It's understandable that patients and some doctors simply can't comprehend the concept of a pre-antibiotic world. But that is what's at stake unless the threat is taken seriously.
Lab tests for Antibiotic Resistance
Much of modern medicine is now underpinned by antibiotics. Surgery is more invasive than ever: from hip replacements to cancer treatment and transplants - antibiotics are essential to prevent and treat infection. There have been repeated calls on doctors to curb the overuse of antibiotics going back many years.In 1988 a UK House of Lords Committee Report was criticised GPs for handing out unnecessary prescriptions. It said patients needed to be weaned off their reliance on antibiotics. Nearly two decades on, the health watchdog NICE estimates that one in four antibiotics prescriptions is inappropriate. "It's nearly 30 years since a completely new class of antibiotics was introduced." BBC Medical Correspondent Fergus Walsh explained. Whilst it is important that the NHS exercises better stewardship of antibiotics, it is worth remembering that this is a global problem that requires global solutions. Superbug infections respect no borders and have spread from continent to continent with ease. This is a serious concerns because many developing countries have far poorer controls on antibiotic use.
The Rise of Superbugs
"Antibiotic Apocalypse" as Fergus Walsh calles the abuse of antibiotics, waas exemplified by a report he published in early 2015, where he investigated the rise of superbugs, and the ease with which last-ditch antibiotics can be bought without prescription in India. In the past decade India has become the world's largest consumer of antibiotics, and drug resistant infections are rampant in many hospitals. But this is not just a developing world issue. Last year the World Health Organization found that some antibiotics could be bought legally over the counter in 19 out of 43 European countries surveyed.
Common Situations in which Antibiotics are Overused
Apparent viral respiratory illness in children should not be treated with antibiotics. If there is a diagnosis of bacterial infection, then antibiotics may be used. When children with ear tubes get ear infections, they should have antibiotic eardrops put into their ears to go to the infection rather than having oral antibiotics which are more likely to have unwanted side effects. Swimmer's ear should be treated with antibiotic eardrops, not oral antibiotics. Sinusitis should not be treated with antibiotics because it is usually caused by a virus, and even when it is caused by a bacteria, antibiotics are not indicated except in atypical circumstances as it usually resolves without treatment. Viral conjunctivitis should not be treated with antibiotics. Antibiotics should only be used with confirmation that a patient has bacterial conjunctivitis. Older persons often have bacteria in their urine which is detected in routine urine tests, but unless the person has the symptoms of a urinary tract infection, antibiotics should not be used in response. Eczema should not usually be treated with antibiotics. Dry skin can be treated with lotions or other symptom treatments. The use of antibiotics to treat surgical wounds does not reduce infection rates in comparison with non-antibiotic ointment or no ointment at all.
There is Widespread Misuse of Antibiotics in Agriculture, in Farmed Animals and Fish
More antibiotics are used in livestock production than for human health and there is widespread concern about the use of long-term, low-dose antibiotics in animal feed in countries like the US, China and India. Part of the problem is due to simple evolutionary pressure: bacteria are constantly evolving, and resistant strains emerging. This means there is a constant battle to stay ahead of the germs. But developing new antibiotics has proved hugely difficult - it's nearly 30 years since the last new class of antibiotics came on the market. Patients like Graham Gaston are a reminder of how dangerous it can be to catch a superbug infection. He spent five months this year in hospital in Liverpool after developing a drug-resistant blood infection. At times he was delirious - the toxins from the bacteria were affecting his brain. He is now back home, but is still taking some antibiotics, in a bid to prevent the infection returning. Graham told me he would not be alive but for antibiotics, and, like most of us, had not realised their importance prior to his illness. The economist Jim O'Neill is heading a review into antimicrobial resistance - which is looking not just at bacterial diseases, but parasitic and viral infections like malaria and HIV too. Lord O'Neill has already published initial recommendations on solving the crisis, which includes a global fund to boost research. His final report will be published next year.
