Antibiotic Resistance in Ireland — What Patients Need to Know

What is antibiotic resistance?

Antibiotic resistance is when bacteria evolve to survive antibiotics that previously killed them. It is one of the most serious threats to modern medicine. Per the HSE Health Protection Surveillance Centre and WHO, resistance is rising globally — and routine infections (UTI, pneumonia, skin infections) are becoming harder to treat. Without effective antibiotics, common surgeries, cancer chemotherapy, and intensive care become much more dangerous.

Why it matters in Ireland

Per HPSC surveillance data:

• Resistance to first-line antibiotics for common infections has risen significantly over the past 20 years
• Hospital outbreaks of resistant organisms (MRSA, CPE, ESBL E. coli) are tracked and reported nationally
• Around 30% of antibiotic prescriptions in Irish primary care have been estimated as potentially avoidable — meaning the patient would do as well without them
• Reducing unnecessary prescribing reduces resistance pressure

What makes resistance worse

• Unnecessary prescribing — antibiotics given for viral infections, mild self-limiting illness, or "just in case"
• Wrong antibiotic — broad-spectrum used when narrow-spectrum would do
• Not completing a needed course — though for many indications, the modern approach is "shortest effective course" not "always finish 7 days"; follow specific prescription instructions
• Sharing antibiotics or using leftover medication
• Agricultural use — globally, antibiotic use in food animals contributes; Irish and EU regulation is tightening

What patients can do

Per HSE's "Under the Weather" campaign and HPSC guidance:

• Accept that most coughs, sore throats, and ear infections are viral — your Online Doctor isn't "refusing" antibiotics when they say one isn't needed; they're practising good medicine
• Get vaccinated — preventing infection prevents the need for antibiotics. Flu, COVID, pneumococcal, MMR, etc.
• Hand hygiene — reduces infection transmission
• Take antibiotics exactly as prescribed — don't share, don't save for later, don't skip doses, complete the course unless your doctor advises otherwise
• Return any leftover antibiotics to your pharmacy for safe disposal
• Discuss watchful waiting and delayed prescriptions with your doctor — these are evidence-based middle-ground approaches

"Delayed prescription" — the Irish middle ground

For some infections (uncomplicated middle-ear infection, sore throat, sinusitis), the evidence supports a "delayed prescription" approach: a prescription is given but only filled if symptoms have not improved by 48 hours. Per NICE evidence, this approach gives equivalent outcomes to immediate antibiotics for many self-limiting infections while significantly reducing antibiotic use.

When are antibiotics genuinely needed?

Antibiotics are the right answer for many specific infections — and not getting them when needed can be dangerous. Some examples:

• Bacterial pneumonia
• Confirmed UTI with significant symptoms
• Strep throat (when Centor/FeverPAIN scoring suggests bacterial cause)
• Cellulitis (skin infection with redness, heat, swelling, sometimes fever)
• Suspected sepsis — emergency antibiotic treatment
• Confirmed STIs (chlamydia, gonorrhoea, syphilis)
• Bacterial otitis media in young children with specific features

Online Doctor consultation

At Dox on Call, we follow HPSC and ICGP antimicrobial stewardship guidance. We will prescribe antibiotics when they are genuinely needed — and explain clearly when they're not. Where the evidence supports delayed prescriptions or symptom-based reassessment, we'll discuss that with you.