Armageddon
Recognising the potential for future problems the Scotish Government established the Sotish Antimicrobial Prescribing Group (SAPG) in 2008 with the explicit aim of delivering “a national framework for antimicrobial stewardship”.
In 2014 there were over 4 million prescriptions for antibiotics issued by NHS Scotland.
Scotish Health Secretary Shona Robison said: “Tackling the over-consumption of antibiotics is one of the greatest public health challenges of this generation. Antibiotic resistance is a very real and very present threat…we must act now to reduce the unnecessary prescribing of antibiotics and we all have a part to play in that.”
But it won’t be easy. Research published in the British Journal of General Practice suggested those GPs who did cut their antibiotic use saw their patient satisfaction ratings decline as a consequence.
Dr Tim Ballard, Vice Chair of the Royal College of GPs, said: “It’s frustrating that GP practices that are working hard to reduce inappropriate antibiotic prescribing, in order to prevent diseases becoming resistant to them, face falling patient satisfaction ratings.”
In November 2015, to coincide with the European Antibiotic Awareness Day, the SAPG launched a campaign to persuade Scots to pledge their support to help preserve antibiotics for future generations by becoming “antibiotic guardians” (see
www.antibioticguardian.com).
Speaking at the time Jacqueline Sneddon, the SAPG Project Lead, said: “Many of us take antibiotics we don’t need and once we have them we don’t always take them the way we should: missing doses, not finishing the course, and saving some of them for future use. If we continue as we are doing common infections will become untreatable and preventing infections during routine healthcare will not be possible. Antibiotics are also widely used in animals so health professionals and vets need to change their practice… but patients and the public also have a part to play”.
SAPG are right to highlight the issue of antibiotics in farming. In the UK nearly half of all antibiotic use occurs in farming and for the EU as a whole the figure is close to two thirds. Modern intensive farming methods can see large numbers of animals confined into small spaces, increasing the likelihood of infections breaking out.
As well as being used to treat such potentially avoidable outbreaks of infection antibiotics are given prophylactically to prevent such outbreaks in an atempt to enhance modern industrial farming methods and maintain productivity in the farming industry.
February 2016 33
by Dr. Steve McCabe
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