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NHS Hot Topics: Antibiotic Resistance

NHS Hot Topics- Antibiotic Usage

Welcome to our new series on NHS Hot Topics 2017! These blogs will cover one recent piece of medical news from this year in detail.

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In a Nutshell

Since the early 2000s, the paradigm shift of pharmaceutical companies from producing essential antibiotics to more “fashionable” treatments such as those for cancer and chronic disease has been well noted.

The last new class of antibiotics developed for widespread use was founded in 1993 and this has led to a reduction in the variety of treatments available to treat a whole range of illnesses, from community acquired UTIs to pneumonia.

Antibiotic resistance is still a huge problem throughout the world. Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth, so when using this antibiotic to treat an infection, the bacteria aren’t killed.

What are the causes?

One key paper titled The Antibiotic Resistance Crisis gave an excellent summary of the main causes responsible for antibiotic resistance.

Overuse

Inappropriate Prescribing

Extensive Agricultural Use

Availability of Few New Antibiotics

Regulatory Barriers

What are some of the issues?

MRSA

Prevalence of MRSA (Methicillin-Resistance Staphylococcus Aureus) colonization in the UK population currently lies between 1-3%. Though most of these individuals do not develop a harmful infection, if an infection develops, not one of the current methods to control the spread of MRSA has been proved to be effective.

However, there is hope in the fact that a study performed by Public Health England, the number of MRSA bacteraemias has reduced from 4451 2007/8 to less than 800 in 2013/14. This significant drop has shown that MRSA management has improved (by quarantining patients more quickly and identifying MRSA more rapidly), but more still needs to be done.

Incurable Gonorrhoea

Following an outbreak of a “Super Gonorrhoea” STI outbreak in Leeds during September 2015, there was a fear that it would spread throughout the UK during 2016.

The problem occurred when Neisseria Gonorrhoeae, the bacterium responsible for causing the disease, became resistant to Azithromycin, meaning that the only drug able to treat it was Ceftriaxone.

However, widespread use of the second line drug raised fears that the strain would also become resistant to that (as a result of increased exposure), leading to an untreatable illness. Gonorrhoea can in rare cases lead to infertility and septicaemia, meaning that control of the illness was paramount.

Further Research and the Future:

Vaccination:

Alternating Therapy:

What questions might I be asked about antibiotic resistance at interview?

Read more NHS Hot Topics 2017

Words: Ben Fox

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