This year on the proposal of the World Health Organization (WHO) / ​​Europe from 16 to 22 November 2015 for the first time is organized the World Antibiotic Awareness Week, which highlights the activities that have been undertaken on November 18 – European Day of rational use of antibiotics. The reason for strengthening activities is the difficult recovery of patients with the infections caused by the growing number of resistant microorganisms. Growing resistance associated with poor development of new antibiotics make infections difficult to treat, often with death.(fatal outcome)

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This week, the WHO published the first report of CAESAR network monitoring for antimicrobial resistance in Central Asia and Eastern Europe, for antibiotic resistance in five countries that are not members of the EU in the WHO European region – Macedonia, Belarus, Serbia, Switzerland and Turkey (available at http://www.euro.who.int/__data/assets/pdf_file/0006/285405/CAESAR-Surveillance-Antimicrobial-Resistance2014.pdf?ua=1).

The data obtained through this network is complementary data from the network of antimicrobial resistance in the EU Member States, thus creating a pan-European insight into the trends and sources of antimicrobial resistance. The data used in CAESAR network provides guidance for treatment of patients, and also an increasing awareness among health authorities and the general population.

- The results from CAESAR monitoring of antimicrobial resistance in the Republic of Macedonia in the period 2013-2015, Dr. Biljana Kakaraskoska Boceska, from the Institute on Public Health of the Republic of Macedonia.

- The situation  with antimicrobial resistance in the Republic of Macedonia in terms of other European countries, prof. Dr. Nichola Panovski, Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje, President of the multisectoral commission for anti microbial resistance.

The main conclusion of this report is that EU Member countries have different antibiotic resistance in non EU countries.

Switzerland has resistance similar to countries in northern Europe, which are characterized by low resistance and high level of awareness. However, there is a relatively high resistance to the bacterium Acinetobacter spp., the cause of pneumonia and wound infections, to carbapenems, which are one of the last discovered antibiotics. This means that only a few alternative remedies are available to save patients with such infections.

 Turkey has similar resistance as the countries of Southeast Europe. They have relatively high levels of resistance to carbapens in the bacterium E. coli, which start as a large hospital epidemic, but has been spread outside the hospital in all the country.

 Republic of Macedonia, Belarus and Serbia, as their neighboring countries in the EU, have a high resistance to bacteria Acinetobacter spp. and Pseudomonas spp.

 The report shows that despite the different level, the antibiotic resistance is a serious public health problem, not only in the five states of CAESAR network, but also globally.

Hence the need for maintaining the World Antibiotic Awareness Week under the slogan “Antibiotics: handle with care” as the most effective way to reduce antibiotic resistance.

Republic of Macedonia, one of the first countries in Europe, which implements a campaign for rational use of antibiotics from 2008, joined the celebration of World week for rational use of antibiotics, following activities offered by multi-sectoral committee on antimicrobial resistence within the Ministry of Health :

1) 16.11.2015 (Monday) at the hotel “Continental”, a meeting of national CAESAR network, inviting all microbiologists (public and private microbiological laboratories), representatives from the Centers for Public Health and representatives from all hospitals. After a welcoming speech by the Dean of the Medical Faculty in Skopje, Prof. Dr. Nikola Jankulovski, followed expert presentations on:

- CAESAR-methodology for monitoring antimicrobial resistance, prof. Dr. Zaklina Cekovska, Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje.

- Results of the external quality controls in microbiology laboratories in the Republic Macedonia, doc. Dr. Anna Kaftandzhieva, Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje.

- Results from CAESAR monitoring of antimicrobial resistance in the Republic of Macedonia, in the period 2013-2015 Dr. Biljana Kakaraskoska Boceska, MA sci, Institute on Public Health of RM

- The situation with antimicrobal resistance in the Republic of Macedonia in terms of other european countries, prof. Dr. Nichola Panovski, Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje, President of the multisectoral commission for antimicrobial resistance.

- Possible reasons for the high rate of VRE (vancomycin resistant enterococci) in the R Republic of. Macedonia, prof. Dr. Gordana Jankoska, Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje.

- CAESAR – future prospects and steps to improve the reporting process control of antimicrobial resistance, Dr Golubinka Boshevska, MA sci, from the Institute on Public Health of the Republic of Macedonia, national coordinator for antimicrobial resistance.

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The meeting is organized by the Association of Microbiologists of Macedonia (AMM) and CAESAR national team, which is part of the multi-sectoral commission of the Ministry of Health and it was supported by the WHO Regional Office for Europe, WHO Office in Skopje, Faculty of Medicine, Institute of Public Health and the Centre for Regional Studies and Cooperation “Studiorum”.

Organizers of activities and lecturers were: Dr.G.Boshevska, Dr. B. Kakaraskoska Boceska, Prof. Sci. Dr. H. Cekovska, prof. Dr. G. Jankoska, doc. Dr. A. Kaftandzhieva, N. Milevska Kostova, Mr. K. Christova, Mr. C. Ivanovska, mr. M. Spasenovska, Mr. S. Cicevalieva, prof. Dr. N. Panovski.

2) As a part of the celebration of The World week, in the period from 18-27.11.2015, were held several professional and educational events to raise awareness of the shared responsibility and the need for joint action.

a) Educational classes for a period of 30-45 minutes for students in 5 schools in Skopje.

b) Lectures on the meetings in 5 university clinics

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Prim.d Dr. G. Boshevska, MA sci, national coordinator for AMP