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Friday, 17 March, 2000, 00:23 GMT
Bad prescribing boosts baby bugs

Premature babies are often given antibiotics
Using the wrong antibiotics in intensive care baby units means they are more likely to get harder-to-treat bugs, say researchers.

Premature babies are naturally vulnerable to infections because their immune systems are not yet fully developed.

These can be picked up during birth as bacteria frequently live in the mother's birth canal.

And if the baby has to spend a long time in an intensive care unit - as many very premature babies do - then it may develop other infections involving bacteria which live on its skin, or elsewhere in the ward.

It is still standard practice for intensive care doctors to automatically prescribe antibiotics to babies to prevent them developing these potentially serious infections.

Premature babies are vulnerable to infection
However, research published in The Lancet compared two neonatal intensive care units in the Netherlands, with very different antibiotic prescribing policies.

One used a "broad spectrum" antibiotic, which targets several harmful bacteria - the other used antibiotics which attacked only the particular type of bacteria associated with neonatal intensive care infections.

Many units still use the "broad spectrum" antibiotics as a standard treatment.

Resistant bugs

When babies were tested for the presence of bacteria on their skin six months later, the researchers found huge numbers of antibiotic-resistant bacteria on those in the "broad spectrum" clinic.

If these were to cause an infection, it would be far harder to treat with conventional antibiotics, and the number of drugs suitable for babies is lower than those suitable for adults.

Dr John McIntyre, an expert in neonatal intensive care at Derbyshire Children's Hospital, said that using "catch-all" antibiotics was steadily falling out of favour with doctors.

He said: "This is very good information which reinforces the decision to switch to other kinds of antibiotics.

"That is the policy in our unit, and we have been able to steer clear of serious drug-resistant infections.

"This study should drive home the message."

The problem of antibiotic-resistant bacteria are a serious problem in many hospitals.

Their development has been blamed on the over-use of antibiotics.

Strains of common bugs which are vulnerable to those antibiotics have been killed, leaving only those with inbuilt resistance to live on and multiply.

Eventually, new generations of bacteria carry varying degrees of resistance to more than one, or even several antibiotics, meaning that far larger doses have to be used - or that the drug is completely ineffective.

One of the most common bacteria which has developed resistance in the hospital environment is Staphylococcus Aureus, a bacteria which can live naturally on the skin of humans.

Methycillin-Resistant Staphylococcus Aureus (MRSA), named after its resistance to a well-used hospital antibiotic has been blamed for thousands of deaths of weakened hospital patients.

However, doctors are fearful that drug resistance may be spreading to more serious infections such as tuberculosis, a respiratory infection treated with powerful antibiotics.

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