Trials done in over 7,000 people prove conclusively that antibiotics could prevent deaths in intensive care units, but many hospitals aren't using them because of unproven fears that it might increase antibiotic resistance.
According to Professor Alessandro Liberati, the author of the new article, mortality rates in intensive care units can be as high as 50%. "Even people who were healthy until they were in a bad accident are at risk of dying of an infection contracted in the intensive care unit. Antibiotics could prevent thousands of infections every week, and save the lives of one in every 23 people in ICUs," said Professor Liberati. "That would amount to thousands of lives saved every year around the world."
Professor Liberati explains that a review of trials, updated this year by his team, shows that 36 trials together have proven the value of antibiotics in preventing infections and deaths. But many ICUs don't use the drugs because of fears that doing so will lead to uncontrollable outbreaks of antibiotic-resistant infections in their units.
However, Professor Liberati says this fear is not based on reliable evidence. "There is no evidence that this would cause more antibiotic resistance. So far it appears to be more a possibility than a published fact," he says in the article published today for consumers at Informed Health Online. "A large European trial carried out in the Netherlands published late in 2003 was specifically designed to study the risk of antibiotic resistance. It is included in our review. Its result did not show an increase in resistance. But it is still important to establish a close monitoring system at least in the intensive care units that use this treatment." He called for more research to be done to settle the question about antibiotic resistance in ICUs.
Hilda Bastian, the editor of the consumer web site, Informed Health Online, called on hospitals and health safety agencies to act. "Hospitals and health authorities should either implement drug policies that will save lives from hospital-acquired infections in intensive care units, or produce research to show why withholding this treatment is justified," she said.
A summary for consumers of the meta-analysis of the 36 trials was published today by Informed Health Online. Professor Liberati and Informed Health Online have also produced a detailed article for the public, which explains the science behind the research in detail. Editor Hilda Bastian said that Professor Liberati's article could help people understand why a treatment that has been proven to save lives isn't used.
Professor Liberati expressed concern at the under-use of antibiotics to prevent deaths in intensive care: "This is I think where the role of consumers becomes very important in ensuring that effective treatments get used."