This is an article from THE IRISH TIMES about the over-prescribing of
antibiotics in general. I thought it might be of interest to some of you,
considering the "conversation" of late.
Hilda

Friday, October 15, 1999

Overprescribing of
antibiotics condemned


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By Kevin O'Sullivan, Environmental and Food Science Correspondent
The new National Disease Surveillance Centre (NDSC) has warned that
overprescribing of antibiotics, both in the treatment of humans and in
farming, risks causing a crisis in the health services within five years.

Everybody had to take responsibility for a failure to curb an accelerating
build-up of resistance to almost all commonly used antibiotics, it said
yesterday. Infections were becoming more difficult and expensive to treat,
with increasing risk of death if patients' immune systems were already under
strain.

The Department of Health has asked the NDSC to devise a strategy to influence
a reduction in antibiotic use.

On key resistance indicators, Irish levels were at best "midtable" compared
to other European countries, said Dr Ed Smyth, consultant microbiologist at
Beaumont Hospital. In others, notably antibiotic resistant chest infections,
the Republic was close to the "top of the league".

With Staphylococcus aureus, which causes potentially lifethreatening
infections and is particularly troublesome in hospitals, up to 15 per cent of
Irish cases involved antibiotic-resistant varieties, necessitating more
complex treatments. While this compared favourably to southern Europe, much
lower levels were being achieved in Scandinavia.

The emergence of resistance to VISA drugs, "the last barrier" to such
infections, was worrying, Dr Smyth said. Resistance had been confirmed in
Japan and the US. "Two weeks ago it was confirmed in Glasgow. It's only a
matter of time before it's in Ireland."

High levels of penicillin-resistant pneumonococci infections, which cause a
variety of chest and ear infections, pneumonia and some forms of meningitis,
were disturbing from an Irish perspective, he said. About a fifth of such
cases involve resistant strains, though this is not the cause of the high
incidence of meningitis.

It was not about cost-cutting or making it harder for people who need
antibiotics to get them, it was about keeping a valuable resource potent. If
not, the implications were longer hospital stays and higher morbidity rates.

In the US, problems with drug resistance were costing $100 million a year.
Some 150 million antibiotic prescriptions a year are issued there, a third of
which are considered unnecessary.

The NDSC director, Dr Darina O'Flanagan, said four simple steps could lead to
less antibiotic use: no prescribing of antibiotics for simple coughs, colds
or viral sore throats; limit prescribing for cystitis to three days in
otherwise fit women; and limit prescribing over the telephone to exceptional
cases.