GPs miss vital antibiotic shot

By MARTIN JOHNSTON

Too few GPs are giving antibiotic injections to patients suspected of having meningococcal disease, the Auckland District Health Board says.

In its latest Public Health Quarterly Report it said 214 people were admitted to Auckland hospitals with the potentially fatal disease in the 12 months to April 30 last year.

GPs referred 111 of them who matched the Health Ministry guidelines for a pre-hospital antibiotic injection, but only 33 had received an injection.

The guidelines advise GPs to give injections to all patients who have a particular type of rash, and in all other suspected cases 30 minutes or more away from hospital.

The report said antibiotics might not have been given because:

* The disease had vague symptoms early on, when GPs are commonly involved.

* There was misguided concern that antibiotics would compromise laboratory diagnosis.

* GPs assumed - wrongly - that patients would be treated quickly in hospital; and

* There was a fear of unnecessary treatment.

"Minimal harm can be expected if an antibiotic is given and meningococcal disease is not confirmed," it said. "A high index of suspicion and low threshold for treatment are needed."

Since New Zealand's epidemic of the disease began in 1991, more than 4700 people have contracted it, 200 people have died and hundreds have been left seriously disabled.

Herald feature: Health