It is possible to reduce the use of antibiotics, especially creams and ointments, through the combined effort of pharmacists, doctors and patients, according to family doctors and pharmacists. “There is overuse of skin creams with fucidic acid by some doctors who overprescribe, pharmacists who sell it over the-counter and patients who demand it,” Anthony P. Azzopardi, president of the Association of Private Family Doctors, said.
Misuse and overuse of creams with fucidic acid, such as commonly used Fucidin and Fucicort, were highlighted as a possible cause of a new strain of an antibiotic resistant bacterium, known as MRSA, a variant of which has only been reported in Malta, a recent study has revealed.
In fact, bacterium responsible for difficult-to-treat infections in hospitals due to antibiotic resistance has been found in the nostrils of 8.2 per cent of the 450 healthy individuals who took part in the research.
The study was carried out by a University student as part of her medical laboratory sciences degree and was supervised by National Antibiotic Committee chairman Michael Borg. Dr Borg was convinced this is not a coincidence because in Europe Malta has one of the highest levels of use of fucidic acid, a component of some antibiotic creams.
He urged doctors to go slow when prescribing antibiotic creams and make sure these were used only when needed. He said it was “vital for pharmacists” not to dispense them without a prescription.
Dr Azzopardi pointed out that everyone at home had a tube of antibiotic cream, saying it was often used “for the most inappropriate things”. He admitted there was overuse by all the sectors, although it was not fair to generalise.
What was needed, he added, was an education campaign to explain to people the use of such medicinals. “Other information campaigns not to misuse antibiotics were very successful and I think that raising awareness will be very effective,” Dr Azzopardi said.
Similarly, Mary Ann Sant Fournier, president of Chamber of Pharmacists, said it was the Chamber’s “conviction that a concerted effort by all involved would go a long way to address the present evolving situation”.
She pointed out that the emergence of MRSA infections was an international and national reality and that understanding the use of antibiotics “is crucial” to control it.
“Pharmacists’ intervention in this area is not only best practice in dispensing antibiotics such as creams and ointments but advising patients to use antibiotic preparations as prescribed, both in terms of regimen and extension of treatment,” she said. Pharmacists also had an important role to play in the fight against self-medication by informing patients on adherence and detecting the wrong use of medicines, she added.
Also, patients had the responsibility “to stop putting pressure on doctors and pharmacists to prescribe and dispense antibiotics in any form” and follow the advice given by health care professionals, Ms Sant Fournier said.
Pharmacists, as health care professionals, were well aware of their legal and professional obligations, she said.
When contacted, the president of the Medical Association of Malta, Martin Balzan pointed out that both doctors and pharmacists were very aware of the issue and were therefore careful in the prescription and dispensation of antibiotics.
Doctors were prescribing fewer antibiotics compared to what happened in the past, even though there were many patients who put pressure on doctors, he said.
Dr Balzan insisted that, before one could make any decisions, scientific research had to be carried out to clearly indicate where the problem was and the extent of it.