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Reliance on antibiotics a ticking time bomb, warns Northern Ireland chief medic


By Lisa Smyth

Northern Ireland's misuse of antibiotics is putting at risk the future of operations such as hip replacements and Caesarean sections, Northern Ireland's Chief Medical Officer is warning today.

Millions of people worldwide will die unless the number of antibiotics prescribed is drastically cut, our most senior doctor also said.

Dr Michael McBride warned some of the most vulnerable people in society, including premature babies and cancer patients, will be most at risk due to the growing problem of antibiotic resistance.

He went on to say that minor infections or injuries such as cuts or scratches - and even cases of food poisoning - could prove fatal without action to address what he described as one of the "greatest threats to health".

Publishing his annual report, Your Health Matters, Dr McBride revealed that 30% more antibiotics were prescribed here than in England.

And he appealed for urgent action to stop antibiotic resistance, which he said is threatening the lives of millions of people around the world.

Dr McBride continued: "We know that Northern Ireland's antibiotic usage is higher on average than the rest of the UK and 30% higher than England, with 1.9m individual antibiotic prescriptions issued annually.

"Northern Ireland's contribution to this global crisis is clearly significant and we must drive this down.

"This is the greatest danger to human health and to medicines worldwide.

"Currently 700,000 people die worldwide each year from drug-resistant infections and this figure is forecast to reach 10 million deaths by 2050 if the problem is ignored.

"This statistic should be enough to make us all stop and think about the impact of the continued overuse and misuse of antibiotics.

"If we don't act now it could mean that even the simplest infections cannot be treated and the most straightforward operations cannot be performed.

"This is an issue that affects every single one of us and could have devastating consequences.

"It is vital that we tackle this problem urgently so we can safeguard the health of ourselves, our children and future generations."

Antibiotics - including the likes of penicillin - are routinely given to patients ahead of or after surgery to prevent them from developing serious bacterial infections. However, the more that antibiotics are used, the more bacteria become resistant to them, meaning the drugs are becoming less effective at offering protection to people undergoing even straightforward, elective surgical procedures.

It also means that infectious diseases, such as pneumonia, meningitis and tuberculosis, may become untreatable in future.

Meanwhile, cuts, scratches or even food poisoning could prove deadly.

Antibiotic resistance also threatens many modern medical interventions that depend on the availability of the drugs, such as chemotherapy, organ transplantation and care of extremely premature babies, warned Dr McBride.

According to his report, the majority of antibiotics in Northern Ireland are prescribed by GPs, while dentists prescribed 8% of antibiotics in primary care in 2016.

Dr McBride also warned of the danger posed by the use of antibiotics in pets and livestock here.

Antibiotic resistant bacteria can spread to humans through the food chain or from contaminated water or soil.

The report also revealed the areas in Northern Ireland where the most antibiotics are prescribed, with hotspots including Londonderry, Enniskillen and parts of Belfast.

As a result, Dr McBride said everyone has a role to play in tackling the growing problem of antibiotic resistance and the report contains advice on the best measures to take to do this.

Responding to the statistics in the study, the chair of the British Medical Association's GP committee in Northern Ireland said family doctors here have already significantly reduced the number of antibiotics prescribed to patients.

Dr Tom Black added: "Prescribing rates in Northern Ireland are higher but then GPs here have a much higher consultation rate than the rest of the UK.

"In saying that, we need antibiotics to work when we use them and GPs here are working very hard to reduce the number of antibiotics patients take. One way of doing this is by delaying the use of antibiotics. So for example, when a patient comes to me on a Friday and tells me they think they have an infection, I would give them a prescription but tell them not to use it unless they develop a temperature or their condition gets worse.

"Quite often when we speak to the patient at a later stage, it transpires that they didn't need the antibiotics and didn't end up taking them."

Dr Black also explained why he believes more antibiotics are prescribed in some parts of Northern Ireland.

"In areas of deprivation there are higher rates of smoking and other unhealthy lifestyle factors which cause infections, such as chest infections," he said.

"Enniskillen and Fermanagh has the oldest population in Northern Ireland therefore they use more antibiotics, while Derry and Strabane have the youngest population and babies and children.

"Young children and babies get 50 infections by the time they are seven so it stands to reason that more antibiotics would be prescribed there."

As well as looking at the issue of antibiotic resistance, Dr McBride's report examined a range of other issues affecting the health of people in Northern Ireland, including breastfeeding rates, tooth decay in children and safe alcohol limits.

The report said more than 250 people die every year in Northern Ireland from alcohol-related causes, while there are more than 12,000 alcohol-linked admissions to hospitals annually.

Eight out of 10 attendances at emergency departments at weekends are alcohol-related, while alcohol misuse is estimated to contribute to 20% of all crimes committed here. Vaping was also analysed by Dr McBride in his report and he warned of the unknown dangers it poses, particularly in young people.

"The use of e-cigarettes has grown significantly in the past five years with an estimated 87,000 adults in Northern Ireland using them regularly," he said. "Although e-cigarettes do not contain many of the harmful chemicals found in tobacco they do contain a lot of other chemicals, and it will be years before we really know the extent of any long-term health consequences of e-cigarette use.

"The fact that they contain nicotine is a concern, as the World Health Organisation believes nicotine may have long-term consequences for brain development if used by adolescents."

Dr McBride also highlighted the dangers of eating too much sugar, and revealed that adults here eat double the recommended amount, while children eat around three times more than they should.

Number of people who die worldwide each year from drug resistant infections

Northern Ireland's antibiotic usage is 30% higher than England's

Number of individual antibiotic prescriptions issued annually in Northern Ireland

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