The National Antibiotic Committee is drafting guidelines for health professionals on the appropriate use of topical antibiotics, the Health Ministry said yesterday after The Times revealed several cases of antibiotic creams being sold without a prescription.

“The committee has been working on guidelines on topical antibiotics for some time … It is hoped that publishing the guidelines will further enhance the appropriate use of topical antibiotics,” the ministry said.

Awareness campaigns for health professions and the public on the use of antibiotics had been carried out on a number of occasions over the past few years.

The ministry said it was concerned about the high local usage of fucidic acid creams, such as Fucidin and Fucicort, which is considered as being the possible cause of a new strain of an antibiotic-resistant bacterium, known as MRSA, which, so far, has only been reported in Malta.

This link was highlighted in a study carried out by a university student. The study was done as part of her medical laboratory sciences degree supervised by antibiotic committee chairman Michael Borg.

With Malta having one of the highest levels of use of fucidic acid cream, Dr Borg has urged doctors to go slow in prescribing it, saying it was “vital” for pharmacists not to dispense it without a prescription.

However, an exercise carried out by The Times this week found that seven out of eight pharmacies were ready to sell Fucidin without a prescription – of these one actually offered another cream of higher strength. Only one refused to sell.

The sale of antibiotics without a prescription is illegal and carries serious penalties. If found guilty by the Superintendence of Public Health, who is the licensing authority, a pharmacist can be slammed with a fine of €9,317, as listed in the Medicines Act. If the pharmacist refuses to pay the fine, then the matter ends up in court and, if again found guilty, he or she could be fined between €4,658 and €46,587, or face a maximum of three months in prison or be punished with both a fine and imprisonment.

The health ministry pointed out that the Medicines Act clearly stipulated which medicines should be sold against a prescription.

“It is to be noted that action in accordance with the provisions laid down in the Medicines Act is taken by the Health Department on all cases where such reports, backed by the appropriate evidence, are received,” the ministry said.

Mary Anne Sant Fournier, president of the Chamber of Pharmacists, was asked to react to the fact that seven out of eight pharmacies were prepared to sell Fucidin and to suggest what action might be taken to remedy the situation.

“The Chamber is concerned at the escalating present consumer approach to medicines use, where medicines are considered ordinary items of commerce, which they are not,” she said.

“It is the Chamber’s conviction that a concerted effort by all involved – doctors and pharmacists as independent healthcare professionals, and patients – would go a long way to circumvent the present evolving situation.”

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