What you can do

General Public

• If you are a business traveler or a tourist, check your destination’s vulnerability for AMR. Please also see the section ‘Travel Advice’.
• Do not ask for antibiotics from your health professional when they are unnecessary.
• Don’t take antibiotics if you have cough, cold or flu because these are viral infections, while antibiotics only treat infections caused by bacteria.
• If you have symptoms such as: fever, chills and sweats, cough, sore throat, shortness of breath, nasal congestion, stiff neck, vomiting, burning or pain with urination, increased urination, diarrhoea, abdominal pain, redness, soreness, or swelling in any body area, including surgical wounds, remind your health professionals that these symptoms can be common for bacterial and viral infections.
• Never dispose of unused antimicrobials in the toilet or sink.
• Be informed on the food you consume and prioritise the purchase of food raised without the use of routine antimicrobials.
• Encourage your national government to implement a national action plan to address the multifaceted causes of AMR.
• Hand hygiene with soap is key to protect yourself from avoidable infections and prevent the spread of AMR.

Human Health Professionals

• Use this website to report AMR cases in a correct yet anonymous way.
• Implement appropriate prescription practices to ensure antibiotics are prescribed and dispensed correctly.
• Whenever available, use a rapid point-of-care diagnostic to support clinical decisions and further develop where inadequacies persist.
• Use preventative measures such as vaccines to educate and protect patients from infections.
• Include environmental criteria in antibiotic procurement decisions.
• Support administrative policy changes to purchase food raised without routine antimicrobials.
• Improve sanitation in hospitals to prevent healthcare-associated infections.
• Improve waste management to efficiently remove pharmaceuticals and microbes.
• Advise patients about the risks associated with antimicrobial therapy and use preventative measures when possible.

Animal Health Professionals

• Always perform clinical examinations for the animal(s).
• Never prescribe if a farmer intends to use antibiotics in a preventive manner or to promote animal growth.
• Take into consideration the OIE list of antimicrobial agents of veterinary importance.
• Only prescribe antibiotics in addition to and never in replacement of good animal husbandry practices, hygiene, biosecurity and vaccination programmes.
• Make an appropriate choice of antimicrobial agent, based on clinical experience and diagnostic laboratory information when possible.
• Stay updated on detailed information pertaining treatment protocols and withdrawal times.

Farmers

• Administer antimicrobials only when prescribed by a veterinarian or trained personnel, authorised to prescribe drugs. Not every infection needs to be treated with antimicrobials.
• Strictly adhere to the exact dosing instructions given by the veterinarian.
• Always follow the length of treatment as prescribed, even if the animal seems to have recovered.
• Obtain the antimicrobials from authorised sources, which can ensure the quality of the products.
• Incorporate impeccable animal husbandry, biosecurity and management practices.
• Develop a health plan for animals with their concerned veterinarian or animal health professional to protect them from infections.
• Adequate archiving; keep written records of all antimicrobials used and laboratory results.

Politicians and Policy Makers

• Prevent the sale of over-the-counter prescriptions by developing legislation that enforces regulations.
• Prevent pharmaceutical waste, one of the leading causes of AMR, by enforcing the development of minimum manufacturing standards.
• Prior to market authorisation, add requirements to assess the risk for AMR development within the environmental risk assessment (ERA) for antimicrobial substances.
• Create legislation to ensure that last-resort antibiotics and those medically important for human are reserved for human use only.
• Increase investment in the development of rapid diagnostic tools for use in human and animal health to decrease the inappropriate use of antibiotics.
• Do not allow veterinarians to sell antibiotics; veterinarians should only prescribe antibiotics to treat diseases in individual animals.
• Add the required regulations to stop the large scale sales with price reductions by industries
• Develop an extensive publicly accessible database for all antibiotics used in human medicine and animal husbandry.
• Enforce that all hospitals take part in surveillance systems and infection control committees to be able to monitor and respond to AMR challenges.
• Invest in education and training for frontline nurses and equip them to report in a correct and anonymous manner on developing AMR cases or a developing AMR outbreak.
• Enforce comprehensive data collection for antimicrobial-resistant bacteria from animals.
• Undertake measures to improve animal welfare, livestock conditions, and animal husbandry practices that take important precautions to secure animal health and reduce the need for medication. This includes the research, development, and authorisation of feed additives to reduce the need for antibiotics as growth promoters.
• Promote research into environmentally-responsible ways to treat sewage and prevent the release of antibiotic-resistant bacteria, as well as responsible waste disposal methods.
• Develop awareness campaigns to:
  • Train human and animal health professionals on responsible prescribing practices
  • Educate the public on correct consumption and disposal of antimicrobials
  • Educate farmers on the responsible use of antimicrobial drugs.
• Make sure that everyone has access to necessary antimicrobials, but also alternatives such as vaccines and diagnostics as well as access to licensed professionals in human, animal, and plant health. (UN IACG, 2019).

Financial and Economic Experts

• Analyse the cost of hospital-acquired infections.
• Research the impact that legislative measures on AMR would have on global trade and economy.
• Examine the economic impact that the death toll due to AMR has on society.
• Work together with policy makers to address AMR.
• Create better tools to monitor consumption of antibiotics, both in humans and in animals, with well-defined parameters.
• Advocate for national authorities to encourage and fund research on AMR-related issues.
• Advocate for national authorities to make data available regarding antibiotic consumption, AMR death toll, along with social and economic implications/expenses due to AMR, and subsequent deaths at country level.
• Regulate against speculative investment in antibiotics production particularly in emerging economies.
• Regulate against the purchasing by EU companies of cheap Active Pharmaceutical Ingredients from industries outside the EU that do not respect essential measures to prevent pollution of surface and ground water as a consequence of antibiotics production waste in the environment.

AMR Patients and Family

• Take your antibiotic therapy exactly as prescribed by your doctor or healthcare professional. Don’t stop the therapy even if you start feeling better. If your therapy was incomplete, there is a risk that your infection would recidivate and the bacteria that caused it may become drug-resistant.
• Immunizations can protect you against some infectious diseases that are treated with antibiotics. If you are exposed (i.e. you have been in contact with sick people or you live in contaminated areas) to different sources of infection ask your healthcare professional if there is a vaccine that could protect you from getting infected and get vaccinated.
• Hospitals can be hotbeds for antibiotic-resistant bacteria. When dealing with infections, whether as a professional, patient or household member, hygiene standards need to be stressed to prevent the spread of microbes (e.g. soap, alcohol-based hand rubs). Clean your hands properly to ensure that you don’t pass your infection to other patients and don’t be afraid to ask your caregivers if they washed their hands properly too. Also, if you have open wounds on your body (e.g., surgical wounds) make sure you are well informed on how to keep them free of infection.
• If the antibiotic therapy doesn’t work and you/your dear one’s condition is getting worse, please address it to your doctor (if already in hospital) or go urgently to the hospital as there might be a serious situation to deal with. Such warning signs include:
  • Fever and chills
  • Very low body temperature
  • Peeing less than normal
  • Rapid pulse
  • Rapid breathing
  • Nausea and vomiting
  • Diarrhea. (WebMD)
• If you survived a resistant infection or you lost a dear one due to AMR, make sure you report this at your national level and to this website. Surveillance plays an important role in containing AMR.

Industry

• Work with all relevant stakeholders in a transparent and mutually appreciated way, including with AMR victims, human and animal health experts, representative civic associations, politicians and policy makers to find solutions to overcome the market failure of the R&D antibiotic pipeline.
• Invest in research and development of rapid diagnostic tests and preventative tools, such as vaccines and other alternatives to the use of antimicrobials in humans, animals, and plants, to reduce the need for antimicrobial drugs.
• Invest in the research and development of feed additives to reduce the need for medication and the use of antibiotics as growth promoters in livestock.
• In collaboration with the public sector, invest in developing surveillance systems and infrastructure for infection prevention and control for both human and animal health.
• Sponsor and promote awareness campaigns to educate the public about the preventative measures to avoid disease, correct use, and disposal of antimicrobial drugs.
• Invest in programmes to educate farmers about measures to improve animal welfare, livestock conditions, and animal husbandry practices – important precautions to secure animal health and reduce the need for medication.
• Implement higher environmental standards throughout the supply chain of antimicrobials.
• Support national governments in financing collection schemes for unused and expired antimicrobials, as well as for infectious waste.