the cost and use of antibiotics in Bermuda remain reasonable.

And Dr. Richard C. Tilton, president of the North American Laboratory Group in New Britain, Connecticut, yesterday told The Royal Gazette he is looking forward to helping the board develop a more effective "antibiotic utilisation'' plan by the autumn.

Although this is Dr. Tilton's first official visit, he has provided support to King Edward VII Memorial Hospital's Microbiology Laboratory since 1989.

His recent appointment means he will visit the Island four times a year to provide on-going advice to the Microbiology Department.

The appointment resulted from a review, at the request of the board, of the laboratory in 1992, laboratory director Dr. Keith Cunningham said.

The review was conducted by Professor of Histopathology and director of clinical laboratories at Guy's Hospital in London, Professor David Levison, who agreed with the hospital's desire to have "close availability'' of a microbiologist's advice.

Dr. Cunningham said usually major hospitals will have four pathologists on staff.

He noted the two incumbents at the hospital did not include microbiologists.

"So the laboratory felt a need to secure one,'' he said. "In addition to that, with the increasing proliferation of various infections, conditions and number of options for antibiotics, this could be of help both to clinical doctors and the laboratory.'' Dr. Tilton said the hospital, particularly staff in the laboratory, deserved credit for recognising the need for a consultant microbiologist.

"It has far-reaching implications,'' he said. "Usually the microbiology lab and microbiologists identify trends in antibiotic existence before anyone else. They are the gatekeepers.

"There is also a considerable savings by doing things this way.'' Noting that the misuse of antibiotics is "rampant'' worldwide, Dr. Tilton said the hospital is privileged to have a pharmacy "that is on top of things''.

"This hospital has been quite responsible in restricting the antibiotics that are available,'' he said. "This is a major factor in controlling cost''.

Dr. Tilton said Bermuda also has very few problems of antibiotics resistance.

"Some of the antibiotics used here have not been used in the US and Canada for years,'' he said, explaining that this was mainly due to the fact that the Island is geographically isolated.

Careful use of antibodies in Bermuda was also a factor, he added.

"In some countries antibiotics are sold over the counter,'' Dr. Tilton said.

"And some are sold before there is a disease for them to be used against.

"But Bermuda does not have this problem.'' Dr. Tilton said while he cannot guarantee Bermuda will not have a problem with antibiotics resistance 10 years from now, an effective antibiotic utilisation plan will mean savings in the short term because there will not be the need for new antibiotics which tend to be more expensive.

The hospital has already begun to phase in the plan. And a major presentation will be made in the autumn.

Dr. Tilton is expected to return to the Island for the launching of the plan.

He will visit Bermuda for two to three days every three months.

But Hospitals Board executive director Mr. Hume Martin noted that Dr. Tilton will also be available on short notice if the need arises and that "he is only a phone call away''.

The appointment was for a year, but was expected to be renewed, he added.

TEAMWORK PAYING OFF -- King Edward VII Memorial Hospital's new consultant microbiologist Dr. Richard C. Tilton is looking forward to a closer working relationship with those in the hospital's Microbiology Department.