The Finnish health authorities may have a simple remedy to the "superbug" threat don't hand out so many antibiotics.

Scientists are fearing that we could be breeding a new strain of bug that is resistant to antibiotics because they have been so overprescribed.The Finns were faced with just this problem in the early 1990s. They found that group A streptococci, a virulent infection that is spreading around the world, was becoming resistant to erythromycin, used for people who are allergic to penicillin.

Their health authority issued nationwide recommendations to reduce the use of macrolide antibiotics among outpatients with respiratory and skin infections. As a result, usage of the antibiotics fell from 2.4 daily doses per 1000 people in 1991 to 1.38 daily doses the following year.

This change almost halved the level of erythromycin resistant group A streptococcal bugs from 16.5 per cent in 1992 to 8.6 per cent in 1996. Researchers from the National Public Health Institute in Helsinki had isolated nearly 40,000 examples of the bug from throat swabs and pus samples to test their susceptibility to the antiobiotic (N Eng J Med 1997; 337: 441-6).

Antibiotics are being over prescribed for treating sore throats. They are only marginally better than giving nothing at all, researchers from the University of Southampton have discovered.

Complications from sore throat are rare in patients, even in those not given antibiotics, the researchers point out. Doctors should avoid or at least delay the prescribing of antibiotics unless they are faced by a patient who is very ill (BMJ, 1997; 315: 350-2).

For more information on antibiotics see WDDTY vol 2, no 2, and vol 8, no 1.