Super bugs - Is restricting antimicrobial medicines the answer to combatting antibiotic resistant bugs
Imagine a world where a routine hip operation or caesarean section is just too dangerous to perform, and a chest infection or an infected wound might kill us? This is the startling future we all could be facing unless something is done about the overuse of antimicrobial medicines.
Antibiotic resistance is a growing threat to human health. Worldwide, superbugs resistant to antimicrobials are estimated to account for 700,000 deaths each year. But experts believe if we do not take action they could be responsible for ten million deaths per year - equivalent to a death every three seconds, and cost the global economy $100 trillion by 2050. 
Resistance arises when bacteria and other infections, including HIV and malaria, are repeatedly exposed to antibiotics. They mutate and evolve until gradually they become resistant to them. And in today's modern world, the problem is not just in the healthcare setting that is causing the problem. It is widely acknowledged that the widespread use of antibiotics in animals has led to resistant strains of some bacteria being transmitted to humans through food.
The problem is now considered so acute that 193 countries of the United Nations have signed up to a pledge to stamp out drug resistant infection, and report back with an action plan within the next 2 years.
193 countries have committed to:
- Developing surveillance and regulatory systems on the use and sales of antimicrobial medicines for humans and animals.
- Encouraging innovative ways to develop new antibiotics and improve rapid diagnostics.
- Educate health professionals and the public on how to prevent drug resistant infections.
The agreement took six years of hard negotiation to agree. It is only the fourth time a UN declaration has been reached on a health issue - following HIV in 2001, non-communicable diseases in 2011 and Ebola in 2013.
The UK has set its own target to reduce inappropriate prescriptions and the incidence of high-risk bacterial infections in hospitals by 50% by 2020, and to cut the level of antibiotic use in the agricultural sector from 62mg/kg in 2014 to 50mg/kg by 2020.
The superbug MRSA is now resistant to so many drugs that it is already hard to treat. Resistance is a particular problem in hospitals and places such as care homes where many vulnerable people are gathered together. In recent years there have been a number of high-profile super-bug cases in hospitals and the NHS has been forced to pay out significant sums to patients who have been infected on wards.
"We need to inform in different ways, all over the world, why it's crucial we stop treating our antibiotics like sweets. If we don't solve the problem we are heading to the dark ages, we will have a lot of people dying.”
The trouble is, antibiotics are more widely used than you might think and a world without them would be a far more dangerous place.
Relatively speaking the UK is doing well. But international travel makes this a global problem. In January 2017, it was reported that a superbug which was "resistant to all available antimicrobial drugs" killed a 70 year old woman in America after a long trip to India. The Centre for Disease Control in America commented that: "[Infections] that are resistant to all antimicrobials are very uncommon." But the case remains a warning of the dangers of what the CDC calls untreatable "nightmare bacteria" and some scientists have argued we are on the cusp of the "post-antibiotic era" with cases like this becoming more frequent.
So what’s the answer? If we are to avoid a future where cancer treatments, chest infections and organ transplants could kill you, or childbirth once again becomes a deadly moment in a woman's life, what action do we need to take? Certainly this recent pledge is good news, but the results will have to be seen quickly.
A renewed focus on developing new antibiotics and using the ones that still work effectively would certainly change the picture dramatically but the question remains, can we drive change faster than a super-adaptable super bug?
Jonathan has been dealing with complex, high value medical negligence cases for over ten years, covering areas such as birth injury, delayed diagnosis, inquests and orthopaedic injury amongst other areas. He is a member of the Association of Personal Injury Lawyers and is acting on behalf of the Trustees for the vCJD compensation scheme – which manages £67.5m for victims of variant Cruetzfeldt Jakob Disease and their families.
He often handles cases which are reported in regional and national press and regularly takes over cases that have been mishandled by other solicitors. He has particular expertise in dealing with complicated cases of clinical negligence which overlap with pre-existing personal injury claims.
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