Half of the antibiotics prescribed in hospitals unnecessary: Experts

KAMPALA, UGANDA: Half of all antibiotics currently prescribed by doctors are not needed, experts attending World Health Organization-WHO meeting in which they were assessing strides made by countries on implementation of National Action Plans on Antimicrobial Resistance (AMR) have revealed.

Speaking at the meeting on Tuesday, Dr. Loice Achieng Ombajo, a lecturer at the School of Medicine of Nairobi University said currently, 50% of inpatients in hospitals in low and middle income countries are being treated unnecessarily with antibiotics that have been categorized as watch medicines, supposed to be used when first category medicines fail.

She said the commonest antibiotic used in Kenya public health facilities for instance is ceftriaxone, which is a watch medicine and it is worse in private health facilities where broad spectrum medicines meant for advanced disease are used to treat simple ailments.

Despite many warnings of antimicrobial resistance dangers arising from misuse of the drugs, experts said world over, there is still over-prescription of antibiotics which is why WHO has created additional guidance in a new booklet where they offer guidance on what antibiotics can be used at what stage.

They have categorized the medicines into three categories listed as Access which are most recommended to use and should be available at health facilities at all times. The Watch and Reserve categories of medicines are supposed to be used sparingly and as a last resort.

Dr. Marc Mendelson, an infectious diseases expert says this book isn’t intended to replace national guidelines on dispensing antibiotics but meant to help countries that are struggling to at least achieve 60% of their national antibiotic prescriptions being picked from the Access category.

So far however, even with a lot of guidance available, Mendelson says doctors are still prescribing antibiotics for infections such as acute bronchitis and sore throat, even with overwhelming evidence from scientific research that they don’t work.

For him, before prescribing an antibiotic, medics have to do an investigation to check whether a patient really needs that particular medicine and whether they are suffering from a bacterial, fungal or viral infection.

On his part, Dr. Benedikt Huttner, the team leader at the WHO Essential Medicines List Secretariat urged countries to align their essential medicines lists with the antibiotic book such that only necessary medicines are made available.

In public facilities for instance, experts note use of broad spectrum antibiotics is not as prevalent as it is for private facilities and Achieng says this is mainly because private providers are a target in marketing by pharmaceutical companies. For her, to tackle over-prescription, health workers need to be made to account for every antibiotic they prescribe.