Finland

The emergence of bacteria that cause infections in humans which are resistant to treatment with antibiotics has become a global public health concern.

Infections by multi-resistant germs are estimated to kill around 25,000 people in the EU every year, with some experts estimating that this number will increase dramatically over the coming decades.

MRSA prevalence

Percent of hospital Staphylococcus aureus isolates that are resistant to methicillin

Finland_MRSA.png

Source: ECDC

But the situation between each member states varies hugely. Some countries have strict rules around antibiotic consumption and some don’t. The EU bodies responsible for addressing the problem recognise that there is no one-size-fits-all solution. This is why it is important to understand the situation in individual countries.

Antibiotic consumption in Finland

Finland is among the highest consumers of antibiotics in hospitals of all the EU countries, with 2.6 daily doses per 1,000 people. This data included antibiotic consumption in remote health centres and nursing homes.

But outside of hospital settings, Finland’s antibiotic consumption, 18.1 daily doses per 1,000 population, was lower than the EU average of 21.6 – equivalent to less than two packets of antibiotics per 1,000 people per day in Finland, while the average in the rest of the EU was more than three.

Antibiotic consumption in humans

Daily doses per 1000 inhabitants per day

Finland_consumption.png

Source: ECDC

According to the European Centre for Disease Prevention and Control, between 2011 and 2015 Finland’s consumption of antibiotics showed a significantly decreasing trend.

Hospital infections

The ECDC also records healthcare associated infection (HAI) prevalence in European hospitals. This data shows what percentage of hospital patients have a hospital acquired infection – a large proportion of these infections are preventable, and are caused by poor hygiene.

Between 2011 and 2012 in Finland 40.9 per cent of people arriving at hospital were recorded as having an HAI, according to the ECDC. This was the highest rate in Europe. The most common HAI’s in Finland during the study were, like in most EU countries, E. Coli, S. Aureus and Enterococcus spp.

Livestock consumption of antibiotics

In 2014 11.4 tonnes of antibiotics were sold for use in food producing animals. This is the equivalent of 22.3 mg per population correction unit of animal biomass – a proxy unit developed to indicate the total antibiotic sales divided by the animals that could have been treated with them – Finland had the fourth lowest rate of mg/PCU antibiotic consumption in the EU, behind Sweden with 11.5 mg/PCU.

From 2011 to 2014, the total annual sales of antibiotics for livestock consumption remained stable at around 22 mg per PCU. Penicillins were the most-sold antibiotic at 45 per cent of the total.

The total livestock population also remained stable between 2011 and 2014, although there was a decrease in the number of pigs and an increase in the number of chickens.

Other indicators

An ECDC report which looked at infections and antibiotic use in European hospitals in 2011-12 reported on hospitals indicators like the use of alcohol hand rub and the number of single beds.

These indicators are important because they are measures that help to keep the number of healthcare associated infections low, which helps to counter resistance – because the fewer infections patients acquire, the fewer antibiotics are used, and the less resistance can develop.

Single rooms are important because they can be used to isolate patients who have infections, preventing the infection from spreading. The amount of alcohol hand rub used indicates how well hospital staff are disinfecting their hands and following hygiene procedures – the more hand rub used, the less chance infections have of spreading.

In Finland, the use of alcohol hand rub was well above the European average. Hand rub consumption was 31.45 litres per 1,000 patient days in Finland, compared to the European average of 25.64 litres.

The report looked at the percentage of hospital beds which were in a single room, and found that Finland had a below average percentage of single room beds with only 11.11 per cent compared to a European average of 15.29 per cent. However Finland was far from being the worst offender in this category – in Hungary only 1.71 per cent of hospital beds were in a single room.

Finland had an above average number of doctors and nurses dedicated to infection prevention and control. The median number of infection nurses per 250 beds was 1.36, compared to a European average of 0.97. The median number of infection doctors per 250 beds was 0.68, compared to a European average of 0.38.