Antibiotics Must be Kept Available and Potent for Those Who Really Need Them - NDSC Calls for Appropriate Antibiotic Usage to Curb Rise in Resistance

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"In Ireland we have a significant antimicrobial resistance problem which we can attribute largely to inappropriate prescribing of antimicrobial agents. To a lesser extent we can attribute the problem to the fact that there is no formal and nationwide infection control mechanism at hospital level or in the community. However at present we cannot define the magnitude of this problem because of the lack of national comprehensive surveillance information. This results in inadequate and scanty data on the prevalence and localisation of resistance in key problematic pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, Neisseria gonorrhoea" said Dr Darina O'Flanagan, Director of the National Disease Surveillance Centre who was speaking at a press conference held in advance of the annual St. Luke's Day meeting entitled Antimicrobial Resistance: A Strategy for Prevention.

Antimicrobial resistance is not an infectious disease, like smallpox or poliomyelitis, that we can eradicate. It is a natural response of microbes to exposure to antimicrobial agents. Therefore the approach has to be one of containment, aiming to reduce the rate of emergence and spread of resistance.

Also speaking at the press conference, Dr Ed Smyth, Consultant Microbiologist at Beaumont Hospital said "What data is available suggests that important causes of potentially life-threatening infection such as meningitis and pneumonia are now commonly resistance to the standard treatments. Reducing antimicrobial usage, which at the moment is projected to grow at 3% annually, is not about cost cutting, or making it harder for patients who need antibiotics to get them. It is about ensuring that a valuable resource is kept available and potent for those who need it, and about ensuring that routine treatment is high quality treatment and not unnecessary treatment. If we do not use antibiotics appropriately, we will return to a pre-antibotic era and loose the scientific medical advance of our century".

It is against this background that the NDSC in partnership with the Department of Health and Children has recognised the need for increased surveillance and a strategy to combat the problem of antimicrobial resistance and has earmarked the emergence of antibiotic resistance as a health priority for Ireland.

The DOHC has therefore asked the NDSC to prepare a multidisciplinary strategy that will influence the nationwide reduction of antibiotic utilisation in Ireland. In response the NDSC has set up a 15 member multidisciplinary committee comprising representatives from the veterinary, pathology, nursing dental, pediatric, agriculture and pharmaeconomic professions. The committee also comprises a GP and public health representative and representatives from the Food Safety Authority, Consumers Association and pharmaceutical industry.

The objectives of this group, which is spearheaded by Dr Olive Murphy, Consultant Microbiologist at the Bon Secours Hospital, Cork, are to develop a surveillance system to monitor the level of AMR, to monitor the supply and use of antibiotics in Ireland, to develop guidance in relation to the appropriate use of antibiotics, to develop principles in relation to infection control in the hospital and community setting and to advise on future research in the area. Ultimately the work of the NDSC's subgroup on AMR will be complemented by a campaign, aimed at both the public and health professionals, which will comprise simple easy to remember messages and be targeted at the main areas of inappropriate prescribing.