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Q J Med 1999; 92: 287-292
© 1999 Association of Physicians

Commentary

Antibiotic prescribing—are there lessons for physicians?

D. Nathwani and P. Davey1

From The Infection and Immunodeficiency Unit, and 1 Medicines Monitoring Unit, Ninewells Hospital, Dundee, UK

Dr D. Nathwani, Infection and Immunodeficiency Unit, Kings Cross Hospital, Clepington Road, Dundee DD3 8EA


   Introduction
 
In 1968, L.P. Garrod wrote `no one recently qualified, even with the liveliest imagination, can picture the ravages of bacterial infection which continued until more than 30 years ago'. Since then, although many new antimicrobials have been developed, we are once again warned of an imminent `post antibiotic era' as a consequence of the rapid emergence of resistant bacteria. This problem has recently culminated in the publication of an excellent report from the House of Lords Select Committee on Science and Technology on `Resistance to Antibiotics and the other antimicrobial agents'.1 The subsequent plethora of editorials2,3 in the medical press and `sensationalist' coverage in the media has brought this important subject to the attention of the non-specialist medical community as well as the public domain. This increased concern has culminated in the British Medical Journal devoting a whole issue to this subject (Br Med J 1998; 317) and . . . [Full Text of this Article]


   How then should we improve practice in hospital general medical wards?
 

   How can sepsis recognition and assessment be improved?
 

   How can we improve the use of parenteral antibiotics?
 

   How can these strategies be effectively implemented?
 

   What is the evidence for the effectiveness of ID physicians in improving the quality and cost-effectiveness of antibiotic prescribing in hospital.?
 

   References
 

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