WHEN it comes to prescribing antibiotics, doctors are in a jam. Giving them too often risks perpetuating the development of聽resistance to these drugs in bacteria. That is a serious threat to聽society. But withholding them is also risky. If the decision is wrong, a patient could develop a聽life-threatening infection.
Even if the doctor is right, this decision often upsets people. I have heard stories of medics being threatened with everything from bad online reviews to physical violence unless they dish the pills.
One of the most dangerous areas of medicine in this regard is urinary tract infections. Many fit and healthy people recover from UTIs without antibiotics. But if drugs are needed, they must be administered quickly, or sepsis might set in. That is why doctors often err on the side of caution and give antibiotics for UTIs before they are sure drugs are needed.
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Previous estimates from the US聽and Australia suggested that about 30 per cent of antibiotic prescriptions given out for UTIs in hospitals and outpatient settings are inappropriate. Now research presented at a conference by Laura Shallcross of University College London suggests the true聽figure is much higher: between 60 and 70 per cent. This is based on real test results from patients entering an emergency department in a UK hospital, so聽there is reason to think the shocking figure is accurate.
How do we fix this? The charity聽I lead, , aims to help fund the development of one new antibiotic treatment and have it聽on the market by the early 2020s. But this is a tall order. The聽pharmaceutical industry isn鈥檛聽putting enough resources into developing new antibiotics. There isn鈥檛 enough profit in them because they are only used for short periods. Governments are also partly to blame. Most haven鈥檛 put in place financial incentives to聽encourage more research by pharmaceutical firms.
But rather than focusing on who is to blame, we must work together to solve the problem. For聽example, we should continue doctors鈥� education around antibiotic prescriptions. And we could support them in the face of public pressure. Greater public awareness, perhaps delivered by campaigns such as the National Health Service鈥檚 Keep Antibiotics Working, would help.
One thing could help far more quickly. Doctors culture bacterial samples from people to identify infections. This method is cheap, but unreliable. What we need are聽tests that can immediately diagnose the type, severity and聽antibiotic sensitivity of an infection. Without that, doctors are working in the dark.
Such tests are becoming available, but they are still at the experimental stage. We must put a rocket under their development and light the fuse now.
