Why is growing resistance to antibiotics so very serious?

THE danger posed by growing resistance to antibiotics is as great as "terrorism" and "climate change", the government's chief medical officer for England has said. Dame Sally Davies warned that routine operations could become "deadly" within 20 years if people lose the ability to fight off infection and called on the pharmaceutical industry to research and develop new forms of antibiotics. 

How is the growing resistance to antibiotics revealing itself? As the threat from one form of bacteria is brought under control, other bugs take its place. Hospital infections from MRSA and C. difficile have fallen sharply – by up to 80 per cent - in the past ten years, says The Independent. But they have been replaced by other bacteria such as E. coli and klebsiella, which are now the most "frequent agents" of hospital-acquired infection in the UK. Dr Ibrahim Hassan, a consultant microbiologist at Wythenshawe Hospital in Manchester, told the BBC that he is seeing more and more cases where patients have infections that are resistant to antibiotics. "You don't have too many options in terms of treatment," he said. "We're beginning to see that in some hospitals, patients coming in with this infection with no antibiotic that can be used to treat them."

Why is resistance to antibiotics increasing? One of the reasons is that they have been prescribed too readily, writes microbiologist Professor Valerie Edwards-Jones in the Daily Telegraph. "Today, GPs are less likely to over-prescribe them," she says, "but for many years they were dished out recklessly, resulting in resistance to their effects. Adding antibiotics to animal feed was "disastrous", she writes because it introduced the drugs into the food chain and increased the opportunity for resistance. " Over time, micro-organisms are able to mutate and build resistance to antibiotics until they can survive exposure to the drugs."

Why aren’t the drug companies developing new antibiotics? Davies says the drug industry hasn’t developed a "new class of antibiotics" since the late 1980s and there are very few new antibiotics "in the pipeline". The problem, she says, is that making antibiotics is "not viewed as profitable". Davies says the pharmaceutical industry needs to be "incentivised" to create new drugs. "We may have to work with the pharmaceutical companies in public-private partnerships, and we may have to do some development of antibiotics on a public basis."

What will happen if resistance continues to build? If no action is taken, Davies says we will find ourselves in an "almost 19th century environment" where people die from infection when they undergo routine operations. Standard procedures such as hip replacements would become far more risky and treatments that suppress the immune system such as chemotherapy and organ transplants would become almost impossible.

What needs to be done? Clearly, the medical profession needs new and effective antibiotics. But Edwards-Jones says the war against bacteria starts at home with "basic hygiene". She also urges more awareness of the appropriate use of antibiotics – for example, the fact that "95 per cent of sore throats are caused by viruses – for which antibiotics are useless". She says hospitals have spent about £250 million on better infection awareness since 2005, introducing measures such as strict antibiotic protocols, hand sanitisers and restrictions on visiting hours. Davies says there needs to be more education of doctors, nurses and vets, so that they know "the risks and advantages" of prescribing antibiotics and "think about that balance". She also believes medical professionals need to spend time with patients explaining why they're not prescribing the drugs. ·