pdf: Huge rise in MRSA linked with childhood antibiotics: anti-staphylococcal drugs for skin conditions has soared by 64% in ten years in UK

[Guest guest]

*/Huge rise in MRSA linked with childhood antibiotics/*

06 Apr 10

By Lilian Anekwe

http://www.pulsetoday.co.uk/story.asp?storycode=4125642

Study link <http://www.cdc.gov/eid/content/16/3/530.htm>

A dramatic rise in the prescription of antibiotics for childhood skin

infections has been linked with a surge in GP consultations and hospital

admissions for serious MRSA infections.

An analysis of UK primary care data found GP prescribing of

anti-staphylococcal drugs for skin conditions has soared by 64% in ten

years.

Over the same period GP consultations for skin infections rose by 19%

and hospital admissions for Staphylococcal aureus increased by 49% - a

relationship the UK authors said was unlikely to have arisen 'by chance'.

Researchers analysed data drawn from a database of 500 GP who contribute

clinical data on more than a million patients between 1997 and 2006, and

counted prescriptions for all oral and topical antibacterial drugs

prescribed for skin infections.

Prescriptions for oral flucloxacillin were taken as a proxy measure for

'unresolved S. aureus skin infections'.

GP consultation rates for all skin conditions in children rose between

1997 and 2006, from 128.5 per 1,000 child-years to 152.9 per 1,000

child-years -- a 19% increase. At time same time there was a 64%

increase in prescribing rates for flucloxacillin, from 17.8 to 29.1 per

1,000 child-years.

But consultation rates for atopic eczema decreased during this time,

which researchers argued proved the rise was not due to severe

complications of other skin conditions but for more invasive infections.

Over the same period prescribing of all other antibacterials in children

decreased by 11%, from 541.4 to 484.3 per 1,000 child-years, while

prescribing rates for amoxicillin, clavulanic acid and fusidic acid

changed by only 2%. Flucloxacillin was the most commonly prescribed

antibacterial drug, representing 37% of all prescriptions.

Lead researcher Dr Saxena, consultant senior lecturer in primary

care and a GP in Putney, London, said: 'The increasing incidence of

childhood skin infections and prescribing of the major

antistaphylococcal drug flucloxacillin, coupled with concurrent

increases in childhood hospital admissions for skin, bone and joint

infections caused by S. aureus, suggests an increase in community-onset

S.aureus disease in England over the past ten years.'

She told Pulse: 'I think that this is a true trend. The implications are

that that GPs should be vigilant that Staph aureus is potentially

serious and does have serious complications. They should not be

prescribing topical agents or recommending over the counter topicals

like Fucidin. These are ineffective and likely to make the condition worse.

'The rise in flucloxacillin prescribing, coupled with the prescribing of

drugs that are not appropriate, means infections persist and become more

serious and could be spread in the community.'

Dr Tim , a GP with an interest in dermatology in Bristol, said:

'I think flucloxacillin is a good antibiotic. The man problem with skin

infections like impetigo is that there might be a resistance problem

with Fucidin, and other agent may not be as a effective. Flucloxacillin

has always been put forward as a good option. We don't have a really

good alternative, which is a problem.'

The study was published in the March issue of Emerging Infectious

Diseases <http://www.cdc.gov/eid/content/16/3/530.htm>.

*/<.>

/*