This item was published during the term of a previous administration that ended in April 2007
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New measures to fight 'superbugs'
25/06/2002
A strategy to control anti-microbial resistance, including funding of £100,000 to ensure that medical undergraduates are properly trained in prescribing practices for antibiotics, was unveiled today.
The strategy - the UK Antimicrobial Resistance Strategy and Scottish Action Plan - highlights the threat posed by the over-use or inappropriate use of antibiotics across a range of settings. This can lead to micro-organisms or 'bugs' quickly building up resistance to antibiotics, making it difficult to treat infection in the future.
The strategy has three key elements. These are:
- Surveillance: to monitor 'how we are doing' and provide the data on resistant organisms, illness due to them and antimicrobial usage necessary to inform action;
- Prudent antimicrobial use: to reduce 'pressure for resistance' by reducing unnecessary and inappropriate exposure of micro-organisms to antimicrobial agents in clinical practice, veterinary practice, animal husbandry, agriculture and horticulture; and
- Infection control: to reduce the spread of infection in general (and some of the need for antimicrobial agents) and of antimicrobial resistant micro-organisms in particular.
Speaking at the launch, Mr Chisholm said:
"Excessive use of antibiotics allows the development of drug resistant bacteria. This not only makes infections more difficult to treat, but may increase the length and severity of illness and the length of hospital admissions. It also means that use of the limited numbers of antibiotics available become less flexible because of patients who have built up resistance to certain bacteria.
"It is vital that the general public, and those working in fields which use antibiotics, work together to dispel the notion that antibiotics are a "cure for all". Importantly, the public must remember that they do not cure common viral infections such as colds and flu and indeed have little or not effect on the course of such illnesses.
"I am pleased to note that there has been some progress in the area of human prescribing. Between 1995 and 1999, the prescribing of antibiotics by general practices in Scotland fell by 18%. This aids the Executive's drive to get this issue recognised as one way of addressing the increasing threat of antimicrobial resistance.
"For medical prescribers, to be forewarned is to be forearmed and this is why the Executive is making available some #100,000 to promote and enhance teaching of this important topic in all Scottish Medical Schools.
"This work will ensure that the problems associated with antibiotic resistance are built into professionals' working ethos early on, making appropriate prescribing practices second nature when new doctors begin work in their respective fields."
Welcoming the publication and the additional funding, Professor Davey, an expert in clinical pharmacology based at Ninewells Hospital and Medical School in Dundee, said:
"I very much welcome the launch of the combined UK Strategy and Scottish Action Plan. This subject is indeed of considerable importance in the fight against infection. It is important that over-use and inappropriate prescribing of antibiotics is stopped in an effort to maintain the effectiveness of antimicrobial agents in the treatment and prevention of microbial infections."
The UK Strategy document on Antimicrobial Resistance was launched previously in England by the Department of Health in response to the House of Lords Select Committee on Science and Technology Report 'Resistance to Antibiotics and other microbial Agents' (April 1998).
The UK Strategy is combined with the Scottish Action Plan to set out in one document, the wide range of action proposed at both UK and Scottish levels to address this important issue. Its publication follows on from a wide-ranging consultation exercise carried out by the Executive in
2000-2001. This ensured that the views of those in the field were taken on board in the final revised Action Plan.
The combined document highlights the importance of prudent use of antibiotics across the fields of medicine, dentistry, veterinary practice, animal husbandry, agriculture and horticulture.
In the medical field, antibiotics are used to treat a variety of major illnesses caused by bacteria including TB, pneumonia, septicaemia, cellulitis and bacterial meningitis. However, they are not effective against viral illnesses such as colds/flu, and many cases of sore throat, earache or catarrh.
The new funding of £100,000 is being allocated to allow Professor Davey to lead a national project, in collaboration with colleagues in the other 4 Scottish Medical Schools, to develop a co-ordinated plan for undergraduate medical teaching in Scotland during 2002.
The initiative for this work was initiated by the Department of Health in England (on behalf of the UK Inter-departmental Steering Group on Antimicrobial Resistance which asked the British Society for Antimicrobial Chemotherapy (BSAC) to look into undergraduate medical education as part of its response to the House of Lords Report (referred to at para 1 above). The BSAC Working Group proposed that Prudent Antimicrobial Prescribing should be made a key learning objective for tomorrow's doctors. They produced a plan for defining the learning outcomes required to achieve this objective. The BSAC Working Party's paper is based on 12 fundamental outcomes of undergraduate medical education agreed by a Medical Curriculum Group established by the Deans of the five medical schools in Scotland in 2000. The BSAC paper has been reviewed by the Education Committee of the GMC who agree that it is consistent with their objectives for the education of tomorrow's doctors in the UK. The Scottish Executive's support will enable the five medical schools in Scotland to take a lead in implementing the plan for educating tomorrow's doctors to be prudent prescribers of antibiotics. Communication with other UK initiatives will be maintained via BSAC, SACAR and the Education Committee of the Council of UK Heads of Medical Schools.
In December 1999, the Executive launched publicity materials to raise public and professional awareness of this issue. This included posters, leaflets and non-prescription pads aimed at helping healthcare staff bring this issue to the attention of the general public. Supplies of these materials are still available and can be obtained by e mailing james.mcmorrine@scotland.gsi.gov.uk or by faxing Public Health Division of the Executive on 0131-244-2157.
The Health Education Board for Scotland is also working up proposals to produce materials to complement the 5-14 curriculum, with appropriate back-up for teachers. It will also produce leaflets and posters to help Primary Care staff to assist in explaining whether or not antibiotics may be needed.
Other work being taken forward by the Executive to address the 2 other key elements of the Strategy, i.e. infection control and surveillance, are:
The setting of infection control standards (full report on this work to be published December 2002) for healthcare settings;
Funding of £200,000 to train additional infection control nurses; and
Funding of £500,000 to the Scottish Centre for Infection and Environmental Health (SCIEH) to set up and operate a national Healthcare Associated Infection surveillance and monitoring programme.
The Executive is also presently finalising the second report of a sub-group of the Advisory Group on Infection. This report provides proposals for the surveillance of antimicrobial resistance in Scotland and will be put on the Executive's web site in the very near future when it is completed.