Hospital practitioners and management are being called upon to be vigilant and cautious when prescribing antibiotics in a drive to help protect patients from acquiring resistant bacteria.
Antibiotic resistance is particularly problematic in hospitals, where studies have shown that patients are two to three times more likely to die from infections caused by antibiotic-resistant bacteria, compared to infections caused by bacteria that remain susceptible to antibiotics. Misuse of antibiotics in hospitals is strongly linked to increased frequency of infections caused by antibiotic resistant bacteria, such as meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), resistant Gram-negative bacteria (such as E. coli and Klebsiella), as well as increased rates of Clostridium difficile infection. Although rates of MRSA infection in Ireland have been falling steadily since 2006, rates of infection with other antibiotic-resistant bacteria have increased.
While progress has been made in many hospitals, much more needs to be done to stem the tide of antibiotic resistance. The key message from this year’s European Antibiotic Awareness Day for hospital-based physician and nurse prescribers is to handle antibiotics with care, as misuse leads to antibiotic resistance. For hospital managers the key message is that having an antibiotic stewardship team in place saves lives and saves money.
Commenting on the European Antibiotic Awareness Day initiative, Dr Edmond Smyth, Consultant Microbiologist and Chairman of the Hospital Antimicrobial Stewardship Group, said:
‘The Strategy for the Control of Antimicrobial Resistance in Ireland (SARI) was set up in 2001 to tackle the growing problem of antimicrobial resistance in Ireland. We are fully committed to this task and welcome the EAAD initiative so that the public, as well as hospital and primary care health professionals, can be reminded of the importance of prudent antibiotic use.’
He continued:
‘Antibiotic-resistant bacteria are now common and cause problems in hospitals across Ireland on a regular basis. The emergence, selection and spread of these organisms has become a threat to patient safety in our hospitals.’
In 2009, the Royal College of Physicians of Ireland (RCPI) published a position statement supporting the principles of prudent antibiotic prescribing, and is committed to providing educational initiatives to promote these principles among doctors. RCPI strongly endorses the key messages for prescribers and hospital managers included in this year’s EAAD.
Supporting the EAAD initiative, Hilary Humphreys, Consultant Microbiologist and Chair of the Healthcare-Associated Infection Policy Group, and Council Member of RCPI commented:
‘RCPI recognises the critical role that specialists such as microbiologists, infectious disease physicians, antimicrobial pharmacists and others play in managing infections and promoting appropriate use of antibiotics. In order to effectively combat the threat of antibiotic resistance, however, it is crucial that all prescribers of antibiotics recognise their individual responsibility to ensure antibiotics are used appropriately. Therefore, RCPI urge all hospital-based prescribers, including medical, surgical and registered nurse prescribers, to apply the principles of prudent antibiotic prescribing to their practice,’ he said.
Although antibiotics are one of the most important medical discoveries of the past 100 years and have allowed us to successfully treat life-threatening infections as well as treat or prevent infections associated with advanced medical therapies, the beneficial impact of antibiotics is being threatened by rising rates of antibiotic resistance. There are now limited options to treat infections caused by antibiotic-resistant bacteria.
Patients in hospital frequently receive antibiotics, and international experience has shown that up to 50% of antibiotic therapy in hospitals is inappropriate. In a survey of Irish hospitals in 2009, 34% of patients were receiving antibiotics on the day of the survey, and 42% of antibiotic therapy was not in accordance with best practice guidelines. Rates of antibiotic use in Irish hospitals are in the mid to high range, compared to other European countries.
Hospital antibiotic stewardship teams have been shown to reduce antibiotic usage and improve outcomes for patients with infection, while also delivering significant cost savings to the health service. Antibiotic stewardship team members include microbiologists, infectious disease physicians, antimicrobial pharmacists and others. In Ireland, hospitals with such teams in place have reported significant reductions in overall antibiotic use and decreased Clostridium difficile infection rates. This lea to an overall 5% decrease in hospital antibiotic use in Ireland between 2007 and 2008. Individual hospitals have also reported annual drug cost savings of between €77,000 and €1 million.
To view a factsheet on Antibiotics click here
To view a letter regarding prduent antibiotic use sent to Irish Hospitals click here
For more information on European Antibiotic Awareness Day, go to: http://ecdc.europa.eu
Media contact:
Nicola Eagles
Communications Manager
Royal College of Physicians of Ireland
Direct Ph: 01 8639770
Mob Ph: 086 329 8707
nicolaeagles@rcpi.ie
Notes for Editor
About RCPI
The mission of The Royal College of Physicians of Ireland (RCPI) is to develop and maintain high professional standards in specialist medical practice in order to achieve optimum patient care and to promote health nationally and internationally. Through its Faculties and Committees, RCPI has responsibility for the postgraduate education and training of doctors in Ireland in 25 medical specialties. RCPI is fully committed to playing a full and proactive part in the transformation of the health service, as evidenced by its involvement in many strategic initiatives with the Medical Council, the Health Services Executive, the Department of Health and Children, and other Irish postgraduate medical training bodies.
About SARI
The Strategy for the Control of Antimicrobial Resistance in Ireland (SARI) was launched by the Minister of Health in June 2001.
SARI is steered by the SARI National Committee, based at the Health Protection Surveillance Centre, Dublin, with multi-disciplinary Regional SARI Committees advising each regional local implementation team on implementation of HSE strategy in relation to healthcare associated infection (HCAI) in each HSE region. In addition a number of SARI Sub-Committees advise on specific areas of SARI implementation, such as promotion of prudent antibiotic use, surveillance and infection control.