Fighting resistant infections

26 January 2010

Scotland's first national report combining information on antimicrobial use and resistance highlights the need to act now to limit the spread of resistant organisms.

Produced by NSS' Health Protection Scotland and Information Services Division, the "Scottish Antimicrobial Prescribing Group (SAPG) Report on Antimicrobial Resistance and Use in Humans in 2008" shows that there is already some antimicrobial resistance present in bacteria other than MRSA, particularly E.coli, which is the most commonly reported cause of septicaemia. This finding confirms the need to act now with appropriate antimicrobial stewardship to prevent further spread of resistant organisms.

Dr Anne Eastaway, Consultant Microbiologist at HPS and programme lead for the national surveillance of AMR, said: "While resistance levels at present remain low and prescribing in general practice is largely in line with national guidance, we cannot be complacent about antimicrobial resistance and must continue to be vigilant in monitoring trends and identifying new resistant mechanisms, working with clinicians to ensure antimicrobials and antibacterials are used cautiously and appropriately."

Dr Dilip Nathwani, Chair of SAPG, said: "On behalf of SAPG, I welcome this important report. The information within the report and planned future work is essential national intelligence to support existing local data. The combination of good national and local surveillance is key to the success of our national stewardship programme, which aims to improve the prescribing of antimicrobials and antibacterials and reduce harm from their inappropriate use in Scotland, both within hospitals and in the community."

The report  also shows that in 2008, prescribing in general practice was already largely in line with guidance subsequently produced by SAPG in 2009, with eight of the ten most commonly used antimicrobials being those which SAPG recommends.

The report is intended to support the work of SAPG at a national level. SAPG is part of the Scottish Medicines Consortium and was set up to oversee a national antimicrobial stewardship programme, of which this report forms a part. It will also support the work of NHS boards, hospitals and primary care services in their long-term planning of antimicrobial and antibacterial prescribing and establish a baseline from which the impact of national and local initiatives to improve the quality of prescribing and contain the spread of resistance can be assessed in the future.

As well as a description of the use of antimicrobials and antibacterials in general practice, the report provides information on antimicrobial resistance in a key range of organisms associated with septicaemia (an infection of the blood stream).

Antimicrobial resistance (AMR) refers to the ability of a bacterium to withstand an antibiotic used in treatment. AMR is recognised as a major threat to public health and patient safety, as it reduces the treatment options available to combat infections such as Staphylococcus aureus, the meticillin resistant strain of which is commonly known as MRSA. It is widely accepted that appropriate prescribing and use of antimicrobials and antibacterials can reduce the risk of AMR developing and therefore preserve the ability to use these drugs in the fight against infection.