Resistance to antibiotics

BMJ 1998;317:1521 ( 28 November )

Letters

Resistance to antibiotics

Prescribing of antibiotics needs to be rational

Restricted prescribing resulted in reduction of resistant strains

Expert controlling bodies need to be established

Prescribing of antibiotics needs to be rational

The first 150 words of the full text of this article appear below.

EDITOR $---$ We agree with Hart that undergraduate and postgraduate medical education in the use of antimicrobials needs to be increased.¹Abbasi's news article² is opposite a full page advertisementfor an antibiotic. This advertisement seems to promote the useof a new fluoroquinolone to treat respiratory infections "even[due to] Streptococcus pneumoniae" in the community. Most strainsof S pneumoniae remain sensitive to penicillin, and there is littleevidence that quinolones are needed to treat acute sinusitis oracute exacerbations of chronicbronchitis.

The only other advertisement for an antibiotic in that edition of the BMJ occurs in the middle of a meta-analysis of antibioticprophylaxis in critically ill people.³ The presence of theseadvertisements emphasises the likely difficulty in changing patternsof antibioticprescribing.

Philip Pearson, Senior house officer.
Paul McWhinney, Locum consultant physician.
Philip Stanley, Consultant physician. .
Regional Department of Adult and Paediatric Infectious Diseases, Seacroft Hospital, Leeds LS14 6UH

^a p.j.stanley@leeds.ac.uk

Hart CA. Antibiotic resistance: an increasing problem? BMJ 1998; 316: 1255-1256[Free Full Text]. (25 April.)
Abbasi K. Report calls for action on antibiotic resistance. BMJ 1998; 316: 1261[Free Full Text]. (25 April.)
D'Amico RD, Pifferi S, Leonetti C, Torri V, Tinazzi A, Liberati A. Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 1998; 316: 1275-1285[Abstract/Free Full Text]. (25 April.)

Restricted prescribing resulted in reduction of resistant strains

EDITOR $---$ Abbasi's news article¹ and Hart's editorial² about resistance to antibiotics raise interesting questions. Mostantibiotics are prescribed in general practice, and . . . [Full text of this article]