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OTHER ITA SITES:
PR Stunts Don't Impress The Superbug
A junior doctor has said that attempts to wipe out the superbug are nothing more than a government PR exercise. Max Pemberton, writing in his Daily Telegraph column, described recent policies as no more than an attempt to reassure the public, with no actual clinical worth.
“Under the dress-code policy rolled out in hospitals last month, doctors are not allowed on to a ward wearing a coat or outer garment, and they must have their shirt sleeves rolled up to their elbows, with no watches or other jewelery,” wrote Dr Pemberton. “This purports to be an attempt to reduce hospital-acquired infections being spread by staff.”
“No one would question the importance of hand washing in clinical settings. But as doctors, we are encouraged to practise evidence-based medicine, so I would expect there to be some evidence that a blanket ‘bare below the elbows’ policy works,” he added. “It’s meaningless, a waste of time and money, and it won't help make hospitals any safer.”
But if these measures are useless, then what measures can be taken to reduce infections that are becoming an increasing problem in our hospitals? It has been claimed that infections kill at least 5,000 people in UK hospitals every year, and a recent survey showed that one in five people who contract MRSA are dead within a year. It is clearly a serious problem, yet despite the huge amounts of publicity given to the issue little progress seems to have been made.
Back in 2005 the Office for National Statistics recorded 1,629 deaths as a result of MRSA – a big increase on the years before. It did not feel that this was necessarily the result of hospitals getting dirtier though, and instead, said that the main reason for the sudden upturn was: “improved levels of reporting, possibly brought about by the continued high public profile of the disease.”
Skip forward a couple of years and Health Secretary Alan Johnson was putting infection at the top of his priority list. Speaking last November he vowed to ‘fight infection on the front line,’ and launched a range of measures to combat the bug.
“To ensure patients' safety I want a regulator with the power to close, clean and then re-open wards if necessary,” he said. “This tough regime will not just apply across the NHS but in the private sector as well.”
It is hard to believe that hospitals are genuinely dirtier than they were thirty or forty years ago though. It may be good PR to introduce more matrons and remove doctor’s wrist watches, but it this really going to see off a superbug?
The answer may come in reducing the amount of antibiotics that doctors use. MRSA great danger is that it is unaffected by many types of antibiotics, and that the delay in finding an effective treatment gives a patient the time to get seriously sick. MRSA was first discovered in 1961, about the time that penicillin use began to become almost ubiquitous.
“In the old days, before we had problems with resistance, people thought it really didn't matter - you could throw antibiotics at these cases and you would pick up the odd one that was treatable that way,” said Dr Mark Enright, an MRSA expert at Imperial College London.
Johnson has ordered GPs to cut back on the amount antibiotics dolled out to patients, and many doctors support his move.
“The use of antibiotics have saved countless lives, but antibiotics do not work on most coughs, colds and sore throats and their unnecessary use can leave the body susceptible to gut infections like Clostridium difficile ,” said Johnson recently. He will hope that his latest move proves more successful than his previous ones.
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