Andrew,
You miss the point.

Firstly I have no idea of your prescribing practice and my second sentence
was typed with my brain very much in gear but driven at the generic GP who
does still give antibiotics to patients (young or old) with URTIs.

Secondly, I am surprised that you feel that the child not having had
antibiotics is relevant. This is precisely the point. He/she caught it off
someone else with MRSA. Do you postulate spontaneous mutation of a pure
growth in a nappy and with no evolutionary pressure? This is why we (note
the person) have been so ill-advised to give sophisticated antibiotics to
patients with viral URTIs. This month a child with MRSA in his nappy rash.
Next month my child with it in his lungs.

Don't take this personally. We should all share the blame for your patient
with MRSA pneumonia. But we must stop now or face the microbiological
consequences. We must resist the urge to give out antibiotics not just in
children but in everyone with viral URTI.

[log in to unmask]

-----Original Message-----
From:	[log in to unmask] [mailto:[log in to unmask]] On
Behalf Of Andrew Herd
Sent:	08 June 1998 21:48
To:	[log in to unmask]
Subject:	RE: MRSA on nappy rash

Curiously, as medical adviser to Durham HA, I did read the Lords enquiry,
having nothing better to do than look after a 64 million quid budget for two
days of my week.

Since I can't ever remember you auditing my prescribing practice, your
second sentence must have been typed with your brain out of gear. I have
always been able to supress the urge to give out anitbiotics to children
with viral infections. I dimly remember learning about it at medical school,
or somewhere like that.

The child had not had antibiotics for two years, and then not for a viral
URTI, and appears to have had no MRSA contact.

A

> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Dr L Russell
> Sent: 08 June 1998 18:17
> To: [log in to unmask]
> Subject: RE: MRSA on nappy rash
>
>
> Ever read the House of Lords enquiry into antibiotic usage? If so, do you
> still want to give them to patients with viral URTIs? I'm afraid it's our
> fault that we've got these multi-resistant strains. The better the
> antibiotic, the less it should be used. Some should be banned in GP.






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