WHEN suffering from a sore throat, a cough or a persistent cold, we make an appointment with our GP, hoping for a magical cure that will make it all go away.

More often than not we would automatically expect some form of antibiotic to send the ailment on its way.

But today one of Southampton's leading GPs had spoken of how over-use of antibiotics is one of the main contributory factors to the surge in E.coli superbug infections in the area, which has killed 29 people in one year alone.

Almost 1,000 cases of E.coli superbug infections were confirmed in the area up to early 2005. Last year alone nearly 360 cases were diagnosed.

An investigation by the Health Protection Agency (HPA) and Southampton University Hospitals NHS Trust, which runs the city's three hospitals, looked at a single strain of infection first recognised in 2003.

They discovered 998 confirmed cases in the area up to early 2005.

In 2004, which saw a large number of cases of the infection, 357 were hospitalised and 29 patients died.

These details were contained in the annual report by the government's chief medical officer Sir Liam Donaldson.

In the report Sir Liam blames the large increases in infections on antibiotic-resistant strains of E.coli occurring around the city.

Dr David Paynton, chairman of the executive committee for Southampton City Primary Care Trust and a local GP, said the number of cases of the extended-spectrum, beta-lactamase (ESBL)-producing E.coli infections - the majority of which are acquired in the community - was largely due to the over use of antibiotics.

"The key message we must get across is the importance of only using antibiotics carefully and selectively," he said.

"There is a lot of pressure from patients for antibiotics for all sorts of reasons from coughs and colds, sore throats and all kinds of things.

"People automatically expect antibiotics for these sorts of things.

"GPs will prescribe them when clinically necessary but will try not to if they are of limited value."

"Incidence has dropped in Southampton. How much of that is due to developing good practices is difficult to say but the big message is that we should only be using antibiotics where absolutely necessary."

Dr Paynton explained that we all have bacteria living in and on our bodies, but E.coli is a drug-resistant bacteria.

"Antibiotics will destroy the healthy bacteria and allow the drug-resistance ones to multiply, which can lead to developing this infection," he said.

E.coli are common bacteria that normally live harmlessly in the gut.

But sometimes they can lead to problems such as urinary tract infections, and, more seriously, blood poisoning.

The Southampton study found that 86 per cent of cases were urinary infections and five per cent were blood infections.

Patients at particular risk include the elderly and those with chronic disease or a weakened immune system.

Dr Paynton added that the superbug is also linked to older people with long-term catheters.

"Essentially catheter users have a foreign body in the bladder that itself can become a focus for infection," he said.

"Long term catheter users are already at risk of urinary tract infections - E.coli will increase that risk."

Dr Paynton added that GPs are also being encouraged to test patients suffering from urinary tract infections for the E.coli superbug.

"Where possible, before treating a patient for a urinary tract infection, we are encouraging GPs to send a sample to the laboratory. That would normally take 48 hours to come back and all surgeries have the facilities for doing it," he said.

"We would normally treat the patient for the infection and review it after we get the culture back to check if we are using the right antibiotic."

Sir Liam's report said that to address the serious problem, which has also been identified elsewhere in the UK, infection control services in Southampton had reinforced general infection control measures and amended antibiotic policies.

"Despite these measures control has not yet been achieved," he said.

The HPA said that the problem of ESBL-producing E.coli infections was not unique to Southampton.

A spokesman said: "This infection is widespread, found across the UK, including London and the south-east and is part of a growing worldwide issue.

However, since a peak in November 2004 rates of new cases in Southampton have been steadily falling.

A spokesman for Southampton University Hospitals NHS Trust said the report recognised the proactive approach being taken by Southampton in dealing with the infections.

"Patients who are ill are coming into hospital with ESBL," he said.

"We identify them as having it - they are not catching it in hostpital. And we are not the only place that is picking this up.

"Why we are being singled out in this report is because of the proactive way we have been managing it and working with the Health Protection Agency.

Dr Paynton said: "We are continuing to work closely with colleagues at the Health Protection Agency and with Microbiology to monitor these cases which are decreasing. We are also working with GPs and district nurses to encourage good prescribing practice. "The important message is really that we are aware of this problem and we are working with GPs to tackle it."