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Surge in antibiotic eye-drop use 'harming infection control'

By Lilian Anekwe

Efforts to control resistant infections in primary care are being undermined by a huge surge in use of chloramphenicol eye-drops since the drug became available over the counter.

Pharmacy sales have soared to almost one million a year since the drug regulator reclassified chloramphenicol in June 2005, while GP prescriptions have remained virtually unchanged, a Pulse investigation reveals.

Overall use of chloramphenicol has soared by 60% in just three years. A former adviser to the Medicines and Healthcare Products Regulatory Agency warned its decision to switch chloramphenicol OTC was ‘deplorable' and would fuel antimicrobial resistance.

Figures provided to Pulse by Cegedim Strategic Data show GPs issued an average of 1.6 million prescriptions for chloramphenicol per year between November 2003 and October 2005, and just over 1.5 million a year since then.

But figures supplied by market analyst Information Resources UK reveal chloramphenicol sales have taken off dramatically, with just over a million doses sold in the year to November 2008.

The revelation is likely to fuel the growing controversy surrounding the drive to make antibiotics available over the counter, after warnings from infectious disease experts that the current consultation to switch trimethoprim OTC was ‘purely commercially driven'.

Professor Hugh McGavock, visiting professor at the University of Ulster and a former adviser to the MHRA on the safety of medicines, said its decisions on OTC antibiotics were ‘madness'.

‘Chloramphenicol is one of the drugs of last resort when people have an infection in hospital, simply because it is a very toxic drug given systemically.

‘I left the MHRA in disgust. It kept making more and more drugs over the counter and refused to put restrictions on some very important antibiotics, and allowed them to be used the community when they should have been reserved for hospital only.

Dr David Harniess, a GP in Eccles, Salford, said: Ninety percent of the time eye infections are viral, so antibiotics – whether prescribed or sold over the counter – are being given inappropriately. For that reason I am still cautious and would rather it was in the GP domain.'

The MHRA made chloramphenicol an OTC medicine in June 2005 after a public consultation, claiming the ‘benefits outweighed the risks'.

Surge in use of antibiotic eye drops since decision to make them OTC is harming efforts to control resistant infections Surge in use of antibiotic eye drops since decision to make them OTC is harming efforts to control resistant infections

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