Rapid communication Open Access
Like 1


Investments to reduce the spread of antimicrobial resistance (AMR) in the European Union have been made, including efforts to strengthen prudent antimicrobial use. Using segmented regression, we report decreasing and stabilising trends in data reported to the European Surveillance of Antimicrobial Consumption Network and stabilising trends in data reported to the European Antimicrobial Resistance Surveillance Network. Our results could be an early indication of the effect of prioritising AMR on the public health agenda.


Article metrics loading...

Loading full text...

Full text loading...



  1. Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. , Burden of AMR Collaborative Group. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019;19(1):56-66.  https://doi.org/10.1016/S1473-3099(18)30605-4  PMID: 30409683 
  2. Earnshaw S, Mancarella G, Mendez A, Todorova B, Magiorakos AP, Possenti E, et al. , European Antibiotic Awareness Day Technical Advisory Committee, European Antibiotic Awareness Day Collaborative Group. European Antibiotic Awareness Day: a five-year perspective of Europe-wide actions to promote prudent use of antibiotics. Euro Surveill. 2014;19(41):20928.  https://doi.org/10.2807/1560-7917.ES2014.19.41.20928  PMID: 25345519 
  3. European Commission (EC). Directorate-General for Health and Consumers. Communication from the Commission to the European Parliament and the Council. Action plan against the rising threats from antimicrobial resistance. Brussels: EC; 2011. Available from: https://ec.europa.eu/health/amr/sites/amr/files/communication_amr_2011_748_en.pdf
  4. World Health Organization (WHO). Global Action Plan on Antimicrobial Resistance. Geneva: WHO; 2015. Available from: https://www.who.int/antimicrobial-resistance/publications/global-action-plan/en/
  5. European Commission (EC). Commission Notice of 1 July 2017 on EU Guidelines for the prudent use of antimicrobials in human health. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 1.7.2017:C 212. Available from:https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52017XC0701(01)&from=EN
  6. European Commission (EC). A European One Health Action Plan against Antimicrobial Resistance (AMR). Brussels: EC; 2017. Available from: https://ec.europa.eu/health/amr/sites/amr/files/amr_action_plan_2017_en.pdf
  7. Council of the European Union. Council Conclusions on the next steps towards making the EU a best practice region in combatting antimicrobial resistance. Luxembourg: Publications Office of the European Union. 25.6.2019:C 214. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52019XG0625(01)&from=EN
  8. World Health Organization (WHO). Collaborating Centre for Drug Statistics Methodology. ATC Index with DDDs. Geneva: WHO; 2019: Available from https://www.whocc.no/atc_ddd_index/
  9. de Kraker ME, Davey PG, Grundmann H, BURDEN study group. Mortality and hospital stay associated with resistant Staphylococcus aureus and Escherichia coli bacteremia: estimating the burden of antibiotic resistance in Europe. PLoS Med. 2011;8(10):e1001104.  https://doi.org/10.1371/journal.pmed.1001104  PMID: 22022233 
  10. Magiorakos AP, Suetens C, Monnet DL, Gagliotti C, Heuer OE, EARS-Net Coordination Group and EARS-Net participants. The rise of carbapenem resistance in Europe: just the tip of the iceberg? Antimicrob Resist Infect Control. 2013;2(1):6.  https://doi.org/10.1186/2047-2994-2-6  PMID: 23410479 
  11. Brolund A, Lagerqvist N, Byfors S, Struelens MJ, Monnet DL, Albiger B, et al. Worsening epidemiological situation of carbapenemase-producing Enterobacteriaceae in Europe, assessment by national experts from 37 countries, July 2018. Euro Surveill. 2019;24(9):1900123.  https://doi.org/10.2807/1560-7917.ES.2019.24.9.1900123  PMID: 30862330 
  12. European Centre for Disease Prevention and Control (ECDC). Surveillance Atlas of Infectious Diseases. Stockholm: ECDC; 2018. Available from: http://atlas.ecdc. europa.eu.
  13. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335-51.  https://doi.org/10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z  PMID: 10649300 
  14. Brown D, Canton R, Dubreuil L, Gatermann S, Giske C, MacGowan A, et al. Widespread implementation of EUCAST breakpoints for antibacterial susceptibility testing in Europe. Euro Surveill. 2015;20(2):21008.  https://doi.org/10.2807/1560-7917.ES2015.20.2.21008  PMID: 25613780 
  15. de Kraker ME, Jarlier V, Monen JC, Heuer OE, van de Sande N, Grundmann H. The changing epidemiology of bacteraemias in Europe: trends from the European Antimicrobial Resistance Surveillance System. Clin Microbiol Infect. 2013;19(9):860-8.  https://doi.org/10.1111/1469-0691.12028  PMID: 23039210 
  16. European Centre for Disease Prevention and Control (ECDC). Surveillance of antimicrobial resistance in Europe 2017. Stockholm: ECDC; 2018. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/EARS-Net-report-2017-update-jan-2019.pdf
  17. Safrany N, Monnet DL. Antibiotics obtained without a prescription in Europe. Lancet Infect Dis. 2002;8(3):278-82.  https://doi.org/10.3201/eid0803.010192  PMID: 22361429 

Data & Media loading...

Supplementary data

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error