Preventing overuse of antibiotics

Sir, – In response to Jacky Jones’s article (HEALTHplus, December 20th), while we agree that public information campaigns alone…

Sir, – In response to Jacky Jones’s article (HEALTHplus, December 20th), while we agree that public information campaigns alone are not the answer to Ireland’s overuse of antibiotics, it is incorrect to say that the prescription used in our current campaign is the wrong one.

Antibiotics can save lives, but all drugs have side-effects, some of which can be serious and using them when they’re not needed leads to increased levels of antibiotic resistance. As part of the HSE’s overall programme to tackle this major health threat, the current campaign was developed with GPs and pharmacists, and is strongly supported by a wide range of health professional and patient representative groups.

Education of prescribers, such as GPs, is a major part of this programme. A successful national education scheme for GPs on better antibiotic prescribing is already in place, and the current campaign includes provision of antibiotic prescribing guidelines and other prescribing tools for GPs.

However, many international studies have shown that prescriber education alone does not produce a sustained reduction in inappropriate antibiotic use; patient and public education is needed as well. We know that public expectation and pressure can influence prescribing decisions, and that public education has been shown to be an essential component in reducing inappropriate antibiotic use.

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A Europe-wide survey, which included Ireland, showed that people often mistakenly believe that antibiotics can hasten recovery from upper respiratory tract infections (coughs and colds) and prevent more serious illness. Such misconceptions were lower in countries that have succeeded in maintaining low levels of inappropriate antibiotic use.

Evidence from other countries (eg, France, Belgium, UK, Australia) shows that public information campaigns, when combined with prescriber education, improve public understanding of when antibiotics work and reduce antibiotic inappropriate prescribing. This reduction saves money for patients and health services, avoids the side-effects associated with antibiotic use and, most importantly, helps to guard against the growing threat of antibiotic resistance. – Yours, etc,

Dr FIDELMA FITZPATRICK,

Consultant Microbiologist,

Royal College of Physicians in

Ireland (RCPI) & HSE Clinical Lead, Healthcare-associated Infection (HCAI); Dr NUALA O’CONNOR, GP, ICGP representative, RCPI Clinical Advisory Group on HCAI; Dr ROBERT CUNNEY, Consultant Microbiologist, Chair, RCPI Hospital Antibiotic Stewardship Subcommittee, PAMELA LOGAN, Pharmacist, Director of Pharmacy Services, Irish Pharmacy Union; Dr BRIAN CAREY, Consultant Microbiologist, Community Antibiotic Stewardship Committee; MARIE PHILBIN, Pharmacist, Chair of Irish Antimicrobial Pharmacists Group; Dr KEVIN KELLEHER, Public Health Specialist, Assistant National Director, HSE; Dr OLIVE MURPHY, Consultant Microbiologist, Chair, RCPI Clinical Advisory Group on HCAI,

C/o Dr Steevens’ Hospital,

Dublin 8.