Antibiotics short on experts

April 24, 1998

DOCTORS need to be better educated in the use of antibiotics, says a House of Lords inquiry into antibiotic resistance.

The Lords' select committee on science and technology warned this week that resistance to antibiotics is a major threat to public health. It says between 5 and 50 per cent of GP prescriptions are unjustified.

The committee calls for a re-examination of the undergraduate medical curriculum on infectious diseases and antimicrobial therapy, and more professional and vocational education. This should include communication skills so that doctors can explain to patients why prescriptions are refused.

The committee found evidence that clinical academic microbiology, which provides much of the expertise for monitoring resistance, is failing to attract recruits and fill senior posts. Chairs in microbiology are vacant at three London and two provincial teaching hospitals.

Drugs giant Glaxo Wellcome told the committee that it is taking much of its antibacterial research to Italy as the ability of United Kingdom universities to conduct microbiology research and produce well-trained graduates declines. SmithKline Beecham also identified a technology gap and a shortage of trained people, blaming many years of underfunding.

Others blamed the research assessment exercise, which, the committee report says, "has laid greater value on the more fundamental aspects of research than those of a more practical and immediately applicable nature".

The Lords committee calls for the National Health Service, the funding councils and medical schools to address this. "This is a special case of a more general problem concerning the pressures placed on clinical academic medicine by the conflicting demands of the RAE and the ever-growing burdens of teaching, service provisions and administration."

The committee says money from the NHS research and development budget should be used to support microbiological surveillance. The Medical Research Council and the medical charities should also be prepared to support such surveillance work.

The committee says: "Research in this area evidently falls between a number of stools, receiving inadequate support from the major grant-giving bodies and the NHS research and development strategy".

It calls for such bodies to reconsider the public health issues around antimicrobial research and to give it greater priority.

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