FIGHTING BACK AGAINST SUPER BUGS
Antibiotic-resistant bacteria are on the rise. Here’s what we need to know – and do
Bacteria are becoming increasingly resistant to antibiotics – and experts are concerned it may mean that even minor diseases and infections could become fatal.
THREE-YEAR-OLD LEVI WALSH, an energetic little boy, was being treated for a common ear infection when things took a turn for the worse.
After several weeks of repeated flare-ups, where he was burning up at night and frequently crying with pain, doctors admitted him to The Children’s Hospital at Westmead, west of Sydney. There they operated to clear his ears and dosed Levi with intravenous antibiotics. But the infection raged on.
The bacteria causing Levi’s sickness, the common pneumococcus bug, had become highly resistant to drug treatment. It was the first time doctors at the hospital had seen a case like it – but they had been expecting and dreading it. Such cases are about to become all too common.
We’ve all heard of virulent, antibiotic resistant bacteria like MRSA and VRE infecting people in hospital. What was
different in Levi’s case was that he picked up the bug in the community.
“There are misconceptions that this is a problem for the future – but antibiotic resistance is a serious problem right here, right now,” says Dr Jeannie Yoo, clinical advisor to Australia’s NPS Medicinewise, an organisation dedicated to improving the way consumers use medicines.
THE INTRODUCTION OF antibiotics to fight bacteria in the 1930s and ’40s was one of the greatest advances in medicine. But it wasn’t long before doctors started needing ever-larger doses to get effective results. These days, prescriptions of antibiotics for conditions that don’t really need them, combined with the use of antibiotics to boost food production in agriculture, has led to a serious situation where doctors are running out of options for people with serious infections like Levi’s.
A UK report last year found that global consumption of antibiotics in human medicine rose by nearly 40% between 2000 and 2010. Resistant infections are already claiming at least 700,000 lives each year across Europe and the US alone – and a staggering 10 million are expected to die annually by 2050 if we continue our current path.
The World Health Organization recognises antibiotic resistance as one of the most significant global health threats today. “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security.
“We are already seeing examples of resistant bacteria for common infections like urinary tract infections and skin infections,” says Dr Yoo. “At the moment there may be an alternative treatment – but in the future it will be very difficult to find a different antibiotic that works, or that doesn’t have a lot of side effects.”
LEVI’S DOCTORS AT THE HOSPITAL tried stronger and stronger antibiotics. Each time the toddler would improve temporarily, before the infection surged back. It spread from his ear to the mastoid bone and he developed an abscess at the top of his jugular vein. The doctors feared it would spread to his brain or spine.
His mother, Tegan, says, “They were telling us, ‘Oh, the bacteria’s resisting all the antibiotics we can give him’. It’s like, OK, there has to be medicine. You think You’re in the hospital, there’s medicines, just keep trying. But they were running short on things to try.”
For Dr John Curotta, an ear, nose and throat specialist at The Children’s Hospital at Westmead, Levi’s case was a glimpse of how devastating infections might become once more. “Before penicillin came along, up to 20 per cent of hospital beds were taken up with patients who had the
complications of ear infections,” he says. “If we can’t rely on penicillin any more, there just aren’t too many other safe antibiotics we can give children.”
So serious has the problem become that health experts are now questioning the advice doctors give their patients.
Professor Gwendolyn Gilbert, of the Marie Bashir Institute for Infectious Diseases and Biosecurity at the University of Sydney, wrote recently in the Medical Journal of Australia that for most common infections, patients were at minimal risk if they finished taking antibiotics as soon as their symptoms fully disappeared rather than waiting until the end of the prescribed course.
Does that mean we’re all taking antibiotics for much too long? Professor Chris Del Mar, a GP and academic at Bond University in Queensland, says the more antibiotics we all take, the easier we make it for bacteria that are resistant to them to multiply and spread. “The more exposure to antibiotics you have, the more resistant the bugs get,” he says. “With a six-day course, you’re twice as likely to build resistance as with a three-day course.”
He is one of a growing group of experts advocating that doctors cut back on the quantity and duration of antibiotics to combat resistance.
However, while new
10 million are expected to die annually by
2050 if we continue on our
current path