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Tuesday, 19 September 2017

Global threat of antibiotic resistance

WHO estimates of impact on mortality from AMR
The European Medicines agency, in partnership with the ECDC (European Centre for Disease Prevention and Control), is holding a workshop on global challenges from antimicrobial resistance (AMR). 

There are 3 major current approaches to tackling AMR: 
1. reducing selection pressure on microbes to reduce the chance of their developing AMR. This needs strategies to reduce overuse of antimicrobial medicines. 
2. reducing human/human and animal/human transmission microbes. This needs effective infection control measures
3. increasing the availability of new antibiotics through more R & D combined with limiting their use within evidence-based guidelines - ie effective antibiotic stewardship.

There needs to be an integrated approach combining a pipeline of effective new antimicrobial and careful stewardship of existing antimicrobials through their effective use. However from a recent international survey, 20% of the public who took part were unaware that overuse of antibiotics leads to antimicrobial resistance to treatment. Furthermore 44% were unaware that antibiotics are ineffective against colds and 'flu'.

The WHO has estimated that, without major global action, by 2050 there may be ~400,000 preventable deaths annualy in the European region alone, as a result of lack of effective antiobiotics for serious infections.

Martial Plantady from the European Commission opened the day by discussing the EU Action plan launched in 2011 and running until 2016 against the threats from antimicrobial resistance. He noted that many solutions were described within the plan however there remain major challenges to effective implementation of the Plan, including:
- widespread and worldwide antibiotic use for growth promotion in livestock
- resulting need to push strategy to ban antibiotic use in livestock beyond the EU
- availability of animal and human data across member states
- effective surveillance on appropriate and prudent use of antimicrobials in humans
Some solutions include 
- effective dissemination of guidelines on prudent use of antibiotics in animals and humans
- Antibiotic Awareness Days
- more effective coordination of R & D across industry and academic sectors on new antimicrobials, alternatives, vaccines and rapid diagnostic tests
- engagement with key health professional and patient stakeholder organisations
The new EU Action Plan on antibiotic resistance was published in June 2017, with 3 pillars supported by strengthened measures for infection prevention and control:
- making the EU Region a best practice region on AMR
- improving research and innovation
- shaping the global agenda on AMR

At the 68th World Health Assembly in May 2015, the World Health Assembly endorsed a global action plan to tackle antimicrobial resistance, including antibiotic resistance, the most urgent drug resistance trend. Carmen Pessoa da Silva from the WHO underlined the key point that if AMR remains unresolved, the global threat would be enormous both for human health as well as for the world economy. She summarised 5 key elements of WHO strategy against AMR.
1. improved awareness and understanding (annual WHO awareness week)
2. strengthen knowledge through surveillance and research 9WHO Global AMR Surveillance System - GLASS - further report due in Jan 2018 - 47 countries are fully enrolled - 25% of member states)
3. reduce incidence of infection
4. optimise use of anti-microbial medicines
5. ensure sustainable investment for R & D

The Pharmaceutical Group of the European Union represents the ~400,000 community pharmacists who dispense medicines for the ~500 million population of the European Union. Around 46 million people visit a community pharmacist every day in Europe.
James Wilkinson discussed efforts of the PGEU to educate community pharmacists and the public in rational use of antimicrobial medicines.

Monday, 4 September 2017

Report on the 2017 EACPT Congress in Prague

The EACPT 2017 Congress was held in Prague from 24th-27th June with 566 participants from all 5 continents - 28% from beyond the European Region, from Australia to China, Japan and South Korea to the USA. 487 abstracts were presented as 171 oral communications and 316 e-poster presentations were given by delegates from the European Region and around the world.

Delegates by global region
The Congress included 2 plenary sessions, 22 parallel sessions with Keynote Lectures, 5 Oral Communications sessions and 3 Guided Poster Sessions on current issues for research, education and clinical practice on safe and effective use of medicines.  The programme provided an international scientific and educational forum for discussion of clinical pharmacology and therapeutics, including personalised pharmacotherapy.

Countries with 5 or more delegates
Themes included the latest developments on effectiveness and safety of medicines, clinical pharmacology in clinical practice, pharmacokinetics/systems pharmacology, including in special populations, innovative techniques, eHealth, biomarkers, education, advanced practices in topics such as drug discovery, drug development, biological therapies, global health with a focus on access to safe medicines, new pharmacology and pharmacotherapy, safety in prescribing and updates on personalised medicines, as well as updates on specific therapeutic areas, including cardiovascular disease, infectious disease, nephrology, oncology, neurology and psychiatry.

Future EACPT Congresses:
- 2019 Stockholm
- 2021 Athens
- 2023 Rotterdam

Number of delegates by region
The EACPT was founded 25 years ago and now includes as members all national organisations for clinical pharmacology in Europe, as well as organisations from further afield internationally. The EACPT aims to provide educational and scientific support for the more than 4000 individual professionals interested in clinical pharmacology and therapeutics throughout the European region, with its congresses attended by a global audience. The EACPT also advises policy makers on how the specialty can contribute to human health and wealth.

Clinical Therapeutics, the Official Journal of EACPT.