Preventing infections to ensure the long-term effectiveness of antibiotics

Antibiotic resistance is a silent pandemic. The main objective of the Swiss Strategy on Antibiotic Resistance (StAR) is to ensure the effectiveness of antibiotics for human and animal health over the long term. Since 2016, this strategy has been implemented by the federal authorities in collaboration with the cantons and other stakeholders, such as physicians, pharmacists, veterinarians and farmers. StAR comprises a wide variety of measures, with the key action areas being the prevention of infections and efforts to control resistance.

Antibiotic resistance is a major concern worldwide. The Swiss Strategy on Antibiotic Resistance (StAR), launched in 2016, has already introduced significant measures, making it possible to reduce the use of antibiotics and control the spread of resistant bacteria. In human medicine, use of antibiotics in the Watch group - which have a higher potential for the selection of antimicrobial resistance - decreased by 37% between 2012 and 2022, while in veterinary medicine antibiotic prescriptions have fallen by almost half since 2012 and the use of critically important antibiotics has been reduced by around two thirds.

Multisectoral approach

As antibiotic resistance concerns human and animal health, agriculture and the environment, the -One Health- approach involves the development and implementation of measures in all of these sectors. This multisectoral approach is essential because antibiotic resistance cannot be tackled in an isolated manner. For this reason, the federal offices responsible for public health (FOPH), agriculture (FOAG), the environment (FoeN), and food safety and veterinary affairs (FSVO) are working in close collaboration with other stakeholders in the research, policy and business sectors.

The federal authorities are seeking to promote appropriate use of antibiotics in humans and animals, to closely monitor resistance data, to strengthen research and education, and to raise public awareness of this important issue. As preventing infections is one way of reducing both the use of antibiotics and contamination with resistant organisms, the national strategy for the monitoring, prevention and control of healthcare-associated infections (NOSO Strategy) also has a vital role to play in combating antibiotic resistance in human medicine.

Targeted monitoring, prevention and control efforts make it possible to avoid 35-55% of healthcare-associated infections (HAIs) in hospitals or care homes, depending on the type of infection. The minimum requirements which must be met by hospitals to ensure effective infection prevention and control were defined at the national level in 2021. In particular, all new health professionals in contact with patients must receive training on measures to prevent the spread of antibiotic-resistant bacteria between patients, such as hand hygiene or appropriate patient isolation. It is also important that hospitals should conduct screening for carriage of multi-drug resistant bacteria among patients transferred from other healthcare facilities, especially from abroad. This measure helps to prevent the introduction of pathogens posing risks to public health in Switzerland.

Infection prevention and control is also of major importance in veterinary medicine. Appropriate measures, such as hand hygiene, can help to reduce the spread of pathogens both in veterinary practices and clinics and in livestock farming. Training has a crucial impact in this area.

Raising public awareness

To provide information for specialists and others interested in the risks associated with the growth of antimicrobial resistance, and to raise awareness of the importance of appropriate use of antibiotics, the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH) are running the annual World AMR Awareness Week. This year, Switzerland is highlighting measures aimed at reducing the emergence of new resistances. For this purpose, the FOPH is providing support and information materials for actors wishing to get involved and launch their own initiatives. In Switzerland, between 18 and 24 November 2023, various actors will be organising panel discussions, training events, company visits or information booths (WAAW 2023).

Communication activities will also be taking place at the national level, with online stories and videos and a website. Forming part of the StAR strategy adopted by the Federal Council in 2015, the campaign is run by the federal offices FOPH, FSVO, FOAG and FoeN, together with other stakeholders in the research, policy and business sectors.