Hotet från omvärlden ökar

Increased knowledge on an increasing problem

number of hits in Pub-MED for (antibiotic or antimicrobial) + resistance by 5 year’s periods

02 0004 0006 0008 000

10 00012 00014 00016 00018 000

1965-70

1971-75

1976-80

1981-85

1986-90

1991-95

1996-2000

2001-05

Reviews

Original publ.

MRSA in Europe 2004. Data from EARSS.

0 10 20 30 40 50 60 70

Iceland Norway Sweden Holland

Denmark Finland Estonia

Czech rep. Slovenia Austria

Hungary Luxembourg

Slovakia Poland

Germany (267)BulgariaLettland

Latvia Spain

France Belgien Croatia

Israel Italy

Ireland United

Greece Portugal Cyprus

Malta Romania

% MRSA

• Crude estimate from Israel: 4% of all fatalities in hospitals related to Gram-neg multiresistant nosocomial inf. (Carmeli 2005)

• Crude estimate from EU-15: 5,800 excess deaths in ICU related to resistance (Harbarth et al 2005)

• Rough estimate of global gonnorhoea treatment failure:3 million cases annually (of total 62 million cases) (Tapsall 2005)

The tip of the iceberg…

The Current ParadoxThe Current ParadoxThe Current ParadoxThe Current Paradox

AntibioticAntibiotic

ResistanceResistance

AntibioticAntibiotic

ResistanceResistance

DrugDrug

DevelopmentDevelopment

DrugDrug

DevelopmentDevelopment

Sveriges beredskap är god?

Sales of Antibiotics in the Nordic Countries

1978-2004 D

DD

/100

0 in

habi

tant

s/da

y

-

5

10

15

20

25

19

78

19

79

19

80

19

81

19

82

19

83

19

84

19

85

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

Iceland

Finland

Sweden

Norway

Denmark

www.reactgroup.org

Sveriges beredskap är god?

Optimal sjukhusanvändning?Optimal kinolonanvändning?Optimal diagnostik?Optimal hygien?Optimal profylax?

Guidelines does not work unless they are implemented !

Implementation does not work unless there is local comittment and educational outreach !