Ireland facing ‘silent epidemic’ of superbugs, doctors told

Ireland and other European countries are experiencing a "silent epidemic" of superbugs caused by rising resistance to antibiotics, a conference on primary care has been told.

The problem far exceeds the threat posed by Ebola, with over 25,000 deaths a year in Europe due to multi-drug resistant organisms, according to Dr Nuala O'Connor of the Irish College of General Practitioners (ICGP).

The use of antibiotics in nursing homes in Ireland is twice as high as in any other European country, Dr O’Connor pointed out, and said 39 per cent of prescribing related to the prevention of infections when there was no scientific evidence this worked.

“The antibiotics we have now are the best we will ever have, and we have to act now to ensure their effectiveness for future generations,” she told the National Primary Care Conference in Kilkenny today.

Areas of medicine such as transplants and chemotherapy wouldn’t be possible without antibiotics.

Resistance to antibiotics has been rising continually for over a decade, more quickly in southern Europe than in northern Europe because of easier availability, greater consumption and the prescribing of too many wide-spectrum antibiotics.

Aside from MRSA, the incidence of superbugs was rising in tandem with this trend. The result was more patient deaths and longer stays in hospital.

Dr O’Connor said there were many factors behind the increase in superbugs and antibiotic resistance.

People were travelling more and “the bugs are hitching a ride”. Society was increasingly litigious and there were concerns about the rising incidence of sepsis. Many healthcare workers lacked awareness of the problem.

“We live in a fast-changing society. People don’t want to be out of work when sick or they want to be able to bring their child to the crèche. People want to be better yesterday and they see antibiotics as the solution.”

Doctors need to prescribe “the right antibiotic to the right patient at the right dose,” she advised.

General practice as currently funded is unviable, unsustainable and at breaking point, Ray Walley, chairman of the GP committee of the Irish Medical Organisation (IMO) told the conference.

The GMS contract employing family doctors was outdated and emigration was increasing as countries such as Australia aggressively recruited newly-qualified Irish GPs, he said.

GPs have suffered a significant decline in their private income, thereby reducing the opportunities to cross-subsidise their work with medical card patients.

Priorities for a new contract will include the provision of a 24/7 contract, chronic care, Hiqa assessment and the administrative burden on doctors.

Mr Walley called for a realistic, long-term and ring-fenced budget for general practice that allowed for growth in population and medical advances.

Kilkenny GP Frank Chambers called for the reform of the GMS (General Medical Services) contract for family doctors.

The contract, which dates back to 1972, is “out of synch” with what doctors now expect in a modern health service, he said.

Many of the items covered by the contract were out-of-date, he said, such as the fitting of diaphragms or the treatment of dental haemorrhages.

In other cases, the payments to GPs were too low, and this work ended up being pushed on to hospitals, at far greater cost to the taxpayer.