Dr Nuala O Connor
ICGP lead advisor on antibiotic resistance
Dr Nuala O Connor ICGP lead advisor on Antibiotic resistance talks about why antibiotics are under threat and what we can do to help keep them effective for future generations.
Antibiotics have utterly transformed modern medicine. Before antibiotics were available, common injuries such as cuts and scratches that became infected could result in death or serious illness because there was no treatment available. The evidence is very clear – overuse and misuse of antibiotics has allowed bacteria to develop resistance and they are becoming immune to the drugs we use to defend ourselves. it is estimated that in 2015, 25,000 people died in Europe from resistant infections. That is one person dying every 10 minutes. If we continue to misuse antibiotics and do not develop new ones, the UK Analysis by Lord Jim O’Neill predicts that by 2050, 10 million deaths worldwide will be attributable to antibiotic resistant infections.
Much of what we take for granted in modern medicine could not happen without antibiotics, for example hip replacements, cancer operations and treatments, kidney transplants and cardiac surgery. If we return to the pre-antibiotic era, common infections such as pneumonia, kidney infections or skin infections will result in death because there will be no effective antibiotics to treat them.
Global international and Irish experts agree that everyone has an important role to play in ensuring correct use of antibiotics, and tackling the global health threat of antibiotic resistance.
There is action required at many levels. The World Health Organisation, United Nations and governments around the world have launched campaigns, adopted resolutions and funded programmes to fight antibiotic resistance. Antibiotics are not just used in humans, but also in animals and in agriculture.
At the end of the day, each professional who prescribes antibiotics or influences the decision to prescribe them must take personal responsibility to ensure that it was necessary.
So what can Irish patients and doctors do to help?
Ireland has a relatively high level of antibiotic resistance compared to most European countries, and the Irish population uses a lot more antibiotics than many European counterparts – especially northern European countries. Irish patients are prescribed twice as many antibiotics as Scottish patients and 5 times more than Swedish.
Why do we use so many antibiotics in Ireland?
Antibiotics are very specific medicines designed to kill bacteria. They are “magic bullets” for bacterial infections, but most common infections are viral. Antibiotics do not kill viruses. Antibiotics will not make your cold, cough, flu, diarrhoea, earache or other illness like this better. Antibiotics will not reduce a fever. They will not relieve pain. However, many patients think antibiotics will help them get better faster from illnesses such as these.
Winter antibiotic public awareness campaigns promoting self-care for self-limiting viral infections such as underthweather.ie are helping to address this problem, but all doctors must support this by stopping to prescribe antibiotics unless there is a reasonable clinical certainty that the patient has a bacterial infection.
The best way to treat most colds, coughs or sore throats is to drink plenty of fluids and get some rest. Take paracetamol or ibuprofen to relieve headache, aches and pains and fever, and ask your pharmacist for advice about other over-the-counter remedies.
If you are concerned about yourself, your child or a loved one, it is important to get your GP to examine them to exclude more serious bacterial infections which could require antibiotics.
Don’t forget about the importance of washing your hands to prevent the spread of infections. Make sure you get all the recommended immunisations for your children, and the flu and pneumonia vaccine if you are over 65 or have a chronic medical condition.
Most people do not realise that antibiotics can be harmful.
What does an antibiotic do to me if I take it when I don’t need it?
If you take antibiotics when you don’t need them it can make bacteria resistant to them. This means that they may not work to make you better when you really need them for another bacterial illness such as a kidney infection, pneumonia or meningitis.
Taking antibiotics may also give you nasty side effects – rashes, upset stomach, diarrhoea or serious allergic reactions which can be life threatening.
If I get an antibiotic do I need to take them all?
If the doctor prescribes an antibiotic for you, make sure you take them exactly as prescribed. Even if you feel better after taking some of them, you need to take them all. If you don’t, some bacteria may be left in your body and can become resistant to antibiotics.
Don’t keep or reuse left-over antibiotics for the next time you, your child, or any other family member is sick.
Does the doctor always prescribe the same antibiotic?
Doctors follow national guidelines when prescribing the best antibiotic to use for different bacterial infections. We need to use effective, safe narrow-spectrum antibiotics where possible and keep the stronger, broad-spectrum antibiotics for more serious infections. Many people mistakenly think they are allergic to penicillin, however true penicillin allergy is uncommon and I would advise patients to check this with their GP.
By using the correct antibiotic to cure your infection, it will be more effective, reduce side effects and will help bacteria not to become resistant to antibiotics.
Keeping antibiotics effective for future generations is everyone’s responsibility.