Antibiotic misuse breeds diseases

DOCTORS AND patients must curb their appetite for antibiotics if the world is to preserve one of its most important pharmacological weapons against disease, the Government's chief medical officer said yesterday.

GPs are handing out more than 15 million inappropriate prescriptions for antibiotics each year and their overuse has led to the rapid growth of drug-resistant bacteria. Sir Kenneth Calman said the increase in drug resistance "ultimately jeopardises our continued ability to treat infections".

The chief medical officers of the European Union are to meet in Copenhagen next week to consider what must be done to tackle the problem. Anxiety at the scale of the threat has been growing for a decade and the House of Lords Select Committee on Science and Technology warned last April that we risked seeing diseases emerge that were untreatable.

Last July, the Government's Public Health Laboratory Service reported that one in six infections with salmonella, the commonest source of food poisoning, was caused by a strain resistant to at least four drugs.

Yesterday, Sir Kenneth launched a report by the Standing Medical Advisory Committee which recommended no prescribing of antibiotics for coughs, colds or sore throats caused by a virus (the commonest sort). It said antibiotics for uncomplicated cystitis in women should be limited to three days. Ministers have accepted in principle the need for a national campaign to curb antibiotic use.

The British Medical Journalthis week says the overuse of the drugs in farm animals as growth promoters is a bigger threat. It says 40 to 80 per cent of antibiotics used in agriculture are of "highly questionable" value.

Sir Kenneth said parents should not be put off taking their children to the doctor when immediate treatment with antibiotics could be life- saving, as in meningitis, and patients should not be deterred from completing their full course of the drugs. He added: "The recommendations ... will require a willingness ... to treat [antibiotics] as a valuable and non- renewable resource, to be treasured and conserved in everyone's interest."

The report says about 50 million prescriptions for antibiotics are dispensed in England each year - one for every member of the population. Of these, 80 per cent were from family doctors and, to a much smaller degree, dentists.

Dr Diana Walford, director of the Public Health Laboratory Service, who chaired the committee sub-group that produced the report, said about half the antibiotics prescribed by GPs were for coughs, colds, sore throats and other respiratory tract infections. Between two-thirds and three-quarters of these - accounting for up to 15 million prescriptions in England - were caused by viruses. But antibiotics are effective only against bacteria. Many patients were being given drugs that could not help them.

Dr Walford said: "You can take a view that there's a significant amount of unnecessary antibiotic prescription in general practice." But she said she did not want to apportion blame or start "casting stones". She added: "What we must do is to help patients understand the problem."