Timely dosing and a body wash may help

Antibiotic resistance is not new – resistance genes have been found in 700 year old faeces!

But WHO state resistance is a major issue in healthcare today. In their Policy Paper, Ontario Medical Association state that antibiotic resistance results in infections being more severe, of longer duration and higher mortality, as well as longer hospital stays and more aggressive treatments with expensive “third-line” antibiotics. This means increased healthcare costs.

Judicious antibiotic use and banning of antibiotics as growth-enhancers in animals are essential. But additional measures are needed.

One new proposal is to change the timing of antibiotic dosing. In a recent paper, Meredith et al used computer modelling to determine that the timing of dose, relative to a bacteria’s recovery, may allow the bacteria to be killed before its production of beta-lactamase can begin.  If successful, it means first-line “old fashioned” antibiotics can still be used.

At last week’s SHEA meeting, a second novel method was proposed. McKinnell et al showed chlorhexidine (CHX) body wash can reduce colonization with MRSA. Compared to MRSA ‘Contact isolation’, they found CHX had fewer MRSA contamination events. Also, the authors argued that CHX use may result in a higher quality of care compared to isolation.

In another life (almost 40 years ago!), I researched the effect of whole-body CHX bathing on the normal flora of patients pre-operatively and concluded in a book chapter, “The course that is apparent is a return to the early concept of ‘total body’ reduction of Staphylococcus aureus carriage..” Goes to show – if you live long enough…:)