‘Smart’ prescribing to halt antibiotic resistance

ANTIBIOTIC use must become cleverer and the number of prescriptions slashed to reverse a recent increase in drug-resistant infections, health officials have said.

Doctors are being urged to cut down on their use of antibiotics. Picture: Getty

The number of reported resistant infections of e-coli in England rose by 12 per cent between 2010 and 2013, which was linked to a 6 per cent increase in prescriptions of antibiotics, Public Health England (PHE) said.

It called for a “culture change” in hospitals after the findings, published in a report yesterday which looked at inpatient prescriptions for the first time.

Scottish health bosses said they supported the conclusions of the report and a need to reduce prescriptions of antibiotics which have been on the rise.

GPs’ prescription figures will be made public from April next year to increase local accountability after the discovery of a north/south divide in the number of pills handed out.

Both US president Barack Obama and David Cameron have recently made fighting antibiotic resistance a top priority, with the Prime Minister saying in July it threatened to send medicine “back into the dark ages”.

Dr Susan Hopkins, a PHE healthcare epidemiologist who co-wrote the report, said educating doctors and the public about when to take antibiotics was vital to cut resistant infections in the next five years. UK-wide figures revealed that 36 per cent of patients were given antibiotics for coughs and colds in 1999 but by 2011 this figure had soared to 51 per cent.

Hospitals should also become more savvy about using targeted drugs.

Dr Hopkins said: “We know that less than 1 per cent of bacteria are extremely multi-drug resistant at the moment; that means resistant to pretty much all the antibiotics we have available to us. So it’s very rare.

“But in countries like India they are approaching 10-20 per cent of individuals where they are not able to treat effectively with the antibiotics they have available.”

About one in 25 “bugs” that cause bloodstream infections – septicaemia – are resistant to at least one key antibiotic ingredient, she added.

When hospital prescriptions are looked at together with GP figures, England moves from mid-table to amongst the top prescribers of antibiotics in Europe, the report found.

Dr Hopkins said: “Far too often antibiotics are prolonged in hospitals, rather than [doctors] shortening the duration and I think as a hospital practising doctor I would like to make sure that on a daily basis antibiotic prescriptions are reviewed.”

She also said she wanted to see GPs give out more so called “back-up” prescriptions, those given to patients with instructions only to take the drugs if their condition worsened, as only half of these prescriptions are usually claimed. It also helps educate the public about when they need antibiotics and when they don’t need to take them, she said.

Professor John Watson, the Department of Health’s deputy chief medical officer, said: “Antimicrobial resistance is one of the biggest threats to health security around the world today and everybody must take action.”