House of Lords

Session 1997-98 Publications on the internet Science and Technology Committee Reports

Science and Technology - Seventh Report Here you can browse the report together with the Proceedings of the Committee. The published report was ordered by the House of Lords to be printed 17 March 1998.

CONTENTS Paragraph CHAPTER 1 INTRODUCTION 1.1 What is resistance? 1.7 Clinical resistance 1.10 Cross-infection 1.14 The international dimension 1.15 Hospital infection 1.16 Does antibiotic resistance matter? 1.19 Can resistance be controlled? 1.31 Acknowledgements 1.42 CHAPTER 2 PRUDENT USE IN HUMAN MEDICINE 2.1 Present use in the United Kingdom 2.3 Towards more prudent use 2.8 Formularies, policies and guidelines 2.10 Rapid testing 2.16 Prescription checking and control 2.19 Pharmaceutical licensing 2.23 Pharmaceutical salesmanship 2.24 Over-the-counter (OTC) antibiotics 2.26 Medical education: undergraduate, postgraduate and vocational 2.31 Continuing professional development 2.32 Audit and feedback 2.34 Educational outreach 2.35 Educating the public 2.36 Are antibiotics bad for you? 2.40 Compliance 2.46 CHAPTER 3 PRUDENT USE IN ANIMALS 3.1 Animal medicines 3.3 Growth promoters 3.5 Human health concerns 3.7 Salmonella 3.15 Campylobacter 3.18 Enterococci 3.20 E. coli 3.25 Swedish experience 3.27 US experience 3.30 Licensing regime 3.31 Aquaculture 3.33 Uses of antimicrobial agents on plants 3.34 Sheep: worms and scab 3.36 Antibiotic-resistance marker genes in genetically-modified organisms 3.42 CHAPTER 4 INFECTION CONTROL 4.1 Infection control in hospitals 4.2 Infection control teams 4.3 Contracting for infection control 4.7 Hygiene 4.9 Isolation 4.12 Overcrowding and "hot-bedding" 4.13 Agency staff 4.16 Screening 4.17 Training 4.19 Infection control in the community 4.20 Power to enforce treatment 4.26 Surveillance 4.27 Infection control in prisons 4.29 Costs and benefits 4.30 A national MRSA strategy? 4.35 CHAPTER 5 SURVEILLANCE 5.1 Duty to report 5.2 Scotland and Northern Ireland 5.7 Information technology 5.10 Linking and feedback: the ICARE model 5.11 Resources for the PHLS 5.14 Crisis in clinical academic microbiology 5.15 A national strategy for surveillance 5.18 CHAPTER 6 NEW DRUG DEVELOPMENT 6.1 How hard is industry trying? 6.2 Licensing: fast-tracking and "orphan drug" designation 6.5 CHAPTER 7 VACCINES 7.1 HIV 7.3 Meningococcus 7.4 TB 7.5 Streptococcus pneumoniae (pneumococcus) 7.6 Hospital infections 7.7 Barriers and bottlenecks 7.8 Surveillance for antigenic variation 7.10 Research 7.13 CHAPTER 8 ANTIVIRAL DRUGS 8.1 Prudent use of antivirals 8.4 Surveillance 8.6 Research 8.8 CHAPTER 9 INTERNATIONAL 9.1 World Health Organization 9.3 Malaria 9.6 New drugs 9.9 Prudent use of drugs 9.12 Infection control and vaccination 9.13 Surveillance 9.14 Research 9.15 CHAPTER 10 RESOURCES FOR RESEARCH AND DATA-COLLECTION 10.1 Research into different ways of using antibiotics 10.2 Research into strategies of professional and public education 10.3 Collection of prescribing data 10.4 Research into infection control 10.8 Collection of denominator data for disease surveillance 10.9 Surveillance beyond the hospital 10.11 Research into systems of surveillance 10.14 A funding gap? 10.15 CHAPTER 11 CONCLUSIONS AND RECOMMENDATIONS 11.1 CHAPTER 12 SUMMARY OF RECOMMENDATIONS 12.1 APPENDIX 1  Sub-Committee I APPENDIX 2  Witnesses APPENDIX 3  First visit to PHLS HQ APPENDIX 4  Second visit to PHLS HQ APPENDIX 5  Visit to King's College Hospital APPENDIX 6  Visit to USA APPENDIX 6 (contd.)  Visit to USA APPENDIX 7  Some important antimicrobial agents APPENDIX 8  Glossary APPENDIX 9  Acronyms References to evidence Q refers to a question in oral evidence; p refers to a page of written evidence. All the evidence is printed in a separate volume, HL Paper 81-II, Session 1997-98.

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