Intensive care patients in South African hospitals are increasingly given the wrong type of antibiotic - which in turn is fuelling the spread of lethal superbugs.
The UK's most senior medical adviser last week called for superbugs to be classified on the country's national risk register for civil emergencies with other hazards such as terrorist attacks and coastal flooding.
An audit commissioned by the Critical Care Society of South Africa involving 248 intensive care unit patients, published in the SA Medical Journal last year, highlighted the urgent need to monitor antibiotic use in South Africa.
Professor Fathima Paruk, director of the university's cardio-thoracic ICU and lead author of the survey, said the results confirmed widespread fears of the abuse of antibiotic drugs. "We have reached a crisis point because there are times when some of the bugs that we isolate from our patients are resistant to most, if not all, available antibiotics.
"Drastic measures are necessary to curtail the irrational use of antibiotics... We believe that it is ethically justifiable to consider restricted use of antibiotics and the application of punitive measures for those failing to comply."
The survey of patients in every adult and paediatric ICU ward - both public and private - in South Africa found that more than half had not only received the wrong drugs, but they had been used incorrectly.
This week the Sunday Times found that:
- Health authorities have raised the alarm about new superbugs, including relatively harmless bacteria that become lethal after coming into contact with an enzyme called NDM-1;
- NDM-1 was linked to four hospital deaths in Gauteng last year and other patients were found to have it;
- Other superbugs on the increase include Clostridium difficile, which attacks the stomach. It kills about 14 000 people annually in the US;
- Health professionals have warned of the emergence of total drug-resistant tuberculosis (TDR-TB), another superbug that has been likened to "airborne cancer"; and
- Faced with a potentially disastrous outbreak of drug-resistant TB, the Medicines Control Council has authorised the use of a controversial drug yet to be officially registered in South Africa - bedaquiline - which is regarded as the last line of defence against dome TB superbugs.