Doctors and the public together against antimicrobial resistance – the key to success

Correspondance karl@landspitali.is

Abstract

Antimicrobial resistance is now one of the leading threats to global public health. The development of new antibiotics has not kept pace with the rapid emergence and spread of multidrug-resistant bacteria, whose prevalence continues to rise. The burden is greatest in countries with high antibiotic use and limited access to clean water and sanitation. Multidrug- and extensively-resistant enteric bacteria, particularly Escherichia coli and Klebsiella pneumoniae, are of greatest concern. While the situation in the Nordic countries remains favorable, Icelanders traveling to high-prevalence regions or seeking medical care abroad are at increased risk of acquiring and importing these bacteria. Major risk factors include antibiotic exposure, use of acid-suppressing drugs, and consumption of contaminated food and water. This article outlines strategies to reduce these risks including prudent antibiotic use, strict hygiene, careful food and beverage choices, and caution when accessing healthcare outside the Nordic region. The Icelandic society is in a unique position, with minimal use of antibiotics in agriculture and a low prevalence of resistant bacteria. Physicians have a pivotal role in educating patients and the public, thereby maintaining Iceland’s low disease burden from resistant bacteria and helping to curb the spread of this “silent pandemic”.