Antibiotics - National Antibiotics Plan (PNA) 2018-2022 (extended to 2024)

Overall objective

The overall objective of the PNA is to reduce the emergence, development and transmission of resistance to antibiotics in Luxembourg through a One Health approach.

Strategic objectives

Several strategic priorities have been developed to meet the overall objective of the plan.

Governance

Adoption of a sustainable governance mechanism.

Prevention, education and communication

Greater awareness and understanding of antibiotic resistance amongst the general population and healthcare professionals through relevant communication and education.

Treatment and diagnosis

Promotion of effective use of antibiotics in human and animal health.

Monitoring

Implementation of a national antibiotics monitoring system (consumption of antibiotics, presence of antibiotics, antibiotic residues and resistant bacteria, and antibiotic resistance) and reinforcement of the monitoring of infections associated with care.

Research

Preparation of a national strategy for research into antibiotic resistance.

'One Health' approach in the fight against antibiotic resistance

As humans and animals represent overlapping reservoirs of resistance, the Luxembourg government has advocated for an integrated 'One Health' approach.

Following the joint efforts of the Ministry of Health and the Ministry of Agriculture, Viticulture and Rural Development, a National Antibiotics Plan (Plan national antibiotiques - PNA) (2018-2022) has been developed and extended to 2024 because of the COVID-19 crisis. It focuses on various strategic priorities such as governance, prevention, education, communication, treatment and diagnosis, as well as monitoring and research.

In the ‘One Health’ vision, this National Plan aims to consider the many different dimensions – human, veterinary and environmental - including all stakeholders. It is essential that everyone does their bit to provide a solution to this problem by applying the principle of reasoned use of antibiotics.

In addition, with the aim of achieving reasoned use of antibiotics in veterinary medicine in Luxembourg, several actions need to be developed in the future, such as the establishment of reliable statistics regarding the effective use of antibiotics on farms, the introduction of high biosecurity on farms, and even the use of vaccines available for certain pathologies in animal husbandry.

Focus on fluoroquinolone antibiotics

Fluoroquinolone antibiotics (FQs) are a class of broad-spectrum antibiotics that are active against various bacterial infections caused by Gram-negative and Gram-positive bacteria, as well as mycobacteria (tuberculosis).

The widespread use of FQs in practice has had a deleterious effect in terms of epidemiological impact, given their selection pressure with the emergence of resistance, which is now problematic.

In 2019, the European Medicines Agency (EMA) re-evaluated these antibiotics due to the risk of serious, long-lasting, disabling and potentially irreversible adverse effects, mainly affecting the musculoskeletal and nervous systems.

According to an EMA study¹, FQs continue to be prescribed outside the recommendations for use.

Given the threat posed by bacterial resistance and the pharmacovigilance aspect, it is imperative to enforce the rules of ‘proper use’ of FQs in accordance with current recommendations.

FQs should only be prescribed when there is no alternative and for validated indications, for documented bacterial infections or empirically for severe infections in hospitalised patients in order to avoid the risk of selecting resistant bacteria and C. difficile infections in the event of repeated use of FQs, as well as debilitating, long-lasting and potentially irreversible adverse effects.

For more information, please see the brochure below.