Superbug fear as use of antibiotic rises 27pc Prescription of one of the strongest antibiotics has surged in Hong Kong's private hospitals, and pharmacists say the practice suggests supervision of doctors may be inadequate. They link its use to the spread of drug-resistant superbugs. Research commissioned by the Society of Hospital Pharmacists shows that 21,419 doses of ertapenem - one of the family of so-called 'big gun' antibiotics known as carbapenems - had been given to patients in private hospitals last year, a surge of 27 per cent from the 16,869 doses in 2006. Overuse of various antibiotics is blamed for causing the rise of drug-resistant strains of bacteria known as superbugs. Society president So Yiu-wah said the surge in use of ertapenem could be related to a rise in the incidence of the superbug Stenotrophomonas maltophilia, which has shown strong resistance to carbapenems. At the Hong Kong Sanatorium and Hospital alone, the number of cases of the bug last year nearly doubled to 68, from 35 in 2005. Mr So said ertapenem was originally used to avoid infection in patients who had had rectal surgery but now seemed to be widely used by private doctors for various infections. 'The number of rectal operations has not increased that rapidly and we do not rule out the possibility that more doctors are using the antibiotics in other types of surgery to prevent infection,' Mr So said. He said the government should issue guidelines to the 12 private hospitals on the dosage of strong antibiotics and monitor closely how they were used. A spokesman for the government's Centre for Health Protection said a guideline on reducing bacterial resistance had been issued in 2005 and distributed to doctors throughout Hong Kong. The Health Department also met representatives of private hospitals regularly to discuss infection control and antibiotic use. University of Hong Kong microbiologist Ho Pak-leung, one of those who drafted the guidelines, said the increase in superbug infections was not necessarily a result of increased antibiotic use. He said the bacteria were more likely to infect patients who stayed in hospitals for more than two weeks, while the chance of infections also varied in different wards. But he conceded that infections of the superbug were on the rise in public and private hospitals. An antibiotic stewardship pilot scheme, led by Professor Ho, to monitor the use of antibiotics by doctors in public hospitals found more than 80 per cent were following the guidelines. However, he said the system could not be directly replicated in the private sector. Private Hospitals Association chairman Alan Lau Kwok-lam said it was not appropriate for it to impose regulations on the hospitals. Edmond Ma Shiu-kwan, director of clinical and molecular pathology at the Hong Kong Sanatorium and Hospital, said doctors would make their own judgments about how to treat their patients. 'The doctors may reckon that the patients cannot afford complications and offer a stronger dose,' he said. 'We should allow private doctors to give a different diagnosis from those at public hospitals.' He said the hospital would establish an infectious disease centre this year to improve infection controls.