Guidelines being drafted for the Hospital Authority aim to buy time in the war against superbugs. The latest bug, whose discovery in Hong Kong the Post reveals today, is immune to all antibiotics. More than 200 types of antibiotics are in use worldwide. About 25 used in local public hospitals will be listed in the guidelines. Dr Raymond Yung Wai-hung, consultant microbiologist at Pamela Youde Nethersole Eastern Hospital, who is writing the guidelines, said a recent check found improper use was common among doctors. Problems included wrong dosage, unnecessary use and administration of potent antibiotics for mild symptoms. In some cases, doctors prescribed three or four antibiotics which were of no use. 'Sometimes they are eager to see the effect, they want to cover everything with antibiotics.' Dr Yung said people were losing the battle against bacteria and it was urgent that everyone 'conserved' antibiotics still available. 'We are failing in the sense that bacteria seem to evolve faster than new drugs.' It took five to 10 years for scientists to develop a new antibiotic at a cost of between US$15 million (HK$116 million) and US$20 million, he added. 'To conserve the antibiotics we have, we must use them more carefully so we can delay the evolution of resistance and buy time for new drugs to be developed.' Dr Yung said public hospitals had been monitoring drug resistance of four major bacteria - Staphylococcus, Pneumococci, Gonococci and E-coli. About 80 per cent of Gonococci, which cause gonorrhea, were resistant to penicillin and 20 per cent of E-coli had shown multiple resistance to antibiotics. The new guidelines, divided into two areas, are expected to be completed this year and will be distributed to all public hospitals. The 'organism-based' section will state which kinds of bacteria each antibiotic is for and the proper dosage, while the 'system-based' section will advise doctors which antibiotics should be used for specific symptoms and diseases. Hong Kong has been lagging in monitoring the drug resistance problem. Australia and the United States, for example, have a national team to monitor the use of antibiotics and guidelines are updated regularly. There is no such system in Hong Kong and there are only 14 microbiologists in eight hospitals to serve the population. Dr Yung said in the long run, Hong Kong would need a central database on infectious disease and antibiotics to monitor the public and private sector. EVOLUTION OF A SILENT KILLER 1900: Staphylococcus aureus causes fatal bacterial infections in humans. No antibiotics available. 1945: Penicillin kills almost all Staphylococcus aureus. 1970s: About 95 per cent of the bacteria becomes resistant to penicillin. The new genes produce an enzyme called penicillinase which destroys penicillin. New strain: penicillin-resistant Staphylococcus aureus (PRSA). 1980s: New antibiotics methicillin and cloxacillin kill 99 per cent of bacteria. 1990s: Thirty per cent of bacteria found to be resistant to methicillin and cloxacillin. Killed by antibiotic of last defence, vancomycin. New strain : Methicillin-resistant Staphylococcus aureus (MRSA). 1997: Japan discovers that bacteria is resistant to vancomycin, following three cases in the United States and one in France. New strain : Vancomycin-resistant Staphylococcus aureus (VRSA). 1998: Hong Kong reports its first VRSA case. A woman dies at Queen Mary Hospital after a two-week antibiotics treatment failed.