Antibiotic use needs better regulation in Estonia

The use of antibiotics in Estonia needs better regulation to prevent the formation of treatment-resistant microbes. Based on their study, the University of Tartu researchers recommend paying attention to regular updating of national treatment guidelines and to doctors’ continuing education opportunities, as well as creating a surveillance and feedback system for prescribing antibacterial therapy.

Increasingly more infectious diseases fail to respond to antimicrobial treatment due to antibiotic resistance. Resistance has been observed, for example, in the case of urinary tract infections, tuberculosis, sexually transmitted infections and bacterial pneumonia. Antibiotic resistance is a global problem, which needs attention and quick action. In Estonia, antibiotic therapy is used less in human medicine than in Europe on average. However, the researchers noticed that Estonian doctors often tend to prescribe too broad-spectrum antibiotics. This may contribute to the development of resistance and undesirable side effects.

Four recommendations to control the use of antibiotics

Researchers have four recommendations to improve the situation. First, it is necessary, in cooperation with professional associations, to prepare national guidelines for antibacterial therapy based on Estonian antibiotic resistance data. Secondly, a national audit and feedback system for antibacterial treatment must be developed. The researchers recommend to start with auditing the doctors who most frequently prescribe antibacterial therapy to their patients – family physicians, paediatricians and dentists.

Thirdly, antibiotic use in outpatient settings must be analysed in depth and regularly, for example, in every three years. In the course of the analysis it is necessary to assess how the level of antibiotic resistance of outpatient microorganisms changes over time. And finally, more attention should be paid to the continuing education of doctors in the area of antibiotic use.

Kärt Sõber, Adviser of the Public Health Department of the Ministry of Social Affairs, said that the intermediate results of the University of Tartu researchers allow to more precisely identify shortcomings in the area of human health. “The project is still ongoing but its results are already of great help in developing and adapting the national action plan for reducing antibiotic resistance, and the national guidelines for antibacterial therapy,” Sõber said.

The researchers’ recommendations are based on the intermediate results of the applied research study “Routes for development and spread of antibiotic resistance and resistance containment measures”. The study will continue until mid-2022. It is funded by Estonian Research Council via the RITA programme from the European Regional Development Fund and the state budget of Estonia.
Intermediate reports of the study are available on the website.

Further information: Margit Meiesaar, Project Manager, Institute of Technology, University of Tartu, +372 5564 9214,

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