NRP 72 syntheses nearing completion
Over the past year researchers on NRP 72 have been analysing the results of their work and drawing up recommendations for action in the fight against antibiotic resistance. Working closely with practitioners, administrators and politicians, they have refined these recommendations with a view to their practical implementation. The key messages and final recommendations of the programme are now being prepared.
Vital importance of the results in view of the current health threats
The expectations for NRP 72 are high and, in view of the current global threats to health, its results are gaining in importance. Commissioned by the Federal Council and planned in close collaboration with the National Strategy on Antibiotic Resistance (StAR), NRP 72 is designed to make important contributions in the fight against antibiotic resistance.
With this aim in mind, the programme has launched a synthesis process: Researchers combine their results and expertise to derive recommendations for action and discuss these with practitioners. In accordance with the three modules of NRP 72, working groups (see box) of researchers in each module have been investigating an overriding topic over the past year:
Module 1 – How resistance develops and spreads
Resistance develops and spreads in a wide variety of processes in which human carriers of pathogens as well as animals and the environment are involved. Clarifying and monitoring key connections between these areas should help should help to target and break the spread of resistance. In this context, NRP 72 shows the huge potential offered, for example, by new technologies and methods such as whole genome sequencing and metagenomics in exploring and monitoring the phenomenon of resistance. NRP 72 also provides valuable new findings about "reservoirs" outside the medical setting that are involved in the spread of resistance, for example wastewater.
Module 2 – Novel active substances and faster diagnostic techniques
In the fight against resistant pathogens, both human and veterinary medicine urgently need new antibiotic substances. Faster diagnostic tests are also important in rapidly identifying resistance and treating humans and animals in a targeted manner. In this area NRP 72 has produced a range of promising approaches, some of which will now be developed further in the industrial setting. At the same time, the experience acquired during the programme has shown that major obstacles to a successful transfer to practice still exist. The Synthesis Working Group has therefore focused on coming up with new ideas for translation activities and market models.
Module 3 – Optimised use of antibiotics
The excessive or inappropriate use of antibiotics promotes the development of resistance. New decision-making tools and operational processes should help doctors, veterinarians and farmers use antibiotics more selectively. In addition to hospital medicine, which has known antibiotic stewardship programmes to support prescribing practices for some time, this partial synthesis also considers primary healthcare, which accounts for a much larger proportion of antibiotic use in human medicine. It shows ways in which antibiotic stewardship can also be implemented here. Another aspect focuses on "antibiotic-sparing" animal husbandry concepts which, thanks to improved animal health in a preventive approach, are able to manage with fewer antibiotics.
Exchanging views among scientists and practitioners
The work is now well advanced in all three modules. To this end, the respective working groups have initially analysed NRP 72 projects and the rest of the current scientific literature. In parallel, all NRP researchers presented their results to the other researchers and the Steering Committee in a series of online events between January and June 2021, during which aspects of implementation were discussed in detail.
Furthermore, in order to bring in the views of practitioners, NRP 72 has set up a Sounding Board of practice partners in each of the three modules (see box) to monitor the exchange of views on conclusions and recommendations. Following this process, all synthesis teams have drawn up a series of practical recommendations. The next step, in autumn 2021, was to present these recommendations in three dialogue events to an extended group of practitioners, administrators and politicians for further refinement so that proposals for implementation can be drawn up.
Key messages and final recommendations of NRP 72 in 2022
In the next step, all three partial syntheses of NRP 72 will be completed, taking account of the extensive feedback from stakeholders. Finally, looking at the results as a whole, the Steering Committee of NRP 72 will draw up a programme summary presenting the key messages and final recommendations of NRP 72 for the attention of decision-makers. The partial syntheses and programme summary will be published in autumn 2022.
Working Groups and Sounding Boards of the NRP 72 modules
Module 1 – How resistance develops and spreads
Working Group
Helmut Bürgmann, Eawag Kastanienbaum (Working Group Coordinator) Adrian Egli, Department of Clinical Microbiology, Basel University Hospital Andrea Endimiani, Institute of Infectious Diseases, University of Bern Wolf-Dietrich Hardt, Institute of Microbiology, ETH Zurich, Institut für Mikrobiologie, ETH Zürich Roger Stephan, Institute of Food Safety and Food Hygiene, Vetsuisse Faculty University of Zurich Sarah Tschudin Sutter, Dept. of Infectious Diseases and Hospital Epidemiology, University Hospital Basel Sounding Board
Maya Graf, member of the Council of States, Green Party of Switzerland, Basel-Landschaft Sophia Johler, Institute of Food Safety and Food Hygiene, University of Zurich / Swiss Society for Food Hygiene Andreas Kronenberg, ANRESIS [Swiss Centre for Antibiotic Resistance] Nicolas Müller, Swiss Society for Infectious Diseases Jean-Claude Piffaretti, Interlifescience Jürg Utzinger, Swiss Tropical and Public Health Institute Saskia Zimmermann-Steffens, Water Body Protection Section, Federal Office for the Environment Annelies Zinkernagel,Dept. of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich
Module 2 – Novel active substances and faster diagnostic techniques
Working Group
Markus Seeger, Institute of Medical Microbiology, University of Zurich (Working Group Coordinator) Petra Dittrich, Department of Biosystems Science and Engineering, ETH Zurich Martin Loessner, Laboratory of Food Microbiology, ETH Zurich Patrice Nordmann, Molecular and Medical Microbiology, University of Fribourg Jörn Piel, Institute of Microbiology, ETH Zurich Jean-Louis Reymond, Department of Chemistry and Biochemistry, University of Bern
Sounding Board
Michael Altorfer, Swiss Biotech Association Rudolf Blankart, Roundtable Antibiotics Claus Bolte, Swissmedic Ken Bradley, Roche Christoph Eymann, National Councillor, LDP Basel-Stadt Marc Gitzinger, BioVersys AG / BEAM Alliance Gilbert Greub, Swiss Society of Microbiology/ Microbiology Institute, Lausanne University Hospital CHUV Laura Piddock, GARDP Katharina Stärk, Federal Food Safety and Veterinary Office
Module 3 – Optimised use of antibiotics
Working Group
Hanspter Naegeli, Institute of Veterinary Pharmacology and Toxicology, University of Zurich (Working Group Coordinator) Noëmie Boillat Blanco, Department of Infectious Diseases, Lausanne University Hospital CHUV Benedikt Huttner, Department of Infectious Diseases, Geneva University Hospitals HUG Mireille Meylan, Clinic for Ruminants, Vetsuisse University of Bern Vivianne Visschers, School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland
Sounding Board
Julia Bielicki, Swissnoso Yvonne Gilli, Swiss Medical Association FMH Olivier Glardon, Swiss Veterinary Society GST Stephen Leib, Institute of Infectious Diseases, University of Bern / ANRESIS Laurent Monnerat, Zoetis, Inc. Daniela Müller-Brodmann, Federal Office of Public Health / StAR Blaise Perrey, Proviande Damiana Rinaldi, Swiss Farmers' Union Gertraud Schüpbach, Veterinary Public Health Institute, University of Bern