Analysis of antimicrobial consumption and resistance ('JIACRA' reports)

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JIACRAThe European Medicines Agency (EMA) works closely with the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) to analyse the potential relationship between the consumption of antimicrobials by humans and animals and the occurance of antimicrobial resistance. The European Union (EU) agencies deliver their findings in joint inter-agency antimicrobial consumption and resistance analysis (JIACRA) reports.

The JIACRA reports analyse data from humans and food-producing animals from the agencies' five EU-wide monitoring networks to better understand the occurrence of antimicrobial resistance across Europe and any trends occurring, providing valuable insights for policy-makers across the EU.

This reflects the European Commission's ‘One Health’ approach to antimicrobial resistance, by addressing the human and veterinary sectors together in a holistic and coordinated approach.

The reports focus on particular combinations of antimicrobials and bacterial species considered important for public health.

Report on 2013–15 (JIACRA II)

The agencies published the second JIACRA report in July 2017. It presents data from the agencies’ monitoring networks from 2013–15 and reflects improved surveillance across Europe:

It highlights that:

  • important differences remain across the EU in the use of antibiotics in animals and humans;
  • overall antibiotic use in food-producing animals is higher than in humans, although this varies across countries;
  • a class of antibiotics called polymyxins (which includes colistin), which are increasingly used in hospitals to treat multidrug-resistant infections, are widely used in the veterinary sector; 
  • third- and fourth-generation cephalosporins and quinolones, which are considered critically important for human health, are more often used in humans. In addition, their use to treat infections caused by E. coli and other bacteria in humans is associated with resistance to these antibiotics in E. coli found in humans;
  • resistance to quinolones, used to treat salmonellosis and campylobacteriosis, in humans is associated with their use in animals.

The report emphasises the need to promote responsible use of antibiotics in both humans and animals.

In addition, the three agencies recommend further research to understand better how use of antibiotics and resistance affect one another. 

Report on 2011-12 (JIACRA I)

The agencies published the first JIACRA report in January 2015, presenting data from their monitoring networks from 2011-12:

This was the first time that data from humans and food animals in Europe were analysed together. It highlighted:

  • important differences across the EU in the use of antibiotics in animals and humans;
  • that the use of certain antimicrobials in animals and humans is associated with resistance to these antimicrobials;
  • higher consumption of several antimicrobials extensively used in animal husbandry in animals than in humans;
  • higher consumption of antimicrobials critically important for human medicine, such as third- and fourth-generation cephalosporins, in humans;
  • a positive association between antimicrobial consumption in animals and resistance in bacteria from humans.

Agencies' monitoring networks

The EU agencies monitor data collected by the EU Member States, European Economic Area Member States and Switzerland. This is a way to pool data from different countries so it can be monitored and analysed together, to provide a Europe-wide overview.

This work involves setting up data-collection networks across the Member States and sometimes dedicated IT systems, and agreeing methodologies to harmonise data collection so it can be compared across several countries.

ECDC monitors human consumption of antimicrobials through the European Antimicrobial Resistance Surveillance Network (EARS-Net) and antimicrobial resistance in bacteria found in humans through the European Surveillance of Antimicrobial Consumption Network (ESAC-Net) and the Food-and-Waterborne Diseases and Zoonoses Network (FWD-Net).

EMA monitors animal consumption of antimicrobials through the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC).

EFSA monitors antimicrobial resistance in bacteria found in food-producing animals, and in food for humans, through the Scientific Network for Zoonosis Monitoring Data.

Outcome indicators

EMA, EFSA and ECDC are also jointly developing a list of harmonised outcome indicators to enable Member States to:

  • monitor the use of antimicrobials in humans, food-producing animals and food;
  • assess the progress made in implementing their action plans against antimicrobial resistance. 

The agencies expect to publish the list of indicators in the second half of 2017. 

For more information, see:

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Infographic: EMA's response to antimicrobial resistance

Antimicrobial resistance infographic