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Elderly at risk due to war on superbugs

Elderly at risk due to war on superbugs
28th February 2019

The battle against superbugs is putting elderly people at risk of sepsis, which can be fatal, experts have warned. It stems from the pressure being put on GPs to cut down on the number of antibiotics they prescribe, as infections become resistant to them, reports the Daily Mail.

Local health boards get extra payments from the NHS when doctors give out fewer drugs and in 2015 there was even a warning issued that those who were found to be overprescribing could be struck off.

Despite this concerted effort to minimise the risk of antibiotic resistance, a study brought to light by the British Medical Journal shows there could be a downside. It suggests that vulnerable people could be more likely to contract sepsis when they are not given antibiotics for infections.

In fact, the chances of being struck down with sepsis increase by eight times and double the risk of dying. It is the most substantial acknowledgement so far that the overuse of antibiotics campaign could be having such an adverse effect.

The Royal College of GPs pointed out that family doctors are being put in a position where they simply can’t win. It acknowledged that GPs are “publicly vilified” for giving out too many drugs, but that withholding them could be disastrous.

In the new study, experts from Imperial College London took the medical records of 157,000 people into account. They were all pensioners who had been diagnosed with urinary tract infections (UTIs) between 2007 and 2015.

UTIs are among the most common reasons why a person would be prescribed antibiotics, but it was discovered that 22,500 of them were not. This equates to seven per cent of the total number of records that were scrutinised.

A further 19,300 - or six per cent - only got antibiotics after returning to their GP for a second time. This will have incurred a delay of seven days. Without the prescription, the chances of developing sepsis increased by a factor of eight.

The conclusion reached by the academics was that for every 37 patients that weren’t given antibiotics, one would lead to sepsis. In reality, that is a staggeringly large rate and one that should not be ignored when policy is being drafted.

In the report, it states: “The question remains as to why a significant proportion - about seven per cent - of vulnerable older patients had a diagnosis of UTI but were not prescribed antibiotics.

“It could be patient or doctor choice, but it is also possible that antimicrobial stewardship programmes and quality premium payments are encouraging a culture of more judicious antibiotic use.”

Public Health England has recently released figures showing a 13.2 per cent reduction in prescriptions being issued for antibiotics between 2013 and 2017. While this seems like an impressive achievement, it’s important not to overlook the wider implications of the move.