Hospital antibiotics misused, finds study

ALMOST two-thirds of antibiotics given to patients at Beaumont Hospital were used inappropriately, a survey has found.

The research, overseen by consultant pharmacologist Dr Edmond Smyth, found 58% of antibiotics were given to patients outside the first 24 hours after surgery, when they should no longer be administered.

The purpose of the antibiotics in question is to prevent infection in patients after surgery. They are administered prior to surgery and are not generally used outside the first 24-hours post surgery.

Dr Smyth said he was "a bit appalled" by the findings, when presenting the research to a Royal College of Surgeons in Ireland Charter Day meeting.

The study involved 171 patients on three wards and was conducted last May. The patients were prescribed antibiotics prior to surgery for prophylaxis (prevention of infection). Up to 100 of these patients continued to receive antibiotics for longer than they should have after surgery, he said.

According to Dr Smyth, 91% of the prophylaxis patients did not need prescribed drugs beyond the first 24 hours post-surgery and 77% were administered two drugs when one drug was enough.

"I was a bit appalled by these numbers, which really are an indication of Ireland's growing problem with antibiotic resistance," he said, according to a report in the Irish Medical Times.

"Patients who have most forms of surgery are given antibiotics before surgery to insure against infection. One of the problems is to make sure the correct dosage is given. We found antibiotics were used beyond the first 24 hours after surgery, which is not necessary in most cases."

Dr Smyth attributed this to a high number of patients in wards and insufficient consultants, resulting in some patients going unseen by specialists. However, Dr Smyth said action had been taken to address the problem and preliminary results of a new audit showed the situation had improved dramatically.

Because of overuse of antibiotics, Ireland has extremely high antibiotic resistance figures compared to the rest of Europe. Dr Smyth presented figures which show Ireland's resistance rate for penicillin is extremely high at between 10% and 25%. British figures are 1%-5%.

"The reasons for this high figure are unclear, and complex," said Dr Smyth, "but clearly there needs to be an extensive investigation into the matter."

The resistance rate for MRSA is even worse, he said, between 25 and 50%, while countries such as Norway have MRSA resistance rates of less than 1%.

The implications of this are huge, said Dr Smyth, and action should be taken immediately. Prescribing needs to be monitored, he said, and the role of pharmacists, who are "very under-utilised," should be strengthened.

He also said educational programmes should be funded, and even introduced onto school syllabuses, to inform the public antibiotics are not always needed.