Alarming surge in use of antibiotics

Hospital prescriptions raise fears of superbug growth

ANTIBIOTIC use in Scottish hospitals has soared despite concern over the drugs’ role in the rise of superbugs.

Overprescription has been blamed for the rise of deadly infections such as methicillinresistant Staphylococcus aureus (MRSA) and Clostridium difficile (C.diff), which attacks the gut.

New figures show there has been a jump of nearly 10 per cent in broad- spectrum antibiotics prescribed by hospitals in the past 12 months.

Recent figures show that while there has been a fall in C.diff infection over the past five years, especially among the over-65s, there has been a resurgence among younger patients.

Yesterday, Scottish Conservative health spokesman Jackson Carlaw said: ‘The Scottish Government has said it appreciates the need to reduce antibiotics in order not to build immunities to them. Since this argument is accepted by the SNP, it has to explain why the figures are on the rise and explain the potential consequences of this.’

The figures from the Scottish Antimicrobial Prescribing Group show that antibiotic use in hospitals was 5.9 per cent higher in 2014 than in 2013. This continues an upward trend since 2009.

For broad- spectrum antibiotics there was a 9.7 per cent increase. The National Institute for Health and Care Excellence (Nice) recommends these should generally be used only when narrow- spectrum antibiotics are ineffective because they increase the risk of MRSA, C.diff and resistant urinary tract infections.

William Malcolm, pharmaceutical adviser with Health Protection Scotland, said: ‘The fact that antibiotic prescribing in hospital is rising is something we need to be considering because the long-term implication is that the more antibiotics we use, the greater the possibility there is of the bacteria becoming resistant to the antibiotics we are using.’

He said a change to more targeted medicines could have led to some of the overall rise. Where doctors had prescribed one antibiotic, now they used two or three specific types.

‘If now you are using three antibiotics, or two, it results in two or three times as many doses,’ said Mr Malcolm, adding they were also investigating whether the rise could be related to the longer courses needed.

‘There is no suggestion that people in hospital shouldn’t get antibiotics,’ he said. ‘Of course they should.

‘They are very important and useful medicines, but it is equally important that as soon as clinically possible doctors, nurses and pharmacists should work together to reduce and stop antibiotics where they can.’ The Scottish Government has directly funded a £4.2million Scottish Healthcare Associated Infection Prevention Institute and i n January set up the Controlling Antimicrobial Resistance in Scotland group to supervise the f i ght against antibiotic-resistant bacteria in humans and animals.

Health Secretary Shona Robison said: ‘Resistance to antibiotics is a global health threat and this Government and NHS Scotland have been working hard to tackle it.

‘Prudent prescribing and active stewardship of antibiotics has a major role to play in achieving this and significant progress has been made.’

She added that the latest figures ‘show that cases of MRSA have reduced by 88 per cent and cases of C.diff in patients aged 65 and over have reduced by 84 per cent and these reductions are in part due to improved use of antibiotics in both hospital and community settings’.

‘Working hard to tackle it’