We hear it endlessly – “don’t demand antibiotics from your GP for a sore throat or the sniffles!” – but with the season of coughs and colds well upon us and that Christmas/New Year poorly period right around the corner, how many people will take this on board?
Perhaps the reason why it’s critical that antibiotics are no longer dished out like sweets needs to be constantly hammered home.
Around 35 million prescriptions for antibiotics – costing an eye-watering £427million – are given out by doctors in England every year and there’s no doubt they have a pivotal place in treating a variety of serious illnesses.
However, a recent study by Antibiotic Research UK has uncovered that GPs in some of the more deprived areas of the country – including Essex – are prescribing antibiotics at almost twice the national average.
Specialist staff at Basildon and Colchester Hospitals have been doing their bit to get the message across that antibiotics can do more harm than good in many cases by supporting a national campaign to highlight the growing problem of antibiotic-resistant bacteria.
Pharmacists and doctors have been educating patients and visitors about the importance of using antibiotics only when they are absolutely necessary.
Paige Cowell, a clinical support worker in the day surgery unit at Basildon hospital, said: “I work with patients who have had surgery and for many of them, antibiotics are a vital part of their treatment so I understand how important it is to spread the word and do everything possible to reduce the problem of antibiotic resistance.”
There are four types of infection – bacterial, viral, fungal and parasitic – but antibiotics are only effective against the bacterial kind. So there is absolutely no point in getting them for viral conditions, such as colds, flu or sinus infections.
Due to over-prescribing, however, resistance to antibiotics is becoming a global threat, according to scientists.
This has serious potential consequences for numerous aspects of medicine, from the treatment of chest infections, to surgery, transplants and some cancer treatments.
Ultimately, it means antibiotics will be ineffective against even minor bacterial infections if this doesn’t stop.
Justin Edwards, consultant microbiologist at Basildon Hospital, added: “We have an individual and collective responsibility to do all we can to prevent this problem becoming more serious. For doctors this means not prescribing antibiotics unnecessarily, and for patients, understanding there are good reasons for GPs not to give them for most colds, coughs and sore throats.
“Antibiotics are one of the greatest discoveries of the 20th century and they have underpinned many of the revolutionary developments in modernmedicine but we have to use them wisely.”
Justin, who works with a team of colleagues in microbiology and infection control, is responsible for providing infection services for the trust and GPs in the area.
There are many reasons why he loves his important job.
“The combination of scientific analysis and its application to patient care is what made me want to also enjoy the broad nature of the job which stretches across all areas of the hospital, as infection can present in any patient,” he said.
“We also work to protect all patients through our work in infection control, trying to prevent and limit the spread of infection within hospital, for example by isolating patients with drug-resistant infections and promoting the importance of hand hygiene.
“We carry out regular rounds of intensive care units and advise clinical staff on infection – this might include best practice to prevent infections in patients who have had surgery, to the treatment of drug-resistant urinary tract infections.”
Justin added how it is also essential the hospital is prepared for patients who are admitted with serious viral infections, such as Ebola.
He said: “Antiviral drugs are currently effective against some but not all viral diseases, such as influenza, herpes, hepatitis B and C and HIV – but research is ongoing.
“We are colonised with so many bacteria that just because we find one it does not mean it is causing an infection. For example, when you take a wound swab there is a lot of ‘background noise’ from all the harmless bacteria present.
“Bacteria were here before us and they will be here after we have gone. They are critical to human life but they have an advantage over us because they can divide up to every 20 minutes instead of roughly every 20 years as we can. They can generate resistance way faster than we create new antibiotics, the development of which can take many years and prove to be very expensive.”
Dr Tony Elston, consultant microbiologist and the director of infection prevention and control at Colchester Hospital University NHS Foundation Trust, said: “Justin has hit the nail on the head and made a number of really good points.
“We are also trying to help prescribers and patients understand the importance of good antibiotic prescribing and, even more importantly, when not to prescribe antibiotics.
“We are working with North Essex Clinical Commissioning Group to set up public and prescriber education sessions.”
Analysis of the Health and Social Care Information Centre’s (HSCIC’s) latest prescribing figures, covering the first quarter of the 2015/16 financial year (April-June), shows the average amount spent by Clinical Commissioning Groups across the country per patient varies hugely – ranging from £4.19 in West London to £10 in other parts of the country.
Many coastal areas of Essex are a long way over the national average for antibiotic prescription, according to the figures.
The North East Essex CCG spent a total of £2.94 million on antibiotic prescriptions during the same time frame – that’s an average of £8.73 on each patient compared to just £6.51 per person in Castle Point and Rochford.
Statistics show Southend spent £1.52 million with an average of £8.24 per patient, in Basildon and Brentwood it was £1.96 million with £7.20 average cost, while the CCG Mid Essex group, which covers Maldon and Witham, spent £2.8 million with an average of £7.41 per patient.
Experts put the higher doses in coastal towns down to the fact more elderly people live there and so more antibiotics are needed to treat serious and complex illnesses.
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