Massive over-prescribing of antibiotics which provide little or no benefit for respiratory illnesses has been discovered in a US study. An Irish doctor has said that a similar situation exists here and warned that it is leading to "super-bug" infections.
Doctors prescribed antibiotics in up to 70 per cent of the cases in which patients sought medical attention from their GPs for colds, upper respiratory tract infections and bronchitis, according to the Journal of the American Medical Association. Surgery visits for these illnesses resulted in 12 million antibiotic prescriptions, more than one-in-five of all such prescriptions to adults in the US in 1992.
However, these illnesses are most commonly caused by viruses. Antibiotics are for infections caused by bacteria and have "little or no benefit" in treating the viral infections studied. According to the authors, this excessive prescribing has contributed to the emergence of antibiotic-resistant bacteria in the community.
Dr Edmond Smyth, a consultant microbiologist in Beaumont Hospital, said the US study was "putting a figure on something that everybody has recognised has been going on for years". He said the over-prescribing of antibiotics by GPs was largely due to patients' expectations.
"People want to get cured in one visit and it is very difficult for the doctor to deter them from wanting an antibiotic or asking them to come back in a day or two. It is also impossible to determine in many cases whether it is a viral or bacterial infection," said Dr Smyth.
He said that Ireland was "really getting very close to the post-antibiotic era". Internationally there had been just one antibiotic, vancomycin, left which was effective. However, in the last six months resistance had been seen in Japan and Michigan to this drug.
"The final barriers are falling. We will soon be at the point where we do not have drugs for the antibiotic-resistant bacteria. The more antibiotics are used the more we will see this problem," he said.
The situation in Ireland was worse than in the UK, he said, because controls to ensure that infections did not spread from patient to patient in hospitals were very underdeveloped here.