Where we are in the fight against Antimicrobial Resistance and Healthcare-Associated Infections. The opinion of the stakeholders of the European Joint Action on Antimicrobial Resistance and Healthcare-Associated Infections (EU-JAMRAI).

During the second European Joint Action on Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HCI) (EU-JAMRAI) annual meeting, the Evaluation Team elicited stakeholders' opinions regarding the implementation of the National Strategies and Action Plans to fight AMR and HCI, the One Health integration and the EU-JAMRAI support to the national and EU authorities in two Focus Groups. This qualitative exercise contributed to identify criticalities and possible improvements in aspects such as political priorities, legislation/legal requirements, human and financial resources, and supervision in many health sectors to ensure effective implementation of the action plans. Stakeholders pointed out at the different speed of EU member states, in particular concerning the One Health integration in the plans. Finally, the Stakeholders strongly asked the EU-JAMRAI to reinforce the integration and dissemination of the best practices and results, to help policymakers at national and European levels in defining and implementing harmonized policies and actions against AMR and HCI.

Changes in antibiotic prescription following an education strategy for acute respiratory infections.

The objective of this study was to assess the impact of an education intervention for primary health care physicians, based on the knowledge of clinical practice guidelines and availability of rapid antigen detection test for group A streptococci (GAS), on the improvement of antibiotic prescription for patients with acute respiratory tract infections. Before and after the intervention, physicians collected data from ten consecutive patients who attended during a 3-week period. This process was performed twice a year for 6 consecutive years (2012-2017). A total of 18,001 patients were visited by 391 primary care physicians during the study period, 55.6% before intervention and 44.4% after intervention. After intervention, the antibiotic prescription decreased significantly, from 33.0 to 23.4% (p < 0.01). However, there was a statistically significant increase (p < 0.01) in the use of penicillins. This study, carried out in daily practice conditions, confirms that the educational strategy was associated with an overall reduction in the use of antibiotics and an improvement in the antibiotic prescription profile in acute respiratory tract infections.