63.

Urges the Member States to implement or develop the following measures: (a) remind physicians of the paramount importance of ensuring that the prescription of antibiotics for treatment is appropriate and responsible; (b) ensure that, whenever possible, appropriate microbiological diagnosis is systematically performed before prescribing antibiotics, for instance by using new diagnostic tools that could allow point-of-care rapid diagnosis, and/or antibiograms, especially in the case of diseases which have a tendency to relapse, as well as work to abolish hurdles that prevent proper microbiological diagnosis, especially in the ambulant sector; (c) regulate the prescription of antibiotics for treatment, and in particular strictly implement laws prohibiting the provision of antibiotics for treatments without prescription, so that an appropriate use of medicines is ensured, specifying the therapeutic objective and selecting the appropriate drug therapy; (d) implement responsible marketing practices avoiding conflicts of interest between producers and prescribers of medicine; (e) encourage the development of new revenue models whereby economic returns for companies are de-linked from prescribed volumes of antibiotics, while encouraging pharmaceutical innovation and balancing it with the sustainability of health systems; (f) regulate the sale and distribution of antibiotics so that patients can only obtain the specific quantity of antibiotics as prescribed by their doctors, because in some Member States rules still exist which authorise the sale of antibiotics in bigger package sizes than those intended for a specific treatment; (g) ensure greater levels of patient adherence to and compliance with antibiotic and other appropriate treatments prescribed by medical professionals, and develop strategies aimed at increasing patient understanding of the importance of the responsible use of antibiotic treatments and the risks of increasing antimicrobial resistance; (h) monitor antibiotic resistance and the use of antibiotics in hospitals and ensure that antibiotics when used in hospitals are only used according to the correct indications, at the correct dose and for the shortest duration possible as recommended by evidence-based guidelines; (i) intensify infection control, in particular from a cross-border perspective, and especially by carefully monitoring potential carriage of multidrug-resistant bacteria, through proper screening of patients transferred from a country/region/hospital known for its high prevalence of multidrug-resistant bacteria, and isolating positive patients in individual rooms or by implementing ‘cohort nursing’; (j) develop a multi-stakeholder strategy on MDR-TB to encompass key aspects such as prevention, awareness-raising, diagnosis, appropriate treatment, and adherence and compliance to prescribed medication; (k) improve safety standards, especially for medical devices that are resistant to sterilisation (e.g. endoscopes), and undertake careful monitoring to ensure that medical devices originally designed and CE-marked for single use, if regenerated, meet all safety standards in order to protect consumer health; (l) launch awareness campaigns targeting a wide audience, including health education courses in schools on the rational use of antibiotics and the risks entailed by increasing antibiotic resistance and the importance of developing good personal hygiene practices; these campaigns should target the young and old, as well as parents and carers, and should be followed up by outcome assessments, keeping in mind the opportunities offered by e-health systems in this regard; (m) increase public funding and create new academic positions to focus on exploring and validating new approaches for treating bacterial infections; (n) increase, in particular, the incentives for research and development of new antimicrobials; (o) invite the ECDC to carry out field missions to give Member States scientific and technical assistance and training on antimicrobial resistance as foreseen in Article 9 of the ECDC Regulation (Regulation (EC) No 851/2004); those Member States that have not yet done so, and especially those in which antimicrobial resistance is already high or is increasing alarmingly, are particularly urged to invite the ECDC to carry out such missions; (p) make the records of hospitals and other healthcare facilities with regard to HAIs publicly available, so that patients can make informed choices;