Norway’s solution: Stop taking so many antibiotics

January 2010

OSLO, Norway (AP) — At Norway’s hospitals, there is no sign of a dangerous and contagious staph infection that killed tens of thousands of patients in the most sophisticated facilities of Europe, North America and Asia last year.

The reason: Norwegians stopped taking so many drugs.

Twenty-five years ago, Norwegians were also losing their lives to this bacteria. But Norway’s public health system fought back with an aggressive program that made it the most infection-free country in the world. A key part of that program was cutting back severely on the use of antibiotics.

Now a spate of new studies from around the world proves that Norway’s model can be replicated with extraordinary success, and public health experts are saying these deaths — 19,000 in the U.S. each year alone, more than from AIDS — are unnecessary.

“It’s a very sad situation that in some places so many are dying from this, because we have shown here in Norway that methicillin-resistant Staphylococcus aureus (MRSA) can be controlled, and with not too much effort,” said Jan Hendrik-Binder, Oslo’s MRSA medical adviser. “But you have to take it seriously, you have to give it attention, and you must not give up.”

The World Health Organization says antibiotic resistance is one of the leading public health threats on the planet. A six-month investigation by the Associated Press found overuse and misuse of medicines has led to mutations in once curable diseases like tuberculosis and malaria, making them harder and in some cases impossible to treat.

Now, in Norway’s simple solution, there’s a glimmer of hope. The Scandinavian country’s model is surprisingly straightforward:

Norwegian doctors prescribe fewer antibiotics than doctors in any other country, so people do not have a chance to develop resistance to the drugs.

Patients with MRSA are isolated, and medical staff who test positive stay at home.

Doctors track each case of MRSA by its individual strain, interviewing patients about where they’ve been and who they’ve been with, testing anyone who has been in contact with them.

Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections.

“We don’t throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better,” said infectious disease specialist Dr. John Birger Haug.

Forty years ago, a new spectrum of antibiotics enchanted public health officials, quickly quelling one infection
after another. In wealthier countries that could afford them, patients and providers came to depend on antibiotics.

Trouble was, the more antibiotics are consumed, the more resistant bacteria develop.

Norway responded swiftly to initial MRSA outbreaks in the 1980s by cutting antibiotic use. Thus, while they got ahead of the infection, the rest of the world fell behind.

In Norway, MRSA has accounted for less than 1 percent of staph infections for years. That compares with 80 percent in Japan, the world leader in MRSA; 44 percent in Israel; and 38 percent in Greece.

Cases have soared in the U.S., and MRSA cost $6 billion last year. Rates have increased from 2 percent in 1974 to 63 percent in 2004.