Sunday 17 December 2017

Sharp rise in number of antibiotics given in maternity hospitals

Eilish O'Regan

Eilish O'Regan

The number of pregnant women given antibiotics in the country's three main maternity hospitals has escalated, new figures reveal.

The rate has more than doubled in the National Maternity Hospital in Holles Street since 2007 and has also risen sharply in the Coombe and Rotunda hospitals.

Consumption of the "magic bullets" to kill infections is also on the increase in several general hospitals across the country, despite warnings that unless the over-use of these drugs is curbed, they will continue to lose their life-saving power.

Dr Susan Knowles, microbiologist in Holles Street, said: "There has been a marked increase in some hospitals that used to use very few antibiotics."

She said the rise in maternity hospitals was strongly driven by guidelines on the treatment of sepsis, a form of blood poisoning triggered by infection, which, if untreated, can eventually lead to multiple organ failure and death.

A woman's vital signs, such as blood pressure, may change dramatically during labour, prompting doctors to start the woman on antibiotics in case of sepsis. "A lot of the women who are started on the drugs turn out not to have infection, although some do," she said.

"In the past, doctors would have monitored the patient over time but now it is much more difficult not to start them on antibiotics."

It means that more of these women are checked over 24 to 48 hours and may have their treatment changed. Six new pharmacists are now being hired for maternity hospitals and they will be crucial to examining women in the postnatal ward to stop antibiotics where a woman has no infection.

Commenting on general hospitals, Martin Cormican, Professor of Bacteriology at the School of Medicine, NUI Galway, said comparing one with another is often difficult, even when size is taken into account.

"This is because those with a large number of patients with very complicated illness - for example, those hospitals treating many patients with acute leukaemia - will almost always need more antibiotics," he said,

The overall figure for 2014 means that for every 100 patients in hospital in Ireland, we use 86 adults doses of antibiotics per day, almost one full adult dose of some antibiotic per person in hospital.

"However this does not mean that almost everyone in hospital is on antibiotics, because some people are on several antibiotics at one time. The first thing to notice is that the overall average at 86 is higher than it has ever been since 2007."

He warned: "A worrying trend is the increase in use in the drug group that includes the carbapenems. Increasing use of this family of antibiotics in hospitals is very worrying for two reasons.

"It is worrying because it is happening at least in part because there are more and more bacteria where there is no other safe antibiotic that can be relied on.

"It is also worrying because we have a real problem in Ireland now with bacteria that are resistant even to the carbapenems and the more often they are used, the faster this problem is likely to grow."

Irish Independent

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