Children should be given formal instruction on how to wash their hands to tackle the increasing threat from drug-resistant bacteria, health advisers in England have recommended.
They also called for national and local campaigns to convince the public they can “self-care” their way through conditions such as colds, flu and earache rather than automatically go to GPs or A&E departments.
Draft guidance from the National Institute for Health and Care Excellence (Nice) is aimed at changing behaviour so that vital antibiotics are dispensed more sparingly, after years in which profligate use has allowed bacteria to develop resistance, putting the treatment of some diseases at risk.
People who use the most antibiotics are those aged 16-24 or the over-65s. The younger group misuse the medicines more than anyone else while antibiotic resistance to them is most evident among older people, according to Nice.
Children should be taught about handwashing in schools, said Nice. Lessons should cover where microbes are found and how they spread, and why handwashing is important.
It recommends running tepid water over hands before applying soap, coating the skin thoroughly and rubbing all the hands’ surfaces thoroughly for 10 to 15 seconds and paying particular attention to fingers, thumbs and areas between fingers, before rinsing.
Hand sanitisers should be available if there is no soap and good quality paper towels should be used to dry hands. Teachers should set an example by washing after using the toilet, before eating, before touching the eyes or mouth and after touching an animal.
Universities, too, should raise awareness of the issue among students both online and with posters in appropriate locations.
The proposed measures, out for public consultation, follow the publication of draft guidance to doctors and other health professionals last month when a senior member of Nice said that about one in four prescriptions for antibiotics was unnecessary and patients’ expectations that they would be given them had become entrenched. These had to be dispelled when their conditions did not need such treatment.
The recommendations on how to change the “risk-related” behaviours among the public were commissioned by Public Health England, although the Nice document admits there is often little evidence on which education and information measures would work best.
It particularly bemoans the lack of basic hygiene guidance in the workplace despite the fact 21% of all days lost at work in the UK (27m days a year) are caused by coughs, colds and other infectious diseases.
The guidance says that when people seek medical advice for self-limiting conditions, they should be told how they could treat their symptoms themselves and given verbal and written explanations on why they are not being prescribed antibiotics.
They should also be told GPs and A&E should not be their first port of call and should be encouraged instead to use pharmacies or “reliable” online sites such as NHS Choices.
The experts did however recognise that there were cost considerations for people – because prescribed medicines might be cheaper than over-the-counter ones. For some they were free.
