Misuse of antibiotics in hospitals falls

PUBLISHED : Saturday, 10 March, 2007, 12:00am
UPDATED : Saturday, 10 March, 2007, 12:00am

Health officials claim early success after programme helps monitor drugs

Health authorities have claimed initial victory in a battle against the misuse of antibiotics in the city's public hospitals.

But officials warned the problem of superbugs - various disease-causing bacteria that are developing increasing resistance to antibiotics - remained a concern.

Inappropriate use of antibiotics at public hospitals accounted for 8 per cent of the 16,000 cases, as of last October, down from the 17 per cent in November 2005.

Ho Pak-leung, chairman of the Centre for Health Protection's programme on antibiotics resistance, said he was pleased with the improvement.

'The 8 per cent level is already an acceptable level. In many cases, doctors may want to use strong antibiotics to treat a critically ill patient when he is admitted to hospital,' Professor Ho said.

He attributed it to the success of a HK$10 million programme co-organised by the Hospital Authority and the centre last year, to monitor the use of antibiotics in 16 public hospitals. Under the antibiotic stewardship programme, doctors who prescribe any of eight kinds of so-called broad-spectrum antibiotics are asked to complete a form giving their reasons.

A group of microbiologists and pharmacists at the respective hospitals will then check to see if the drug is suitable and give feedback to the clinicians. A database is set up to establish the patterns of use of antibiotics. A database on antibiotics resistance is also established.

Despite some minor improvement, the methicillin-resistant Staphylococcus aureus (MRSA) remained a concern. The bacteria could be treated successfully with penicillin in the 1940s and 1950s. But nearly all strains are now resistant to penicillin, leaving only a narrow selection of drugs useful for treatment.

Bugs develop resistance to drugs that do not kill them. It is natural, but the process is being exacerbated by the misuse of antibiotics.

In Hong Kong, the resistance rate of MRSA was 47.03 per cent in 2004 and remained at 42.5 per cent as at the third quarter last year, Hospital Authority figures show. Professor Ho said: 'It remains a concern. MRSA is highly adaptable to a hospital environment.'

But he said great improvement had been shown in the resistance rates of E coli - which can cause intestinal infections - and Pseudomonas aeruginosa - which typically infects the pulmonary tract, urinary tract, and also causes other blood infections.

The resistance rate of E coli to the antibiotic cefotaxime dropped from 45.65 per cent in 2004 to 21.9 per cent in the third quarter last year.

The World Health Organisation issued a report in 2000 warning of the misuse of antibiotics.

It said although major infectious diseases were slowing, they were becoming more resistant to existing medicines.

Hong Kong is one of the few places in the world to have developed a comprehensive programme to monitor the use of antibiotics in public hospitals.