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[e-drug] UK Considers Antibiotics Study

E-DRUG: UK Considers Antibiotics Study

In rational drug use we are always advocating the reduction of antibiotic
prescribing, particularly for spurious indications

I wondered if e-druggers would be interested in this news item which caught
my attention last week. I have not yet sourced the original article but it
comes from University of Aberdeen and was reported on the BBC website

I would be interested to see other reactions to this.

Brian Gunn

Dr B C Gunn
Senior Clinical Pharmacist Specialist
DRDU, MoH, Oman

[BBC news feature reproduced as fair use; I requested Dr Thomas of Aberdeen
to send us some more data. Best wishes for Xmas! WB]

UK considers antibiotic policy

A big rise in pneumonia deaths may be linked to a clampdown on the use of
antibiotics for coughs and sore throats, say researchers.
University of Aberdeen scientists found pneumonia deaths rose by 50% during
a five-year period in the late 1990s.

Doctors were told in 1998 to curb antibiotic use amid concern about growing
bacterial resistance.

An expert government advisory panel is now considering whether to revamp its
guidance on the use of the drugs.

The Aberdeen study found that excess winter deaths rates - those above
average levels - from pneumonia went up from 20.4 per 100,000 in 1995-96 to
30.7 per 100,000 in 1999-2000.
Over the same time period, GPs cut antibiotic prescriptions for lower
respiratory tract infections by 30%.

This followed advice from the Specialist Advisory Committee on Antimicrobial
Resistance (SACAR) that antibiotics should not be used to treat coughs,
colds and sore throats because most are caused by viral infections, which do
not respond to antibiotics.

The over-use of antibiotics has been blamed for many bacteria developing
resistance to the drugs. This has led to the rise of superbugs such as MRSA.

Plausible link

Researcher Dr Mike Thomas told BBC News Online: "There has been a lot of
emphasis to GPs and the general public about the need to resist the use of
antibiotics to areas where they are appropriate and effective.

"And we found that during the period of our study there was quite a major
fall in antibiotic prescriptions, particularly to people with coughs."

Dr Thomas said further research was required before it could be proved that
the rise in death rates from pneumonia was caused by a fall in antibiotic

But he said: "It is quite plausible that it is a significant factor, and it
certainly warrants further investigation.

"It is well known that it can be very difficult to diagnose early signs of
pneumonia because the symptoms are very similar to those of relatively
minor, self-limiting illnesses.

"Even with a careful examination by a GP it can be difficult to pick up
early pneumonia. The only way to be sure would be to x-ray everybody who
came in with symptoms, and that is not feasible."

However, Dr Thomas stressed the need for caution when dealing with
vulnerable people, such as the elderly and those with chronic respiratory

Professor Richard Wise, chair of SACAR, said: "The committee met last week
to consider the need to update advice on GP prescribing of antibiotics for
lower respiratory tract infections.

"We are concerned that patients might not be receiving optimal treatment for
respiratory tract infections but we are cautious about over-interpreting
information from one published paper.

"As a result we have asked a number of experts to urgently evaluate the
current evidence in detail, and identify further evidence of any potential
risk to patients of promoting prudent prescribing.

"Once this is completed, we will be in a position to look at whether changes
need to be made to prescribing advice."

It is well known that it can be very difficult to diagnose early signs of
Dr Mike Thomas

Story from BBC NEWS:

Published: 2003/12/16 10:19:36 GMT


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