GPs urged to cut antibiotic use
Wednesday February 04 2009
CURBING the use of antibiotics would not just cut deaths from superbugs but also lead to cost savings for hospitals, a leading infection-control expert warned yesterday.
Prof Hilary Humphreys warned that if Ireland did not change prescribing patterns, doctors would be left with limited options to treat difficult infections.
The microbiologist at Beaumont Hospital in Dublin was launching a new report by the Royal College of Physicians urging the public and doctors to cut back on the use of antibiotics.
The drugs are frequently taken for viral colds and flu, when in fact they are only effective against bacterial infections.
"Antibiotics kill bacteria and not viruses," Prof Humphreys warned.
The more frequently antibiotics are used unnecessarily, the more resistant some forms of bacteria become to them.
That in turn leaves doctors increasingly powerless to fight life-threatening infections.
The report found Ireland is among only three countries in Europe where antibiotic prescribing outside of hospitals is on the rise.
Ireland is ranked ninth highest in Europe for the volume of outpatient antibiotics prescribed, while the UK manages a much more creditable 18th position, alongside Norway and Sweden.
He said if antibiotic use was cut, killer superbugs like MRSA and C Difficile would fall, while hospitals could also make reductions in their budgets.
"Medicines account for 20pc to 30pc of hospital budgets and if that was reduced to 10pc, it would be significant in cost terms."
Explaining how resistance occurs, he said: "When somebody with a bladder infection receives an antibiotic, it is given to treat the E-coli in the bladder. It also has effects on bacteria in other parts of the body.
"Many of those bacteria are killed but some will survive and counteract the antibiotic.
"The bacteria becomes stronger because it has more space and nutrients in the body to survive.
"Bacteria replicates and becomes the dominant bacteria in the population."
He said he was concerned that if Ireland did not change prescribing patterns, doctors would be left with limited options to treat difficult infections.
Patients who take antibiotics are also at risk of nausea, vomiting and skin rashes.
The problem was not just related to a patient's expectations that they are due a prescription from their GP, but also down to the doctor's need for more precise guidelines on prescribing.
Tackled
It could be possible to reduce consumption by 10pc to 15pc in a couple of years, he added.
Ireland is behind other countries, like Sweden, which have vigorously tackled this problem.
The report said: "Antibiotic-resistant bacteria, such as MRSA and vancomycin-resistant enterococci (VRE), have become frequent causes of infection in Irish hospitals.
"While there are still drugs available to treat these infections, they are more expensive and tend to have serious side effects.
"In the cases of multi-resistant E-coli and Acinetobacter, both of which can cause life-threatening infections, there are sometimes only one or two powerful antibiotics to choose from and these can be associated with significant toxicity and serious side effects."
The report stressed that the doctor must balance the needs of the individual patients and the choice of antibiotic against the potential consequences of emerging antibiotic resistance.
- Eilish O'Regan
