When the drugs don’t work

Experts warn that a public health catastrophe is inevitable if we do not make a concerted effort to tackle the problem of antibiotic-resistant bacteria.

If we do not tackle the escalating threat posed by antibiotic-resistant bugs, we could see infection-related fatalities return to early 20th-century levels, medical authorities have warned.

A report from the US Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the US, which was issued to raise awareness during its annual Get Smart About Antibiotics Week (November 18-24), provides a timeline showing that the problem was first identified in 1943.

However, efforts to address it over the past several decades have been insufficient, sparking fears that many of the past century’s medical advances could effectively be erased if immediate and coordinated global action is not taken.

According to the Alliance for the Prudent Use of Antibiotics (APUA), the failure of drug companies to produce a sufficient number of new antibiotics is a key contributing factor. Only two systemic antibacterial agents have been approved for use on humans since 2008, compared to 16 between 1983 and 1987.

The reasons include the fact that “Big Pharma” does not consider it profitable enough (antibiotics are short-course drugs and developing products for long-term use is much more lucrative), complicated regulatory obstacles in some countries such as the United States, and the growing scientific complexities involved in developing ever more sophisticated drugs.

This problem is exacerbated by the use of antibiotics in food production – huge amounts are given to fish and livestock, and the exposure contributes to bacterial resistance.

The APUA stated in its newsletter: “The time has come to admit that the ways we have used, developed and protected antibiotics over the past 70 years have failed. The time for bickering over half-measures has passed.

“The time has come for innovative and bold solutions to slow resistance and speed development of new antibiotics.”

Health Authority Abu Dhabi launched a major initiative to tackle the problem in 2011 called Antibiotic Resistance Surveillance (ARS), after a study carried out by UAE University found the lethal drug-resistant superbug Acinetobacter baumannii, which causes pneumonia and blood and wound infections, in Abu Dhabi hospitals.

Under the new surveillance programme, data is gathered and analysed to identify antibiotic-related problems in communities.

While health authorities play a key role in tackling the problem, individual awareness is crucial, as it is, to a large extent, the misuse and unnecessary use of antibiotics that has resulted in bugs evolving to become resistant to drugs.

Dr Peter Swinyard, chairman of the UK’s Family Doctor Association, told The Independent on Sunday newspaper: “We need education. Not every ill needs a pill.

“People need to realise the link.

“If you treat little Johnny’s ear infection with antibiotics, his mummy may end up dying of pneumonia.

“It’s stark and it’s, of course, not direct, but on a population-wide level, that’s the kind of link we are talking about.”

A study conducted in 2010 found that 68 per cent of a sample of 510 antibiotic sales in Abu Dhabi chemists were illegally made without a prescription being presented.

Stricter controls on the sale of pharmaceutical drugs combined with greater awareness of the dangers of using antibiotics improperly would greatly complement government efforts to address this potentially catastrophic public health threat.