Intended for healthcare professionals

Rapid response to:

News

New antibiotics are needed as resistance grows, expert says

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1660 (Published 12 September 2008) Cite this as: BMJ 2008;337:a1660

Rapid Response:

Do antimicrobial policies serve the purpose?

In the News “New antibiotics are needed as resistance grows, expert
says” Philip Wilson beautifully chalked out the views of experts about the
necessity of new entities in the area of anti-infectives as well as
highlighting the hurdles and fears of industries to invest in this
presumably unprofitable field.

As pointed out in last paragraph we have to look the other side of
coin too.

Irrational prescribing of antibiotics and increased antimicrobial
resistance being directly proportional to each other seem to be a global
phenomenon.

A view of the studies of either 1970’s or 2000’s on antibiotic
prescribing patterns clearly reflects results in accordance with each
other. Moreover, there are detailed proofs, which thoroughly relate
antimicrobial resistance to overuse.
Hospital acquired resistance is more common as more antibiotics are used
in this setting.In order to cut down on antimicrobial resistance with
proper check on prescribing patterns, the induction of policies must be an
integral part of hospital infection control program.

Although a large body of evidence strongly pointed out fruitful
outcomes in this regard, the studies generally encompass single
institution or even single entity in an institution.
An antibiotic policy is much more than an established code of principles.
It must emphasize on imparting and acquiring knowledge with evaluative
responses as well as different plans to improve prescribing patterns.
Educational strategies should be tailor- made according to the need of the
institution. For instance, ICF i.e. Immediate Concurrent Feedback, being a
strategy to arrest irrational use of sultamicillin or co-amoxiclav in a
Hong Kong hospital decreased the average monthly usage with net monthly
savings being HK$26-30,000. [1].
But still this is not a hard and fast rule that Antibiotic policies and
National guidelines always work.

For a change in prescribing pattern a change in the mindset of every
stakeholder will reap the benefit.

"There is no pillow so soft as a clear conscience”

Reference

[1] Seto WH, Ching TY, Kou M, Chiang SC, Lauder IJ, Kumana CR.
Hospital antibiotic prescribing successfully modified by 'immediate
concurrent feedback'. Br J Clin Pharmacol. 1996 Mar;41(3):229-34

Competing interests:
None declared

Competing interests: No competing interests

14 September 2008
Shazia Qasim Jamshed
PhD Scholar
Dr Zaheer-ud-din Babar, Dr Mohamed Izham Mohamed Ibrahim
Social Pharmacy, Universiti Sains Malaysia