Fighting the growing threat of superbugs

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After being described as one of the biggest health threats mankind faces now and in the future, reporter Michael Holmes delves into the work being done to combat anti-microbial resistance.

It’s an alarming statistic, but superbugs could kill one person every three seconds by 2050 because ever-mutating and evolving viruses are becoming immune to everyday antibiotics.

A woman taking her antibiotics.

A woman taking her antibiotics.

That’s 10 million a year — more people than currently die from cancer, and up from around 700,000 currently, experts have warned.

Already, one million are estimated to have already died since the summer of 2014, when Lord Jim O’Neill began working on a report that last week called for a change in global attitudes.

Put simply, our desire to treat even the most minor ailments with a course of antibiotics is making dangerous infections resistant to drugs that could otherwise safe our lives.

The huge human cost aside, it will also cost the world economy £68,075,142,000,000. That’s just over £68 trillion.

I find it incredible that doctors must still prescribe antibiotics based only on their immediate assessment of a patient’s symptoms

Lord O’Neill

“As with all forecasts of this sort, it is of course possible our estimates may turn out to be too large,” Lord O’Neill said.

“But we believe it is even more likely they could be too small.

“We need a global public awareness campaign to educate all of us about the problem of drug resistance, and in particular children and teenagers.”

New drugs have to replace ones that no longer work, and governments need to put a stop to the unnecessary use of antibiotics in farming, the review on antimicrobial resistance (AMR) recommended.

MRSA and superbugs are becoming more resistent to antibiotic drugs.

MRSA and superbugs are becoming more resistent to antibiotic drugs.

Importantly, we need to use antibiotics — medicines used to treat or prevent some types of bacterial infections — more sparingly.

Lord O’Neill said: “I find it incredible that doctors must still prescribe antibiotics based only on their immediate assessment of a patient’s symptoms, just like they used to when antibiotics first entered common use in the 1950s.

“I can understand why this is the situation: there aren’t enough good and rapid tests to confirm the professional judgement of the doctor, and the tests that are available are often more expensive than prescribing the drugs ‘just in case’.

“Yet this is not acceptable.”

Dr Felicity Guest

Dr Felicity Guest

In England, the number of antibiotics being prescribed by GPs fell by more than 2.6 million last year, though it still tops 34 million.

The drop was heralded a ‘fantastic result’ by NHS Improvement, which said the figures show doctors are being careful not to over-prescribe antibiotics, as part of the wider drive to stop harmful infections developing resistance to them.

Fylde and Wyre Clinical Commissioning Group (CCG), which plans and buys health services for 152,000 people, has in recent years produced posters that have been displayed across the Fylde coast, including at bus stops, as well as leaflets and banners, which were sent to its 19 GP practices.

The same material is also thought to have distributed among Blackpool CCG’s 21 practices, and calls for patients to ‘Think! Antibiotics may not always be the answer’.

Doctors have also been told to fill out forms advising patients of more suitable treatment. Some common illnesses, such as the flu or colds, are best treated with rest, warmth, and fluids, which coughs can be left for up to three weeks.

The work has seen the number of dispensed prescriptions fall from 108,478 in 2013/14, to 105,270 in 2014/14, to 98,913 last year.

Lord ONeill

Lord ONeill

Dr Felicity Guest, a GP at The Thornton Practice in Church Road, and the CCG’s medicines management boss, said: “Antibiotics can kill off helpful germs, as well as the harmful ones, meaning taking them can make patients pick up other infections more easily.

“Harmful germs can outsmart antibiotics and become resistant to them, so new infections are developing that are harder to treat with antibiotics.

“We could soon be close to the point where antibiotics may no longer be able to treat some everyday infections or diseases.”

Most patients are prescribed antibiotics without their doctor knowing the cause of the infection, according to the CCG.

But when they are suffering from an infection caused by a virus and not bacteria, antibiotics will not help - and could expose them to more dangerous illnesses such as Clostridium difficile.

The condition, also known as C. difficile or C. diff, is an infection that can infect the bowel and cause diarrhoea.

It can cause serious problems, and usually develops when patients are taking antibiotics, or when they’ve just finished taking them.

At Blackpool Victoria Hospital last year, 66 C. diff cases were reported.

Some 43 were avoidable, slightly above a trust target of 40, and were blamed on lapses in care, such as inappropriate prescribing of antibiotics.

Although the hospital has made huge strides in tackling the bug in recent years - some 208 cases were reported in 2008/09 - numbers are understood to have plateaued in recent years, and are up compared to 2014/15.

Infection prevention nurses work with staff to help stop the highly infectious bug spreading, while an expert in microbiology has been recruited.

She has since launched a ‘wide-ranging’ campaign to teach doctors how to properly prescribe antibiotics, medical director Prof Mark O’Donnell said.

“Although not a superbug, C. difficile can cause serious illness when its growth becomes uncontrolled as a result of inappropriate or excessive use of antibiotics.

“The issue of superbugs is something that concerns not just our local health economy but the whole world.

“Health practitioners are concerned that, with their rise, patients may again have infections that cannot be treated with antibiotics,” he said.

“It is for this reason that members of the public are being discouraged from asking doctors to prescribe antibiotics for trivial infections, or for colds or flu when we know they are of no benefit.”

The hospital also recorded six cases of MRSA last year, up from none the year before.

The superbug, resistant to a number of widely-used antibiotics, is also contagious, spread through contact with contaminated objects such as towels, bedsheets, door handles, and floors, or through skin-to-skin contact.

One of the cases involved a contaminated blood sample, hospital documents revealed.

Prof O’Donnell added: “All cases of MRSA are examined in detail in meetings between ourselves and our partners in primary care to see where lessons can be learned and care improved.”