The availability of effective antibiotics is something we take for granted. But we only have to go back 70 years or so before the “golden era” of antibiotic discovery, to an age when infectious disease was the commonest cause of death in humans. As resistance to antibiotics becomes a daily challenge for doctors, the possibility of pneumonia and sepsis becoming killer diseases again increases.
In 2009, the Health Information and Quality Authority (Hiqa) published National Infection Prevention and Control Standards. A key element of these is antibiotic stewardship, which aims to ensure that every patient receives the right antimicrobial therapy at the right dose, route and duration, and for the right infection type at the right time.
In a review published last week, Hiqa notes that performance in the linked areas of antimicrobial stewardship and infection prevention and control “are significantly hampered by the lack of an up-to-date national plan to inform progress in both the health sector and other related areas”.
The review found that while larger acute public hospitals are implementing best practice in the area, there is a significant risk to patient safety from the use of antibiotics in smaller hospitals. Specifically these smaller units do not have antibiotic stewardship programmes in place and they lack specialist resources leading to a “significant patient safety concern that should be reviewed as a matter of urgency by the HSE”.
A national plan to deal with these problems has not been updated in the Republic since 2001. This is in stark contrast to the UK where a personal initiative by former Prime Minister David Cameron led to the recent landmark O'Neill report into antibiotic resistance. Underlining the gravity of the issue, it estimated that by 2050 some 10 million lives a year will be at risk due to the rise in drug resistant infections unless proactive solutions are put in place now.
Minister for Health Simon Harris must order immediate action by the HSE on what is a key strategic risk for the State.