The Chief Medical Officer (CMO), professor Dame Sally Davies has warned of the threat of antibiotic resistance and highlighted the need to use antibiotics responsibly.
She has called for urgent action, at a national, EU and international level, to make sure antibiotics are used in the right way, at the right dose and at the right time, to help slow down the development of antibiotic resistance. She warned that unless action is taken to prevent the emergence of resistance, some of the problems we could face include:
• Increased deaths from hard-to-treat infections. A recent study suggests that deaths could double in patients with multiresistant E. coli.
• Increased infection and deaths associated with routine medical procedures such as heart surgery.
• The spread of an untreatable form of gonorrhoea.
The CMO has provided a list of things to do and not to do, for patients to help prevent the emergence and spread of antibiotic-resistant bacteria. Prof. Davies said: “Antibiotics are losing their effectiveness at a rate that is both alarming and irreversible. I urge patients and prescribers to think about the drugs they are requesting and dispensing. Bacteria are adapting and finding ways to survive the effects of antibiotics, ultimately becoming resistant so they no longer work.” A recent survey has shown that the Start Smart Then Focus (SSTF) antimicrobial stewardship resource has helped improve prescribing practice in hospitals. The Start Smart Then Focus toolkit, published by the Department of Health in association with the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), provides a guide for evidence-based antimicrobial stewardship within the hospital setting. A total of 75 acute hospital Trusts responded to a survey on the implementation of the toolkit. Of those who had formally or informally assessed the programme between 65% and 75% said it had led to a reduction in the use of broad spectrum agents and between 77% and 85% a reduction in inappropriate prescribing. When asked what was seen to successfully facilitate the programme not only was adequate pharmacist time a factor but also an enthusiastic pharmacist. Similar qualities were needed in the hospital microbiologist with 80% saying that enthusiasm for the programme was more important than just having adequate time. Those that had an established antimicrobial strategy group found this to be very beneficial in taking action on the use and type of antibiotics used. Conversely, lack of pharmacist time, lack of the hospital microbiologists’ time and lack of management interest were cited as being the three main barriers to the effective implementation of the programme.
