Views & Reviews No Holds Barred

Margaret McCartney: Blaming doctors won’t reduce antibiotic overuse

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4697 (Published 01 September 2015) Cite this as: BMJ 2015;351:h4697

Antibiotic misuse: doctors are easy targets but not the right ones.

Antibiotic misuse: doctors are easy targets but not the right ones.

Antibiotics continue to improve health and save lives of human beings and animals. So to threaten livelihood of doctors based on crude prescription data perversely risks inappropriate under-prescription of antibiotics with risk of injury to patients. [1]

Antibiotic prescriptions to patients involve complex interplay of various factors including clinical factors such as co- morbidity, social factors such as overworked doctors in inner city practices and perhaps, the most important of all, patient expectations from a clinical encounter. The crude prescription data does not encapsulate all these factors.

The single most inappropriate use of antibiotics on an industrial scale occurs in livestock industry.[2] Prophylactic antibiotics are widely used in animal feed to enable animals grow faster and heavier with the sole motive of improving profitability. Food and Drug Administration (FDA) reports that 14 million kilograms of antibiotics were sold to food-producing animal Industry in 2012 in USA alone.[3]

I suspect the financial and political clout of livestock industry makes them a tough target. Hence the livelihood of those in livestock industry would take precedence over the livelihood of overworked doctors who make an easy sitting target.

References
1 McCartney M. Margaret McCartney: Blaming doctors won’t reduce antibiotic overuse. The BMJ 2015;351:h4697. doi:10.1136/bmj.h4697

2 Silbergeld EK, Graham J, Price LB. Industrial Food Animal Production, Antimicrobial Resistance, and Human Health. Annu Rev Public Health 2008;29:151–69. doi:10.1146/annurev.publhealth.29.020907.090904

3 Antimicrobials Sold or Distributed for Use in Food -Producing Animals. Food and Drug Administration, Department of Health and Human Services. 2014.http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActAD... (accessed 12 Sep2015).

Competing interests: No competing interests

12 September 2015
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospital NHS trust