Last-line antibiotics are failing : options to address this urgent threat to patients and healthcare systems

The emergence and spread of highly-resistant bacteria, especially those resistant to 'last-line' antibiotics, such as carbapenems and colistin, is a grave public health concern and a threat to patient safety and economies in Europe and globally. When last-line antibiotics are no longer effective, this means that there is no antibiotic left with which to treat a patient, making such infections in children and adults potentially fatal. Resistance to last-line antibiotics also compromises the effectiveness of life-saving medical interventions such as cancer treatment and organ transplantation. Therefore, it is imperative that we contain the spread of these highly resistant bacteria now, particularly since the antibiotic pipeline is empty for the development of new antibiotics and will likely remain so for years to come. Patients who are infected with bacteria resistant to antibiotics are more likely to develop complications and up to three times more likely to die from the infection. It is estimated that the global burden of deaths could reach 10 million each year by 2050 if no action is taken. This poses serious challenges to the functioning of healthcare systems and represents high economic costs to society. This briefing aims to draw the attention of policymakers to examples of measures that can be taken at national and local levels to halt the spread of these highly resistant bacteria. Case studies illustrating successful implementation of such measures, with positive outcomes, will also be highlighted.