Third of antibiotics prescribed by doctors are 'unaccounted for', warns Chief Medical Officer
Originally published on The Telegraph
A third of the antibiotics used in the NHS are prescribed despite there being no evidence of an illness requiring them, the Chief Medical Officer has said.
Dame Sally Davies warned that the struggle to contain antimicrobial resistance (AMR) is being hampered because family doctors too often hand out the drugs to “validate” that a patient is feeling unwell.
She pointed to research indicating that approximately 33 per cent of all prescriptions for antibiotics are recorded with no associated diagnosis.
Dame Sally also warned that clinicians are losing ground in the fight to prevent healthcare-acquired infections, for which antibiotics are essential, following a successful drive to reduce deaths from bugs picked up in hospitals during the previous decade.
The intervention followed the announcement last month of a 20-year Government strategy to crack down on AMR, whereby bacterial infections become resistant to antibiotics, largely through overuse of the drugs in human and animal healthcare.
Resistance means a risk of returning to the era before antibiotics when common infections and routine surgery were often fatal.
A report chaired by Lord Jim O’Neil in 2016 estimated that, unless progress is made, AMR could cost approximately 10 million lives a year by 2050.
“It is really difficult at the moment in the NHS to know what’s used where and now often,” Dame Sally told the Westminster Health Forum.
“A third of prescriptions do not have an associated diagnosis - people are not using the [Nice] guidelines.”
She added: “There is a difference between what’s needed physically and what’s needed socially.
“Doctors think patients are asking for antibiotics, but actually when you talk to them they are asking for validation that they’re sick and antibiotics are the best way.”
Previous research has indicated that 20 per cent of antibiotics prescribed by GPs are handed out inappropriately.
Dame Sally said that as well as feeling a need to validate a patient’s illness, GPs were too busy to accurately record how they have used the drugs, making it difficult for watchdogs to keep track of prescribing.
However, the NHS has made progress in recent years, with a 7.4 per cent reduction in the amount of antibiotics prescribed between 2014 and 2017.
The new strategy requires the health service to bring this down a further 15 per cent by 2024.
Part of its role is to “set an example” to other nations in the world to reduce their antibiotic use in medicine and agriculture.
While applauding a 40 per cent reduction in antibiotic use among parts of the UK farming sector, Dame Sally bemoaned a recent decision in the US which allows citrus fruit farmers to spray streptomycin on their crops.
She also pointed to the practice of injecting dates with antibiotics in the Middle East.
The new strategy aims for a further 25 per cent reduction in antibiotic use in food-producing animals in the UK by next year.
Part of the strategy to tackle AMR involves Government incentives for the development of new classes of antibiotics, of which none have come on stream for decades.
However, Dame Sally warned that policymakers would not work with pharmaceutical companies which paid bonuses to their sales staff for selling antibiotics in bulk, nor those who released antibiotic-contaminated waste into the environment, thereby prompting resistance.
“I don’t think this should be a free pass for companies that are behaving badly in other countries,” she said.
“If I have a say in it bonuses for sales staff are out, dirty effluent are out, and a good many other things.”
On Friday Dame Sally announced she would leave the post of Chief Medical Officer for England later this year to become the first female Master of Trinity College Cambridge.
However, she promised to continue fighting against AMR in her new role.