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SCMP Reporter

The use of 'big-gun' antibiotics in public hospitals is rising slowly, even though weaker drugs would have sufficed in 10 per cent of cases, an infectious disease control specialist said.
The Hospital Authority's chief infection-control officer Dr Dominic Tsang Ngai-chong disclosed the statistics  yesterday in a yearly round-up.
'Big gun' antibiotics refer to the strongest category of  the infection-fighting drugs, reserved as the last line of defence against superbugs, whose drug resistance has been blamed on the rampant overuse of antibiotics for minor illnesses. 
The dosage per patient in public hospitals rose by 8.7 per cent overall from 2006 to last year, the authority said. The use in surgical wards rose by 12.5 per cent in the same period, but the figure in orthopaedic departments dropped by 5.8 per cent.
In intensive-care units, where the strongest antibiotics were prescribed about seven times more than in general wards, usage rose by 4.5 per cent.
Despite the rising trend, Tsang said it was commendable that it was occurring in moderation.
'It is difficult to control the rise, as superbugs are becoming more common,' he said. 'Hospitals therefore must be extremely cautious.'  
Doctors can only prescribe the super-strength antibiotics  with the approval of a scientific committee,  Tsang said. 
However, he added that such antibiotics were unnecessary in about 10 per cent of cases where more conventional antibiotics would provide effective treatment.
Tsang said the authority would look at ways to use the drugs more appropriately.  
To control the spread of superbugs, all public hospitals will adopt a colour-coding scheme in coming months. Red, blue, green and yellow labels will be attached to cleaning equipment such as mops, buckets and towels, indicating their sole use in bathrooms, general wards, catering departments and kitchens, and isolation areas.  
Tsang said  the coloured labels would help frontline staff restrict the use of certain equipment to their designated areas, thereby reducing the risk of cross-contamination. 
 The authority is also testing patients for a superbug called carbapenem-resistant enterobacteriaceae (CRE). Starting last  month, all patients  who have been admitted to hospitals outside the city before returning to Hong Kong  will have to undergo screening for CRE. 
Four cases of CRE were detected among about 400 patients tested to date. The patients proved to be CRE carriers and were immediately isolated.  No internal transmissions have been detected so far in Hong Kong hospitals.
Overdoing it?
The percentage of cases in which more conventional antibiotics would provide an effective treatment: 10



Use of last-recourse antibiotics rises as new superbugs emerge