Issue 283, Friday 30 November 2012 - 16 Muharram 1434
Health and Science: Chief Medical Officer gives warning on antibiotic use
By Rachel Kayani
England’s Chief Medical Officer, Professor Dame Sally Davies, and the Health Protection Agency (HPA) have both warned that resistance to antibiotics is one of the greatest threats to modern health, and that antibiotics are being used unnecessarily for mild infections helping to create resistance.
There has been a growing concern about the rise in resistant strains of common bacteria like E Coli, and they have urged patients to take more care with how they used medicines and take their doctor’s advice on when antibiotics are needed.
As we enter the traditional coughs and colds season healthcare professionals are urging patients to only take antibiotics when necessary and only when prescribed by a doctor. In most cases colds and flu are caused by a virus and antibiotics have little effect as they are used for bacterial infections.
Prof Davies said: “Antibiotics are losing their effectiveness at a rate that is both alarming and irreversible - similar to global warming.” To reinforce her message, she has issued a list of “dos and don’ts.”
Do remember antibiotics should be taken only when prescribed by a health professional.
Do complete the prescribed course even if you feel better, as not taking the full course encourages the emergence of resistance.
Don’t share antibiotics with anyone else.
Do remember that antibiotics cannot help you recover from infections caused by viruses, such as colds or flu.
The HPA said the last point was one of the common misconceptions among the public.
Dr Cliodna McNulty from the HPA said: “We all seem to forget just how awful you can feel with a bad cold, let alone flu, and this maybe makes us think that we are more poorly than we really are and that we need antibiotics to get better. But this isn’t the case..” Instead in most cases over -the-counter medicines that can help to ease headaches, aching muscles and fever are more effective in relieving symptoms while the body recovers naturally.
If the growing problem of antibiotic over use, and bacterial resistance, keeps rising we face the prospect of many infections becoming difficult to treat or even fatal. There are currently very few new antibiotics in the research and development stage, so the prospects for new antibiotics coming to market soon are limited. People always think science will come to the rescue but many of our antibiotics have been around for a long time and resistance to them has built up. Developing new antibiotics to treat resistant superbugs has proved increasingly difficult and costly, also as antibiotics are only taken for a short period there is limited commercial returns for the pharmaceutical companies, making investment into researching new drugs less attractive - the pipeline of new drugs is almost dry.
The warning comes six months after a similar call by, Head of the World Health Organisation, Margaret Chan, who said the world faced the “end of modern medicine as we know it” as a result of the “global crisis in antibiotics”.
In the European Union alone, an estimated 25,000 people die each year from antibiotic resistant bacterial infections. Britain has seen a sharp rise in cases of blood poisoning caused by E Coli since 2005 and those resistant to antibiotics have increased from 1 per cent a decade ago to 10 per cent. It is hoped that educating the public about the sensible use of antibiotics will prevent the rise of more resistance bacteria, which could become increasingly more common and difficult to treat otherwise.
Fake medicines are a global problem
Experts have warned that international action is needed to clamp down on the trade in fake medicines. Writing in the British Medical Journal, Amir Attaran from the University of Ottawa, and colleagues warn that patients around the world are losing their lives as a result of substandard and counterfeit medicines. Yet there is currently no international agreement on how to stop the trade in fake medicines.
According to the World Health Organisation (WHO) up to 10% of drugs in some poorer countries are fakes, and research suggests around a third of malaria drugs are counterfeit. Even wealthier countries that have strict controls for the manufacturing of pharmaceuticals still have problems with counterfeit drugs, with substandard drugs causing adverse reactions and even death.
For example, in America, a contaminated drug supplies recently caused an outbreak of meningitis that has so far killed 16 people. In Canada, a fake version of the heart drug Avastin came into the country that was found to contain no active drug, just starch and nail polish remover.
Some countries already have laws prohibiting fake medicines, but under international law, there is no global treaty, which means organised criminals can continue to trade using haven countries where laws are lax or absent. The number of countries that do not have strict medicine control laws is significant, in fact the WHO estimates that nearly a third of countries have little or no medicine regulation.
The study’s authors noted that a new protocol on tobacco control, which forms part of a global treaty, will soon criminalise the illicit trade of tobacco products, making the law on cigarette counterfeiting tougher than the one on medicine falsification. Currently, there are more sanctions around the use of illegal tobacco than counterfeit drugs. They have stated that a similar global treat should be implemented for medicines to protect public health.