Resistant germs

SIR – The excellent reports on antibiotic resistance (March 27) made frustrating reading. Antibiotics are a huge success story in combating lifethreatening infections and enabling much of modern surgery to be done. This is now under threat from the spread of resistance, which was predicted 50 years ago.

In 1970, as an undergraduate at Edinburgh, I did my first research project, showing that Escherichia coli from urinary infections, already resistant to some antibiotics, could transfer resistance to other bacteria.

For most of our careers, my colleagues and I in microbiology warned of the risks, but little happened. From the late Nineties, the Public Health Laboratory Service and British Society for Antimicrobial Chemotherapy established programmes to monitor resistance. Reports by the House of Lords Science and Technology Committee (twice) and the Chief Medical Officer’s Standing Medical Advisory Committee gave the same message – resistance posed a major public health threat and modern medicine was at risk.

The Department of Health produced a strategy and an advertising campaign repeated for a decade, and in 2007 I wrote the first version of national guidance on what has become the Antimicrobial Stewardship programme to control healthcareassociated infections.

The current Chief Medical Officer, my former colleague Dame Sally Davies, rightly continues to promote policy based on the same principles, but despite some progress, antibiotic usage in this country remains high.

However, as you emphasise, elsewhere in the world there is little control. Excessive use is promoted, resistance rates have soared and, with global travel, none of us is free of the risks. It is a sad reflection on the failure to implement half a century of knowledge, strategy and guidance. Professor Brian I Duerden Chepstow, Monmouthshire