Antimicrobial resistance: a silent threat we must confront

Antimicrobial resistance (AMR) is a global public health crisis driven by the inappropriate use of antibiotics. In the EU, more than 35 000 people die each year from multidrug-resistant infections, with an estimated annual cost of €11.7 billion.

The “One Health” approach recognizes that resistance spreads through human medicine, veterinary medicine, and the environment. The EARS-Net network is the primary AMR surveillance system, monitoring key pathogens.

The European targets for 2030 include reducing total antibiotic consumption by 20% and ensuring that at least 65% falls within the AWaRe “Access” group. Spain, with a less favorable baseline, has been assigned one of the most demanding reduction targets in the EU: 27%.

The most alarming issue for primary care pediatrics is the 58.8% increase in cases of bacteremia caused by E. coli resistant to third-generation cephalosporins (with a direct impact on the management of UTIs) and the rise in macrolide-resistant S. pneumoniae across the EU.

In Spain, the 2025-2027 National Plan against Antimicrobial Resistance (PRAN) establishes specific measures for primary care pediatrics: rapid diagnostic tests (RDTs), PROA certification, deferred prescribing, and updating of the Spanish National Health System’s antimicrobial treatment guidelines.

Primary care pediatricians play a key role in the fight against AMR: prioritizing “Access” antibiotics, systematizing the use of RDTs, participating in PROA teams, and providing health education are the actions with the greatest impact.