Antibiotic consumption rate up 16.3%, says HSE

The use of antibiotics in Ireland has increased by over 16 per cent in recent years, according to a new internal Health Service Executive (HSE) briefing paper.

The HSE document says that Ireland is now in the moderate-to-high range of antibiotic consumption in the league table of European countries. The report maintains that in 1993-2004, antibiotic consumption overall increased by 16.3 per cent in the Republic.

"This contrasts with the overall reduction in antibiotic use in Northern Ireland over the same period," states the HSE document, which was drawn up by the population health directorate.

The HSE report also says that, within smaller hospitals in Ireland, there was "much greater variation" in the use of antibiotics.

It maintains that the Strategy for the Control of Antimicrobial Resistance in Ireland (Sari) National Committee had proposed putting in place a clinical pharmacist in all hospitals to advise on antibiotic prescribing.

The report says a national household survey had found that 40 per cent of people had had an antibiotic in the previous 12 months. It maintains that medical card patients were more likely to have had an antibiotic than those not covered by the scheme.

"In another survey of public perception, 18 per cent believed that an antibiotic helped them to get better if they had an upper respiratory tract infection, and 44 per cent had expected an antibiotic by the time they consulted the doctor with an upper respiratory tract infection," the paper states.

The document says the Sari Antibiotic Stewardship Sub-Committee has developed guidelines for GPs on rational prescribing of antibiotics.

"As part of the evaluation of the implementation of these guidelines, 112 GPs have been asked to collect data on 100 consultations to assess the level of adherence. To date, there is 40 per cent strict adherence," it states.

The report says that evidence from a project sponsored by the Sari National Committee has shown that both value for money and improved quality of care, including reduction in infection caused by clostridium difficile, can be achieved by putting in place a clinical pharmacist whose role is to advise on antibiotic prescribing in a hospital setting.

"The Sari Hospital Antibiotic Stewardship Sub-Committee has recommended that all hospitals should have a designated pharmacist with responsibility for this area. The intention is to appoint such an antibiotic liaison pharmacist in each of the major hospitals or groups of hospitals in the first phase. To allow this to occur, 20 whole-time equivalents are required. Once these posts are established, they would be self-financing," the report states.

HSE assistant national director for population health Dr Kevin Kelleher yesterday said that healthcare- acquired infections were an unfortunate side effect of healthcare: "They have existed for hundreds of years and have been treatable with antibiotics for the last 50 or 60 years. As bacteria evolved, they have become more resistant, therefore there is a need to be far more careful in the use of this magic bullet if we are to protect the effectiveness of antibiotics moving forward."