Call to Resist Resistance

Medical experts around the world warn that inappropriate use of Cipro (ciproflaxin) is only one aspect of the growing problem of bacterial resistance to treatment. Much greater are the dangers posed by the general overuse of antibiotics.

In Australia, the country's chief medical officer, Professor Dick Smallwood, says research into the issue is a priority. Dr. John Brooker, associate professor in animal science at Adelaide University, addresses the danger of adding antibiotics to animal foodstuffs, citing the possible transference of antibiotic resistance from animals to humans.

In Ontario, Canada, where new cases of methicillin-resistant staphylococcus rose twentyfold between 1994 and 2000, the province's chief medical officer, Dr. Colin D'Cunha, dedicated his annual report to the problem. He says, "Unless we recognize that antibiotic resistance is a serious problem, we face the prospect of life-threatening illnesses that cannot be effectively treated by any antibiotic."

In November, experts from 33 European Union countries gathered in Brussels for a conference on antibiotic use. It was the launch meeting for the European Surveillance of Antibiotic Resistance (EASC), funded by the European Commission, which will collect and standardize information about antibiotic use in the European Union and other European countries.

Existing data show large variations in antibiotic use across the European Union. Nordic countries consume half as many antibiotics per capita as France, Spain, and Portugal with no damage to public health. But delegates noted that such data are expensive to compile, that methods vary from country to country, and sometimes those methods are not clear.

Delegates proposed developing guidelines for appropriate use of antibiotics and better patient education. They also expressed support for continuing the ban on advertising antibiotics to the public.

The conference coincided with the European Union's adoption of a community strategy against antimicrobial resistance, which it plans to implement by the end of 2002. Magda Aelvoet, Belgium's public health minister, said that "prudent" use of antibiotics is too cautious a term: "What we mean is less use."

The European Federation of Pharmaceutical Industries and Associations doubts the value of such an inventory unless it includes type of antibiotic, dosage, and duration of use. Although EFPIA supports efforts to reduce resistance, it claims that the relationship between consumption and resistance is complex, noting: "Broad reductions in antibiotic consumption may fail to address resistance and may negatively impact patient care. Any such moves should be aimed to improve and optimize use of antibiotics based on sound scientific principles."