RHEVA - The Swedish Innovation That Can Help Combat Antibiotic Resistance
As international organisations unite to combat drug-resistant infections, a small equestrian business in Sweden might hold the cards for reducing the use of antibiotic treatments in wound management and healing.
Antibiotic and antimicrobial resistance has become a crisis in health care. The problem has emerged from the overuse and inappropriate use of antibiotics and antimicrobials. These resistant elements of bacteria, viruses, fungi, and parasites have made diseases that were once easily treatable deadly again(1). Bacterial resistance to medications is the result of microorganisms rapidly changing their genetics to combat new generations of antibiotics. With this dangerous development come higher health care costs, poorer outcomes, and a higher risk of death for patients infected with resistant strains (2). This development cannot be reversed, and when combined with the pressure to use antibiotics and antimicrobials it is guaranteed that the cases of MDRO (multi-drug resistant organisms) will increase and become a persistent phenomena.
With MDRO occurring more rapidly than new generations of antimicrobials can be developed (3), it is estimated that in the United States alone the direct costs as a result of MDRO exceeds $20 billion annually, and that the indirect costs are in excess of $35 billion (2).
So how does wound care effect this?
Bacterial colonisation, biofilm production, and infection are huge global problems in chronic wound care (4). Chronic wounds have a complex microenvironment that houses multiple bacterial species, yet there is a lack of evidence on the effectiveness of antibiotic therapy as well as the optimal regimens for treatment. Despite this, more often than not, antibiotics will be made a part of the treatment regimen with the patient receiving broad-spectrum antibiotics for an extended period of time as a part of their treatment (5, 6).
The UN, international agencies and associated experts released in 2019 a groundbreaking report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis. The report warns that if no action is taken, drug-resistant diseases could damage the economy as catastrophically as the 2008-2009 global financial crisis by 2050, and that by 2030 antimicrobial resistance could force up to 24 million people into extreme poverty. Recognising that human, animal, food and environmental health are closely interconnected, the report calls for a coordinated, multisectoral “One Health” approach (7).
One solution to the problem can be found within the equine industry and the Swedish company RHEVA. As with all brilliant business ideas, RHEVA (established in 2016) came to life as no solutions could solve the problem Founder Sofie Westberg was facing. Her horse gained a nasty wound on its front knee; a notoriously difficult area to bandage and treat. This happened at the height of summer, with the added risk of infections from flies hindering the wound healing process. Sofie's veterinary suggested that she 'solved the problem', which she did! By cutting a piece from her horses fly mask and securing it over the wound using elasticated tape, the idea for RHEVA was born. A few years later Sofie started her own business and with help from her family the production of RHEVA medical band-aid was up and running.
The RHEVA plasters come in two sizes, and protects agains insects, won’t be damaged if wet, lets the wound breath and will stay put on the horse’s coat. It’s versatility allows it used on animals of all sizes, as well as humans, and all materials are medically classified. RHEVA has been on the market for a few years in Sweden with incredible feedback from veterinarians, professional equestrians and private horse owners.
On areas of the body where there are extensive movement such as areas where large muscles attach or directly on or in the vicinity of joints, it can be necessary to use extra attachment to ensure the RHEVA will stay in place. You can also use tape or elastic bandages around the RHEVA, allowing you to continue your already existing management routines.
Team RHEVA.
Allowing wounds to heal in a gentle way, reducing the worry about caring for open wounds, and ideal for protecting surgical stitches, it is the perfect solution for proactive wound management. This is exactly what is needed and is a step in the right direction to achieve the ‘One Health’ approach urged by the UN and the World Health organisation.
The product is patented and trademarked in Sweden. It is manufactured by Cenova AB in Mjölby, with the adhesive utilised sourced from Stokvis Tapes in Norrköping, making it Swedish invention through-and-through. You can visit RHEVA’s website here.
1. Brown ED, Wright GD. Antibacterial drug discovery in the resistance era. Nature 2016;529(27):336-43. doi: 10.1038/nature17042
2. World Health Organization. Antimicrobial Resistance: Global Report on Surveillance. Geneva, Switzerland: World Health Organization; 2014.
3. Medina E, Pieper DH. Tackling threats and future problems of multidrug-resistant bacteria. In: Stadler M, Dersch P, eds. How to Overcome the Antibiotic Crisis: Facts, Challenges, Technologies, and Future Perspectives. Cambridge, MA: Springer; 2016:3-3.
4. Dryden MS. Reactive oxygen species treatment in the management of wounds. In: Recent Clinical Techniques, Results, and Research in Wounds. Cham, Switzerland; Springer; 2017:1-10. Retrieved from https://doi.org/10.1007/15695_2017_39
5. Tzaneva V, Mladenova I, Todorova G, Petkov D. Antibiotic treatment and resistance in chronic wounds of vascular origin. Clujul Med. 2016;89(3):365-70. doi: 10.15386/cjmed-647. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990431/. Accessed February 17, 2018.
6. Murali TS, Kavitha S, Spoorthi J, et al. Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections. J Med Microbiol. 2014;63(10):1377-85. doi: 10.1099/jmm.0.076034-0.
7. https://www.who.int/news-room/detail/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis
