Tuesday, April 12, 2011

scmp.com: 30pc given antibiotics in public hospitals


30pc given antibiotics in public hospitals

April 13, 2011
Ella Lee

Thirty per cent of patients admitted to public hospitals are given antibiotics, a Hospital 

Authority audit shows.
A third of these are given two types of antibiotics. And 3 per cent of all patients suffer various kinds of infections after admission.

Some of the hospital-acquired infections are caused by drug-resistant bacteria, the so-called superbugs, the audit found. Hong Kong's hospital-acquired infection rate of 3 per cent is at the lower end of the international scale, which in some countries reaches 10 per cent.

"The local figures are not alarming," said Dr Dominic Tsang Ngai-chong, the Hospital Authority's chief infection-control officer. "Many patients admitted to public hospitals suffer rather serious diseases and the use of antibiotics is necessary to save life. Some need several types of drugs to control the infections."

But a leading microbiologist warned that the spread of one superbug - methicillin-resistant Staphylococcus aureus (MRSA) - was getting "out of control" in public hospitals, and said many countries used antibiotics far more sparingly.

Professor Yuen Kwok-yuen, head of microbiology at the University of Hong Kong, said the antibiotics prevalence rate in Scandinavian countries and some European countries was in single digits.

Yuen said: "It is worrying that now between 30 and 50 per cent of all Staphylococcus aureus cultured at public hospitals laboratories are resistant to methicillin, compared with just single digits 20 years ago. Compared with many European countries, Hong Kong has been too slow in fighting against drug resistance."

Tsang yesterday released some of the findings of a survey conducted between July and September at 37 public hospitals. The survey, carried out every four years, aims to find out how commonly antibiotics are used at public hospitals, and how prevalent are the infections that patients acquire in hospitals.

By using computer software, the audit checked the prescriptions for 20,355 patients. Some 5,900 received intravenous antibiotics. If oral and tropic antibiotics are counted, the rate stands at 30.3 per cent.

Tsang said the antibiotics prevalence rate and hospital acquired infections rate were comparable to many developed countries. He noted that in Belgium, the antibiotics prevalence rate was 38 per cent.

The Hospital Authority's 2007 survey of 20,001 patients found a 4 per cent hospital acquired infections rate. Tsang said figures from the reports could not be compared directly as they used different methods.

Professor Ho Pak-leung, head of the University of Hong Kong's Centre of Infection, said the authority had to release more detailed analysis of the survey. "The authority should come out and tell the public how many of these antibiotics are used properly, are any misused or overused?"

Ho expressed concern about the rising number of patients in the past two years requiring treatment with the last-defence antibiotic called colomycin, or colistin. The number jumped from single digits per month in 2009 to more than 30 this January.

"It means an increasing number of patients have infections that cannot be treated by most other antibiotics, so the last defence has to be used," Ho said.

Tsang said it was premature to jump to such a conclusion. He said in some cases, doctors gave colomycin to high-risk patients carrying drug-resistant bugs as a form of prevention. "Those patients do not have any symptoms, they are just carriers. But doctors, for the sake of the patients' safety, apply colomycin to kill those drug-resistant bacteria."

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