More than 50 per cent of family doctors say they have prescribed antibiotics to patients who may not need them - yet an overwhelming majority of general practitioners agree that antibiotic resistance is a problem in the Republic, according to new research.
The study of some 100 GPs published in the current issue of the Irish Medical Journal found that 70 per cent of doctors felt pressurised by patients to prescribe antibiotics.
Family doctors under the age of 40 and those practising in rural areas were most likely to prescribe anti-microbial medications to patients for whom there was no clear indication to do so.
The over prescribing of antibiotics has been linked to the emergence of drug-resistant organisms. A 2001 report - the Strategy for the Control of Antimicrobial Resistance in Ireland (SARI)- highlighted the need to tackle inappropriate prescribing to minimise the threat to public health from drug resistant superbugs.
Medical student Maura Cotter and Dr Leslie Daly of the School of Public Health and Population Science at University College Dublin (UCD), used a postal questionnaire to asses GPs' opinion on the prescribing of antibiotics and to determine what factors influenced their practice.
Unsurprisingly, GPs with more consultations per day wrote significantly more antibiotic prescriptions. On average, 25 per cent of GP consultations resulted in a prescription for antibiotics.
When asked which factors affected their choice of a particular antibiotic, doctors said that a medication's safety, their personal experience of prescribing it and the antibiotic's effectiveness were major influences.
Some 45 per cent of GPs said that cost was a significant factor, while 4 per cent said drug representatives influenced their decision-making when choosing an antibiotic for a patient.
Just over a quarter of the doctors surveyed said they wrote a prescription for an antibiotic but asked the patient to delay filling the prescription while waiting to see if symptoms resolved spontaneously over time.
The only factors that significantly related to inappropriate prescribing were the age of the GP and the area of practice.
"The odds of a younger doctor (aged 40 or under) prescribing antibiotics inappropriately were four times that of the older doctor aged over 50. Doctors in rural practices were over three times more likely to prescribe inappropriately than those in urban practices," the authors said.
The Minister for Health, Mary Harney, said last week that the superbug clostridium difficile should be made a notifiable disease. While the organism may be a normal resident of the human gastroentestinal tract, the over-prescribing of antibiotics causes it to proliferate leading to a severe form of diarrhoea that can be fatal.
At present, the Health Protection Surveillance Centre is obliged to collect data on staphylococcus aureus infection, including MRSA, but hospitals are not required to notify it of cases of clostridium difficile.
Meanwhile, research published recently in the Journal of the American Medical Associationfound that drug-resistant staphylococcus aureus infections are more prevalent than previously estimated.
The study, by the Centres for Disease Control and Prevention in the United States, found a death rate from invasive MRSA infection of 6.3 per 100,000. The resistant bacterium has become much more common outside hospitals and is regularly found in community settings.