The excessive use of antibiotics is a primary cause of the emergence and prevalence of MRSA and other so-called "superbugs" in communities and in hospitals. In spite of that, a study has found that more than half of all family doctors prescribe antibiotics for patients who do not need them. This is a very serious matter. In most cases, doctors are responding to the demands of patients who view the medication as a "silver bullet" that kills infection, rather than a double-edged sword that may cause self-inflicted injury.
In order to alert the public to the dangers involved, the Department of Health and the Health Service Executive should conduct an intensive education campaign. After all, misuse of antibiotics has become a life-threatening issue. Family doctors, particularly in rural areas, need to be supported in bringing about a change of public attitudes. The bottom line in such situations, however, is that duty of care must outweigh all other considerations.
Earlier this month, coroners' courts in Dublin and Cork conducted 10 inquests where "superbug" infections had contributed to the deaths of patients. These infections have been known about for years. But the organisms have mutated and become much more virulent, even as hygiene standards in hospitals have fallen. A new strain of clostridium difficile is said to kill one in 12 of those infected. The over-use of antibiotics can cause this organism to proliferate and cause a form of diarrhoea that may be fatal.
Minister for Health Mary Harney recognises the need to make clostridium difficile a notifiable disease. That is the least that should be done. Some hospitals are not responding robustly to the threat posed by "superbugs" and hygiene and infection control measures are inadequate. Overcrowding continues and isolation facilities are scarce; ward cleaning and hand-washing by staff are patchy and, in some cases, microbiologists have not been appointed.
The last hygiene audit of acute hospitals, published 15 months ago, showed a considerable improvement over 2004. In spite of that, 21 out of 53 hospitals failed to meet the standards required. The results of a new survey are due shortly. For the first time, an evaluation of kitchens, operating theatres and intensive care units will be included. The results may be disquieting.
There is a tendency to excuse hospital infection levels by saying the situation is worse in Britain. So it is. But, in Britain, hospital executives are now facing prosecution arising from the deaths of patients and for failing to meet hygiene standards. We need accountability at all levels if patients are to be protected here.