Antibiotic resistance occurs when bacteria change and become resistant to the antibiotics used to treat the infection that they cause. Antibiotic resistance is rising to a dangerously high level, threatening our ability to treat common infectious diseases. Antibiotics are often over-prescribed by health workers and over-used by the public. The World Health Organisation (WHO) stated “that without urgent action, we are heading for a post antibiotic era, in which common infections and minor injuries can once again kill.” The Chief Medical Officer stated in March 2013 that “Antibiotic resistance is as big a threat as terrorism.” It is estimated that drug resistant bacteria are already responsible for 5,000 deaths each year in the UK and this number is likely to increase.
Most common infections such as coughs, colds and sore throats are caused by viruses. If you are normally well, your immune system is good at fighting off most types of viral infection. An antibiotic is not appropriate if a virus is causing the infection because antibiotics kill only bacteria, not viruses. You may feel unwell for several days or more until a viral infection clears. Even if an infection is caused by bacteria, the immune system can clear most bacterial infections and antibiotics do little to speed up the recovery of bronchitis or most nose and ear infections that are caused by bacteria.
Although we prescribe half the number of antibiotics in the UK compared to some other European countries, we are still prescribing too many antibiotics for infections that would resolve without treatment and we all have a duty to heed the serious concerns about antibiotic resistance.
It is not appropriate or acceptable to prescribe antibiotics for illnesses that do not require them- this especially applies to the early stages of an infection. If you are unwell and think that you might need an antibiotic then make an appointment to see the GP or Nurse who will examine you properly and make the decision as to whether an antibiotic is required or not. If you do not need an antibiotic then we hope that you don’t think that your visit has been a waste of time. We must remember that the purpose of antibiotics is to save lives and not to treat self limiting illnesses and we all need to work together to reduce the risk of the post antibiotic era that the WHO are warning of.
FACTS AND FIGURES
Acute Sore throat- without antibiotics, 40% resolve within 3 days and 90% within 7 days
Acute sinusitis- without antibiotics, 80% of adults resolve within 14 days and 90% of children in 2-7 days.
Acute cough/bronchitis- Antibiotics reduced symptoms by only one day in an illness lasting three weeks.
80% of antibiotics are prescribed in Primary Care and Health Care Professionals have to take the lead in the global effort to prescribe antibiotics appropriately. Guidelines suggest that GP’s and Nurses should adopt the following policy.
- No prescribing of antibiotics for simple coughs and colds
- No prescribing of antibiotics for viral sore throats
- Limiting antibiotics for uncomplicated cystitis to 3 days in otherwise fit women
- Not prescribing antibiotics without examining the patient- i.e. prescribing antibiotics on the basis of a telephone call. (The only exception to this rule would be uncomplicated cystitis in women.)
All of the GP’s and Nurses in the practice fully support this advice. Please do not be upset if we feel that you do not need an antibiotic. This is nothing to do with cost- antibiotics are cheap- but antibiotic resistance is an issue that affects us all and will seriously affect generations to come.
Of course antibiotics are still required quickly in certain situations. These include
- If you are very unwell
- If you have serious pre-existing medical conditions
- If you have a respiratory infection and are over 65 with pre-existing medical conditions or over 80 then it would be sensible for you to be examined.
- Babies under 1 year should be seen promptly if they have a temp or are unwell. If you are concerned about a baby who is unwell at night or over the weekend then you should call the Out Of Hours Service on 111.
If you are given an antibiotic, it is vital that you finish the course and never save some for later. This is one method that bacteria develop resistance. Also you should never give anyone else your supply of antibiotics.
Become an antibiotic guardian.
The serious issue of increasing antibiotic resistance is not well understood in the general public. Please help to spread the word!! Visit www.antibioticguardian.com
Sir Alexander Fleming- who discovered penicillin- stated in 1940
“the microbes develop resistance and these resistant strains are passed to other individuals and perhaps from there to someone else and to others until they reach someone with a pneumonia which antibiotics cannot save. In such cases the thoughtless person playing with antibiotic treatment is morally responsible for the death of the man who finally succumbs to infection with the antibiotic resistant organism. I hope that this evil can be averted.”