Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

RCSI supports drive to improve practice in antibiotic prescribing

18 November 2015

Misuse of antibiotics threatens to undermine the progress that has been made in medicine over recent decades as the overuse of antibiotics makes patients less likely to respond to treatment, warns Ireland's leading clinicians, today, on European Antibiotic Awareness Day (EAAD) 2015. Leaders from medical, veterinary and pharmaceutical professions are gathering today for the fifth annual antibiotic awareness event, which aims to improve practice in antibiotic prescribing and create awareness to antibiotic resistance.
 
Healthcare professionals from RCSI (Royal College of Surgeons in Ireland) will contribute to today's event entitled "Improving Practice in Antibiotic Prescribing" which is taking place in the Royal College of Physicians in Ireland (RCPI). The event will involve a plenary session and an interactive workshop which will advise attendees on how to deliver improvements in antibiotic prescribing.
 
The plenary session will be chaired by Dr Fidelma Fitzpatrick, Senior Lecturer in Microbiology at RCSI and Consultant Microbiologist at Beaumont Hospital. Dr Fitzpatrick warns that infections caused by many types of antibiotic resistant bacteria are increasing in Ireland, and that the onus is on prescribers to ensure antibiotics are used effectively so their efficacy is preserved for future generations.
 
She said, "Antibiotic resistance is a major threat to patient safety and to public health. Of course antibiotics are life-saving medicines and modern healthcare would not be possible without them but they have come at a cost, which is antibiotic resistance. As prescribers, it is vital that we apply a rational approach to antibiotic prescribing that maximises the likelihood of successfully treating infections, while minimising the risk of selecting out antibiotic resistance. We need to ‘start smart' and following our hospital antibiotic guidelines and after one or two days of treating a patient with antibiotics, consider changing the medication when we have microbiology results or indeed stopping it if it becomes clear that the patients does not have an infection'.
 
‘Also, as educators of future doctors, we need to focus on preparing the prescribers of the future to use antibiotic appropriately. In RCSI in addition to face to face teaching on antibiotics and antibiotic resistance we have recently launched an interactive Technology Enhanced Learning project for intermediate cycle students based around real-life clinical scenarios that takes students through the decision making processes in choosing the correct antibiotics for a particular scenario. Increasing antibiotic resistance and the potential emergence of untreatable infections is the reality for this generation of future doctors so it is really important that they are prepared for their responsibilities in choosing antibiotics wisely in order to preserve antibiotics for future generations'.
 
Ms Deborah McNamara, RCSI Council Member and Consultant Surgeon (General/Colorectal) at Beaumont Hospital will deliver a presentation at the plenary session at today's meeting entitled "Quality improvement: how it works in clinical practice", which will focus on barriers to delivering high quality healthcare and how they may be overcome, emphasising the role of quality improvement methodologies.
 
Ms McNamara will outline the work she has done, with Dr Fitzpatrick, in Beaumont Hospital to develop improvement capability and increase engagement by front-line staff using the ‘Better Beaumont' initiative. The new structures, as part of this campaign have led to a reduction of the rate of surgical site infections on one of Beaumont's busiest surgical wards by 37%.
 
Dr Robert Cunney, Consultant Microbiologist and HSE/RCPI Clinical Lead warns that a casual attitude to antibiotics is damaging their effectiveness and we are seeing an alarming rise in infections caused by so called ‘superbugs', such as MRSA and multiple-resistant strains of E.coli. He said, "Taking antibiotics when they aren't needed means that they might not work when you really need them for a serious infection. Leading clinicians from the HSE (Health Service Executive), general practice, hospital care, surgery, dentistry and pharmacy will attend this event to mark EAAD and to raise awareness amongst health professionals about using antibiotics wisely. We all agree that everyone has an important role to play in ensuring correct use of antibiotics and tackling the global health threat of antibiotic resistance. The evidence is very clear - overuse and misuse of antibiotics has allowed bacteria to develop resistance and they are becoming immune to the drugs we use to defend ourselves against them."
 
RCSI is ranked 46th in the world for ‘International Outlook' and #251 - 300 in the Times Higher Education World University Rankings (2015-2016). It is an international not-for-profit health sciences institution, with its headquarters in Dublin, focused on education and research to drive improvements in human health worldwide.

 

More information on antibiotics and antibiotic resistance:
• Watch the lecture called, 'Have the Superbugs won' by Dr Fidelma Fitzpatrick & Dr Nuala O'Connor (Irish College of General Practitioners) for some practical advice. This was filmed in March 2015 as part of the RCSI MiniMed Lecture Series.
 

• The HSE, in partnership with pharmacists and general practitioners has developed a website, www.undertheweather.ie, which gives practical, common sense advice and information on dealing with many common illnesses like colds, flu, earaches, sore throats, tummy bugs and rashes.Undertheweather.ie provides the sound advice required to give us the confidence and skill we need to take care of ourselves and our families without resorting to antibiotics.

• Antibiotics don't work for colds or flu. If you have a cold or flu, visit www.undertheweather.ie for advice on how to help yourself get better and ask your doctor for advice if you are concerned.

• For easy access to credible health information, download the RCSI MyHealth App from the App Store or Google Play. 
 

If you are prescribed an antibiotic:
• Antibiotics should be used only as prescribed and when needed.
    - Antibiotics should be taken exactly as prescribed - at the right time for the right duration. See www.hse.ie/antibiotics   
 
    - Always finish an antibiotic course - even if you feel a lot better. This is to ensure that all the bacteria are killed completely and that no survivors are left that could multiply and develop resistance.
 
    - Never store antibiotics and never share with others - antibiotics are specific medication for specific infections so they are likely not to be the correct antibiotic and won't work and also may cause harm (e.g. side effects)
 

Resources and information for prescribers:
• Antibiotic prescribing guidelines for primary care: can be viewed at www.antibioticprescribing.ie
 
• The RCSI Hospitals Group Antimicrobial Guidelines can be downloaded for iPhone or Android smartphones.
 
RCSI and RCPI Start Smart and then Focus Antibiotic Care Bundle (click to download)
 
RCSI and RCPI Preventing Surgical Site Infections Care Bundle