In this weeks Topics, Eamonn discusses the perils of antibiotic overuse

Antibiotic Overuse becoming a major threat to public health

Overuse of antibiotics in Ireland, and around the world, represents one of the most significant threats to long term public health. Antibiotic overuse is a major cause of the rise of resistant strains of bacteria including superbugs such as MRSA and previously eradicated tuberculosis. Antibiotics should only be prescribed for confirmed and severe bacterial infections. They should not be prescribed for viral infections which are the cause of over 80% of colds and flus. Increased levels of resistance, coupled with the lack of new antibiotics coming on stream, means there is a risk that we could return to the ‘pre-antibiotic era’ if this overuse is not addressed. This will not only cripple our ability to fight routine infections but will also undermine the treatment of more complicated infections, especially in patients with chronic diseases and could make many surgeries impossible.

It is concerning that, at a time when we should be reducing our use of antibiotics, in the first half of 2018 the rate of antibiotic consumption in Ireland increased, with Irish people taking 7% more antibiotics than they were 15 years ago.

HSE Antibiotic awareness campaign

The HSE campaign has the key message that “Taking Antibiotics for colds and flu? There’s no point”. By taking antibiotics when they aren’t needed means that they will not work when you really need them for a serious infection. Taking antibiotics for a viral illness, such as a cold or flu, is of no benefit to you and is a waste of a precious life-saving resource. If antibiotics are taken when they are not needed, it enables bacteria to become resistant to antibiotics.  This means that antibiotics may not work for infections when you really need them such as serious blood infections and pneumonia.  The bacteria are developing resistance faster than the pharmaceutical industry can develop new antibiotics. The world is fast running out of antibiotics.

No need to see a doctor for colds and flus

Seeing a doctor when you have a cold or flu is a waste of your money on GP fees and prescription fees and, in the case of medical card holders, a waste of taxpayers’ money. It is also a waste of your time to visit a GP for a cold or flu as you must take time off work, travel to the GP surgery and pharmacy. GPs surgeries are being unnecessarily blocked up in Ireland with people visiting them for cold and flus and it reduces accessibility for people who have genuine reasons to see the GP.

What the experts say?

Dr. Fidelma Fitzpatrick, Consultant Microbiologist and HSE Clinical Head for the Prevention of Healthcare-associated Infection explains “Antibiotics have revolutionised the way we treat patients with bacterial infections and have saved many lives since their introduction in the middle of the last century. …. we are using more and more antibiotics each year in Ireland and are seeing more infections caused by antibiotic resistant bacteria (such as S. pneumonia a cause of pneumonia and meningitis) or infections due to antibiotics (such as Clostridium difficile infection) as a result.  If we don’t take-action now, we risk wasting one of the most important medical advances of the past 100 years.”

Key points to remember

Most common viral infections such as common colds, coughs or flu don’t need antibiotics, they get better by themselves. Antibiotics are only effective against bacterial infections and can be lifesaving in certain infections such as meningitis, pneumonia and TB. We need to keep antibiotics for when we really need them. Taking antibiotics when they are not needed causes bacteria to become resistant to antibiotic treatments. Antibiotics can cause side effects such as diarrhoea, nausea and skin rashes. About one in five people taking antibiotics get side effects. Taking antibiotics when they are not needed puts your health at risk.

What to do if you have cold or flu

Many infections are viral, so an antibiotic should not be prescribed, and you should take the following advice:

• Stay at home and rest if necessary
• Drink plenty of water or soft drinks
• Take paracetamol to reduce your temperature, if feverish or if you are in any discomfort
• You may wish to take other remedies, but be aware that they may contain paracetamol - do not exceed the maximum daily dose of paracetamol by combining different products - ask your pharmacist
• Ask your pharmacist about other remedies you can safely take to relieve your symptoms
• If you are concerned that your symptoms are getting worse or you are not better in a few days, phone the surgery for further advice.

What to do if you have a cough?

Antibiotics are rarely needed for coughs as most are caused by viruses. A cough is a sign your body is clearing an infection and is normal. Steam inhalations can be very useful, particularly in productive (chesty) coughs.  Simply putting hot steaming water (not boiling) in a basin, putting a towel over your head and inhaling the steam can accelerate the clearing of catarrh. The steam helps to liquefy lung secretions and the warm, moist air is comforting.

Chesty cough mixtures contain an expectorant which liquefy the catarrh, so it can be coughed up easier.  There are other cough mixtures that cause drowsiness which can be used at night to help you sleep.  Sugar free versions of cough mixtures are available for diabetics. Dry cough mixtures contain ingredients such as pholcodeine, codeine and dextromethorphan and are useful where there is no mucus to clear. There are also cough mixtures available which contain decongestants which are effective if you have a congested head as well as a cough.  

For comprehensive and free health advice and information call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).