Fewer antibiotics prescribed, but still fears over resistance

DOCTORS in Scotland are prescribing fewer antibiotics in attempts to combat drug resistance but concerns remain that dangerous new bugs could emerge, a report has revealed.

Figures showed that GPs issued 44,500 fewer prescriptions for antibiotics in 2009, with a 19.5 per cent drop in drugs specifically linked to Clostridium difficile infection following guidance to cut their use.

But experts said they remain concerned that new types of resistance becoming more common in other countries could increasingly find their way to Scotland.

Anne Eastaway, consultant microbiologist at Health Protection Scotland, said they needed to remain vigilant and monitor these resistant infections to make sure they did not become common in Scotland.

Last year, concerns were raised about the emergence of enzymes known as carbapenemases which affect the usefulness of a common group of antibiotics.

Researchers reported the presence of a carbapenemase producing gene known as NDM-1 which is carried by bacteria, making them resistant to the antibiotics. Alongside other genes with a similar effect, these are now concerning experts.

Dr Eastaway said: "In Scotland at the moment it is safe to say they are rare. The majority of the ones that have been identified that cause us concern have almost certainly been imported from parts of the world where they are known to be a problem."

In 2009, they found ten so-called carbapenemase producing infections. Dr Eastaway said the most concerning were those with the gene KPC - of which there were two in Scotland - and NDM-1, with one Scottish case.

"These two particular types of resistance concern us because they spread easily," she said.

She added: "The message in our report is that things are looking good on the antibiotic resistance at the moment in that nothing has got worse, and if anything things seem to be looking a bit better. But because of international travel and the constant emergence of new types of resistance, we can't be complacent."

But figures for 2010 so far suggest that cases of these infections have not increased, Dr Eastaway said.

"To date, from the data we have, the first impression is that it is no worse."

Dr Eastaway said they also needed to remain vigilant for multi-drug resistance, with a small number of cases where infections were resistant to eight or more groups of drugs.

Health Secretary Nicola Sturgeon said: "Inappropriate use of antibiotics is also linked to the development of resistant strains of infections which is why it's important that we avoid overusing them to ensure that antibiotics - which have revolutionised healthcare - remain effective in future."