“Think Hard Before Using Antibiotics” Message To UK Hospitals

Timed to coincide with European Antibiotics Awareness Day on Friday 18th November, the UK’s Department of Health is urging hospitals to “think hard before using antibiotics”. The message reflects a call by the European Centre for Disease Prevention and Control (ECDC) for more prudent use of antibiotics, as latest figures show that resistance to antibiotics, including the carbapenems - the major last line of defence against multidrug-resistant bacteria - is increasing across Europe.

The Department of Health urges doctors and nurses to think twice before prescribing antibiotics because too many patients are receiving too many of them with the result they become more and more resistant to these life-saving drugs.

The Department of Health has published a new guide titled “Start Smart, Then Focus” on the use of antibiotics in hospitals. The use of the word “Smart” echoes a similarly intended “Get Smart” campaign launched in the US.

The guide gives hospital prescribers best practice advice on how to ensure patients get the right drug, at the right dose, at the right time and for the right length of time. The aim is to reduce the practice of giving out too many broad-spectrum antibiotics and avoid unnecessary lengthy duration of antibiotic treatment.

Chief Medical Officer Professor Dame Sally Davies told the press:

“It is important we use antibiotics in the right way if we are to get the best outcome for the patient, slow down resistance and make sure these important medicines continue to stay effective for ourselves and for future generations.”

“Many antibiotics are currently prescribed and used when they don’t need to be - meaning antibiotics lose their effectiveness at a rapidly increasing rate,” she added.

Professor Mike Sharland, Chair of the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), said the new guidance is an important tool to help doctors and nurses tackle the “serious problems of antibiotic resistance and healthcare associated infection”.

“The guidance encourages all hospital prescribers to use the most effective antibiotic as fast as possible to treat serious infections, then review the treatment 48 hours later,” said Sharland.

The guide is titled “Antimicrobial stewardship: Start smart - then focus” and you can view a copy here.

According to the latest surveillance data released by the European Surveillance of Antimicrobial Consumption (ESAC), the vast majority of human consumption of antibiotics occurs in the community, but resistance to last-line drugs like the carbapenems cannot be explained only by use of antibiotics outside hospitals.

The ECDC says studies show that half of all antibiotic use in hospitals is inappropriate. They conclude prudent use of antibiotics, together with good hand hygiene practice, is the best way to prevent spread of infection in hospitals.

Another area of concern is the lack of new drugs coming on stream.

This is the subject of an article by Professor Laura Piddock of the School of Immunity and Infection at the University of Birmingham, UK, published in the The Lancet Infectious Diseases on Friday 18 November, who writes:

“The demise of antibacterial drug discovery brings the spectre of untreatable infections.”

Piddock’s article describes a new initiative called Antibiotic Action, which was launched in response to the theme of World Health Day 2011: “antimicrobial resistance: no action today and no cure tomorrow”.

“Antibiotic Action: The Arms Race”, is a UK-led global initiative launched through an event at the House of Commons and the delivery of a petition to the Prime Minister’s residence at No 10 Downing Street to call for action in “what is unquestionably one of the most important crises modern medicine has faced,” says Piddock in an opinion statement posted on the Birmingham University website.

The initiative is led by by the British Society for Antimicrobial Chemotherapy of which Piddock is currently President. It urges support for all efforts to contain resistance and preserve the current pool of antibiotics, while we look at new ways to stimulate interest in the discovery and development of new ones.

This includes adapting the regulatory framework to allow fast-tracking of new antibiotics to market without compromizing public heath, finding ways to ensure developers get a decent return on investment so they have an incentive to invest in drug development, and getting governments worldwide to work together and with stakeholders to replenish the new antibiotics pipeline before it runs completely dry.

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Written by Catharine Paddock PhD