Dooms­day warn­ing over drug re­sis­tance

Global call to show cau­tion on an­tibi­otic pre­scrib­ing as fu­ture threat to cancer treat­ment and surgery looms

The Scotsman - - Front Page - By SHÂN ROSS

The world is fac­ing a “postan­tibi­otic apoc­a­lypse” un­less ac­tion is taken to ad­dress the grow­ing threat of an­tibi­otic re­sis­tance, a lead­ing health ad­viser has warned.

Dame Sally Davies, chief med­i­cal of­fi­cer for Eng­land, said al­low­ing an­tibi­otics to lose their ef­fec­tive­ness against dis­ease would mean “the end of mod­ern medicine”.

The world is fac­ing a “postan­tibi­otic apoc­a­lypse” un­less global lead­ers take ac­tion to ad­dress the grow­ing threat of an­tibi­otic re­sis­tance, a lead­ing health ad­viser has warned.

Dame Sally Davies, chief med­i­cal of­fi­cer for Eng­land, has out­lined the stark con­se­quences of al­low­ing an­tibi­otics to lose their ef­fec­tive­ness, claim­ing it will spell “the end of mod­ern medicine”.

With­out the drugs used to fight in­fec­tions, com­mon med­i­cal in­ter­ven­tions such as cae­sarean sec­tions, cancer treat­ments and hip re­place­ments would be­come in­cred­i­bly “risky” and trans­plant medicine would be a “thing of the past”, she said. “We are fac­ing, if we don’t take ac­tion now, a dread­ful post-an­tibi­otic apoc­a­lypse,” she said.

Health ex­perts have pre­vi­ously warned that re­sis­tance to an­timi­cro­bial drugs could cause a big­ger threat to mankind than cancer.

Dame Sally said the lat­est es­ti­mates were that about one in three or one in four pre­scrip­tions in pri­mary care are prob­a­bly not needed.

An­tibi­otics are used to pre­vent and treat bac­te­rial in­fec­tions. But an­tibi­otic re­sis­tance takes place when the bac­te­ria change in re­sponse to the use of th­ese medicines.

Bac­te­ria, not pa­tients, be­come an­tibi­otic-re­sis­tant.

Dr An­drew Buist, deputy chair of the Bri­tish Med­i­cal As­so­ci­a­tion’s Scot­tish GP com­mit­tee, said: “GPS are of­ten placed un­der huge pres­sure from pa­tients to pre­scribe an­tibi­otics even when the GP con­sid­ers it’s not nec­es­sary. The pub­lic should be made aware that an­tibi­otics are not a cure-all.”

In March Pro­fes­sor Alis­tair Leonard, the Scot­tish Govern­ment’s in­fec­tion ad­viser, warned Scot­land’s an­tibi­otic use was three times the level rec­om­mended by ex­perts to ward off a su­per­bug cri­sis that could threaten mod­ern med­i­cal pro­ce­dures.

Prof Leonard also said Scot­tish hospi­tals had the high­est an­tibi­otic use in the UK.

Anas Sar­war MSP, Scot­tish Labour health spokesman, said: “This is a grave warn­ing from Eng­land’s chief med­i­cal of­fi­cer, and although the in­ter­ven­tion is not di­rectly aimed here, it is a warn­ing we must heed.

“Scot­land has the high­est use of an­tibi­otics any­where in the UK, the num­ber of pre­scrip­tions al­most three times the level ex­perts rec­om­mend. The Na­tion­al­ists should ex­plain how their decade in power has led to Scot­land with the high­est an­tibi­otic use in the UK.”

Around 700,000 peo­ple around the world die an­nu­ally due to drug-re­sis­tant in­fec­tions in­clud­ing tu­ber­cu­lo­sis (TB), HIV and malaria. If no ac­tion is taken, it has been es­ti­mated that drug-re­sis­tant in­fec­tions will kill ten mil­lion peo­ple a year by 2050.

Dame Sally said that be­cause an­timi­cro­bial re­sis­tance (AMR) is “hid­den”, peo­ple “just let it pass”.

“This AMR is with us now, killing peo­ple,” she said. “It does not re­ally have a ‘face’ be­cause most peo­ple who die of drug re­sis­tant in­fec­tions, their fam­i­lies just think they died of an un­con­trolled in­fec­tion. It will only get worse un­less we take strong ac­tion.”

The com­ments come as the UK govern­ment and the Well­come Trust, along with oth­ers, have or­gan­ised a “call to ac­tion” meet­ing in Ber­lin for health of­fi­cials world­wide.

West­min­ster will also use the gath­er­ing to an­nounce a new project which will map the spread of death and dis­ease caused by drug-re­sis­tant “su­per­bugs”.

West­min­ster has also pledged to high­light the threat at home with a do­mes­tic aware­ness cam­paign alert­ing the pub­lic to AMR, re­duc­ing ex­pec­ta­tions they will be treated with an­tibi­otics and sup­port­ing change among health­care pro­fes­sion­als.

Pro­fes­sor David Gal­loway, Pres­i­dent of the Royal Col­lege of Physi­cians and Sur­geons of Glas­gow, said: “I wel­come the an­nounce­ment of this im­por­tant part­ner­ship, and the chief med­i­cal of­fi­cer’s clear warn­ing call for ac­tion on this is­sue. Do­ing noth­ing is not an op­tion. Whether it’s ac­tively cam­paign­ing and ed­u­cat­ing pa­tients and clin­i­cians about the ten­dency to overuse an­tibi­otic agents or clamp­ing down on an­tibi­otics be­ing sold over the counter or via so-called on­line phar­ma­cies, there is an ur­gent need for co­or­di­nated ac­tion now, and all med­i­cal pro­fes­sion­als must play our part.”

A Scot­tish Govern­ment spokesman said: “We un­der­stand the spread of multi-drug re­sis­tant bac­te­ria means that we could be close to reach­ing a point where we may not be able to pre­vent or treat ev­ery­day in­fec­tions or dis­eases. That’s why, since 2007, we have achieved sig­nif­i­cant re­duc­tions in Health­care As­so­ci­ated In­fec­tions due to bet­ter pre­scrib­ing of an­tibi­otics in hospi­tals and com­mu­ni­ties.

“We have pro­vided £4.2 mil­lion to set up a Scot­tish Health­care As­so­ci­ated In­fec­tion Preven­tion In­sti­tute, the largest ever sin­gle in­vest­ment into re­search in Scot­land. We have also com­mis­sioned key part­ners, in­clud­ing Health Pro­tec­tion Scot­land, to come up with bet­ter ways of work­ing to im­prove re­sis­tance to an­tibi­otics now and in the fu­ture.”

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