Colds, flu and most other infections are caused by viruses. Some infections – such as bladder infections or pneumonia – are caused by bacteria. These infections can be treated with antibiotics, which either kill the bacteria or suppress their growth. If the same antibiotic is regularly used against a bacterium, then that bacterium can become ‘resistant’. This means the bacterium will no longer be susceptible (vulnerable) to that particular antibiotic. If you become infected with these resistant bacteria, then that antibiotic will no longer be of any help. The resistant bacteria will not be suppressed, meaning you can become very ill. That is why infections like these are more difficult to treat.

Resistance in the Netherlands

Antimicrobial resistance (AMR) is a global problem. Figures provided by the European Centre for Disease Prevention and Control (ECDC) show that resistance rates in the Netherlands are low compared to those in other European countries. This is partly because, in the Netherlands, you cannot obtain antimicrobials without a doctor’s prescription. As a result, the use of antimicrobials in the Netherlands is relatively limited. In addition, the healthcare system places great emphasis on effective hygiene measures.

One Health

We know that bacteria in all parts of the world are becoming increasingly resistant to antimicrobials. This is why it is important to keep on fighting antimicrobial resistance. Resistant bacteria are found everywhere – in the healthcare system, in animals, in food, in the environment and in every country in the world. This calls for an integrated approach, also known as the ‘One Health’ approach. The Netherlands is taking steps in each of these important areas.

Information about antimicrobial resistance

If we are to protect ourselves against antimicrobial resistance, we need to know how often – and where – resistant bacteria occur, and if there are any trends in this regard. The National Institute for Public Health and the Environment (RIVMNational Institute for Public Health and the Environment ) systematically collects and analyses such information. We call this ‘surveillance’. This allows RIVM to track the use of antibiotics and the number of infections involving resistant bacteria in the Netherlands. For example, various laboratories help us by providing information about hospital patients and nursing home residents. Based on this information, we can see how often antimicrobials are being used, which bacteria occur where, whether the number of such cases is increasing or decreasing, and whether new bacteria are appearing. Click here for a summary of our surveillance studies.

RIVM’s role

RIVM keeps track of the current state of affairs with regard to antimicrobial resistance in the Netherlands and advises the Ministry of Health, Welfare and Sport of its findings. In this regard, it is important for the parties tackling antimicrobial resistance to keep each other informed. Read more about the role of RIVM.

International cooperation on antimicrobial resistance

Resistant bacteria don’t care about international borders. This is why it is important to cooperate with other countries in fighting antimicrobial resistance. If we can reduce the numbers of resistant bacteria, the entire world will benefit. RIVM cooperates with other countries and shares any information it uncovers when tracking antimicrobial resistance. RIVM also helps others to use this information in specific operations to fight resistance. All international activities focus, to some extent, on work that is being done here in the Netherlands. RIVM focuses specifically on surveillance, AMR in the environment, and One Health. Click here for more information about international cooperation.

You, too, can do something about antibiotic resistance

To keep antibiotics effective for as long as possible, we must use them wisely (i.e. in the correct way, and not too often). Sometimes the body needs help to overcome a bacterial infection, so doctors prescribe antibiotics. It is important to use them properly, to minimize any risk of resistant bacteria emerging.

  • Only use antibiotics when your doctor says that this is necessary. So always contact a doctor first, even if you are abroad.
  • Take the prescribed amount at the right time, every day. Do not skip any doses.
  • Never stop a course of antibiotic treatment without first checking with a doctor. In some cases it is possible to stop the course of treatment before it is finished, but always check with a doctor first.
  • Never use leftover antibiotics or other people’s antibiotics. For each specific infection, a doctor needs to decide whether a course of antibiotic treatment is required, which antibiotic is right for you, and how long the course of treatment should last.

How to prevent the spread of resistant bacteria?

(On-screen title: How to prevent the spread of resistant bacteria. An animation. Voice-over:)

SILENCE

TRANQUIL MUSIC

VOICE-OVER: Bacteria can make you ill.

Some bacteria are resistant,

in which case treatment with antibiotics has a limited effect, to none at all.

This can cause you to become very ill, and possibly even die.

(A little figure falls over.)

You can also carry bacteria without becoming immediately ill,

in which case you can still spread them.

The spread of resistant bacteria is dangerous,

especially for people with poor health.

You can be contaminated with a resistant bacterium,

for example, as a result of admission to a nursing home or hospital,

admission to a hospital abroad, or through contact with farm animals.

This is why proper hygiene, such as washing your hands, is important.

If someone is contaminated with a resistant bacterium,

it's important to become aware of this as soon as possible

in order to prevent further spreading.

This is why doctors enquire about possible exposure to resistant bacteria,

whether you have been treated in other nursing homes or hospitals,

in a foreign hospital, or if you have had any contact with farm animals.

Everyone should be attentive to this, so we can minimise the risk.

(On-screen text: National Institute for Public Health and the Environment. Ministry of Health, Welfare and Sport. www.rivm.nl/amr.)

Antibiotic resistance: why do some antibiotics fail?

This animation explains what antibiotic resistance is and why some antibiotics fail. Doctors prescribe antibiotics when the body needs help to recover from an infection. Sometimes bacteria have protected themselves against the antibiotic. This infection is more difficult to treat, because the usual antibiotics do not work. If antibiotics are used incorrectly or too often this increases the chances of bacteria becoming resistant.