Another tactic, if counter-intuitive (or maybe not), in the never-ending war on MRSA*: stop giving out so many damn antibiotics:
Norway’s model is surprisingly straightforward.
• Norwegian doctors prescribe fewer antibiotics than any other country, so people do not have a chance to develop resistance to them.
• Patients with MRSA are isolated and medical staff who test positive stay at home.
• Doctors track each case of MRSA by its individual strain, interviewing patients about where they’ve been and who they’ve been with, testing anyone who has been in contact with them.
Haug unlocks the dispensary, a small room lined with boxes of pills, bottles of syrups and tubes of ointment. What’s here? Medicines considered obsolete in many developed countries. What’s not? Some of the newest, most expensive antibiotics, which aren’t even registered for use in Norway, “because if we have them here, doctors will use them,” he says.
He points to an antibiotic. “If I treated someone with an infection in Spain with this penicillin I would probably be thrown in jail,” he says, “and rightly so because it’s useless there.”
But can Norway’s program really work elsewhere?
The answer lies in the busy laboratory of an aging little public hospital about 100 miles outside of London. It’s here that microbiologist Dr. Lynne Liebowitz got tired of seeing the stunningly low Nordic MRSA rates while facing her own burgeoning cases.
So she turned Queen Elizabeth Hospital in Kings Lynn into a petri dish, asking doctors to almost completely stop using two antibiotics known for provoking MRSA infections.
One month later, the results were in: MRSA rates were tumbling. And they’ve continued to plummet. Five years ago, the hospital had 47 MRSA bloodstream infections. This year they’ve had one.
“I was shocked, shocked,” says Liebowitz, bouncing onto her toes and grinning as colleagues nearby drip blood onto slides and peer through microscopes in the hospital laboratory.
In Ontario, at least, provincial efforts to control the spread of MRSA focus on identifying and isolating patients with MRSA in health care facilities, and providing best practice guidelines for hospitals and health care professionals. Maybe a rethink of the paradigm is needed?
*Methicillin-resistant Staphylococcus aureus. Particularly nasty and highly communicable. And kills lots of people — 2600 a year in Canada is one figure I’ve heard, but I can’t find any official figures, yet.