hornung A, Böhmer F, Altiner A, et al. Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review. Implement Sci. 2018;13(1):47.PubMedPubMedCentral
51.
go back to reference Mangione-Smith R, Zhou C, Robinson JD, Taylor JA, Elliott MN, Heritage J. Communication practices and antibiotic use for acute respiratory tract infections in children. Ann Fam Med. 2015;13(3):221–7.PubMedPubMedCentral Mangione-Smith R, Zhou C, Robinson JD, Taylor JA, Elliott MN, Heritage J. Communication practices and antibiotic use for acute respiratory tract infections in children. Ann Fam Med. 2015;13(3):221–7.PubMedPubMedCentral
Metadata
Title
Antibiotic consumption and antimicrobial resistance in Poland; findings and implications
Authors
Jadwiga Wojkowska-Mach
Brian Godman
Amanda Glassman
Amanj Kurdi
Andrzej Pilc
Anna Rozanska
Szymon Skoczyński
Marta Wałaszek
Tomasz Bochenek
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2018
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-018-0428-8

Other articles of this Issue 1/2018

Antimicrobial Resistance & Infection Control 1/2018 Go to the issue