Super bugs

Antibiotics for colds

In France, resistant germs have it easy. Because patients want antibiotics when they have a cold – and doctors oblige. But there are first signs of improvement.

von Annika Joeres

© Ivo Mayr

Parents who refrain from administering antibiotics to their coughing children are often regarded as unreasonable in France. „Haven’t you seen a doctor? He will prescribe you something“, fellow parents keep saying at kindergarten. For many French people it is just natural to administer antibiotics to coughing children, elderly people who have a cold, or adults who incurred a flu. Physicians who do not rely on antibiotics usually acquire a bad name.

It is, therefore, quite easy for germs to develop resistances against antibiotics in France. Various European studies rank France, next to Greece, among the worst European countries: According to a study conducted by the European Centre for Disease Prevention and Control, five packages of antibiotics per thousand inhabitants are being prescribed outside hospitals every day. This is almost twice as often as the EU average.

This is a reason why France had problems with superbugs earlier than other countries. Superbugs are bacteria that are resistant against numerous antibiotics. For 15 years, doctors and ministers of health have periodically been warning about the problem. But still, France is among those countries in the EU where the number of resistances is significantly increasing. MRSA (Staphylococcus aureus resistant to methicillin and mostly other drugs) might have been declining. Other germs, however, like Escherichia coli or Klebsiella pneumoniae develop more and more resistances against the substances of antibiotics. Escherichia coli, for example, was found to have developed three times more resistances in 2013 than ten years before – more than 50 percent of these pathogens, therefore, have ceased to react to classic antibiotics. When it comes to the pathogen Klebsiella, resistances increased from eleven to 25 percent during the same period of time.

There is one advantage France has in comparison to other countries, though: It cultivates an open approach when it comes to its problems with antimicrobial resistances. Just a few months ago, the government published a report blaming multi-resistant bacteria for 12,500 deaths.

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The problem is well known and has been widely discussed. Since 2002 already, health authorities have tried to sensitise doctors and patients. Every winter, when many children and adults are suffering from colds, flu-like infections and ear infections, the statutory health insurance issues spots in TV and radio in order to raise awareness. The slogan says: “antibiotics do not help automatically.“ As a consequence, doctors ought not to prescribe them systematically as well.

The campaign has paid back a little. According to a recent investigation run by the national administrative authorities controlling public health, consumption of antibiotics decreased for the first time by two percent between 2013 and 2014. After  years of continuous increase, this can be considered a first, small success.

At least, the highest public health authority in France is putting pressure on private and public hospitals. Once a year their officials visit every hospital for a week. They analyse blood and urine samples and observe everyday life on the wards. This way, every citizen is able to look for their hospital on the webpage „scope-santé“ and see which mark it got in the valuation. There is also a report listing all the deficiencies of the hospital. For example, it lists cases in which surgical instruments were disinfected insufficiently, or where relatives were not informed adequately.

The examiners also assess whether the staff uses enough disinfectants and gloves. When treating a patient in the intensive care unit, for example, employees have to disinfect their hands about forty times a day. A high number, which French clinics gradually start reaching. The past ten years saw an increase from fifty to eighty percent of the required disinfections. Some hospitals, however, received a „red“ and, therefore, worrying, valuation. Their employees disinfected their hands half as often as it is required. France has a lot to do if it really aims at fighting superbugs earnestly.