Hooked on antibiotics? National study finds ‘worrying’ 30% increase in consumption
Experts say self-medication by antibiotics, and wider prescription by Maltese doctors of broad-spectrum antibiotics increasing consumption.
A study based on data collected by the National Antibiotic Committee from all licensed wholesale distributors found that consumption of antibiotics had increased by 30% from 2007 to 2009.
The over-consumption of antibiotics increases resistance to microbial infections and is considered a major hazard.
Although the problem is often linked to over-the-counter sales and self-medication by antibiotics, the latest study links the problem to the kind of prescriptions issued by Maltese doctors who tend to prescribe broad-spectrum antibiotics rather than those with a narrow spectrum.
In fact the study by National Antibiotics Committee members Peter Zarb and Michael A. Borg shows that that antibiotic consumption in Malta has shown a consistent increasing trend over the past three years, despite a reduction in over-the-counter acquisition.
It also found evidence of "strong and possibly unjustified" prescriptions of broad-spectrum antibacterial.
The term broad-spectrum antibiotic refers to an antibiotic that acts against a wide range of disease-causing bacteria. On the other hand, narrow-spectrum antibiotics are effective against specific families of bacteria. An example of a commonly used broad-spectrum antibiotic is ampicillin.
Overuse of broad-spectrum antibiotics, such as second- and third-generation cephalosporins, greatly hastens the development of resistance to various microbial infections.
The study shows that the increase in antibiotic consumption over the past years, is predominantly attributable to an increase in the use of second-generation cephalosporins.
Penicillins with beta lactamase inhibitors, cephalosporins and fluoroquinolones are well-recognised drivers for Clostridium difficile enterocolitis (which causes severe diarrhoea). Cephalosporin and fluoroquinolone use is a major driver for methicillin resistance in Staphylococcus aureus (MRSA).
The authors of the study describe the results as "very worrying."
This resistance originating from the community has a potential "knock-on effect on hospitals" as it contributes to could result in infection within hospitals.
A survey by Eurobarometer in 2009 confirmed that the vast majority of antibiotic consumption in Malta is the result of medical prescription, which had declined by 15% in 2001 to just 4% in 2009.
For the purpose of the study licensed wholesale distributors (WSL) were requested to submit their antimicrobial distribution records for the year 2007, 2008 and 2009.
The study was published in the Malta Medical Journal.