As drug-resistant infections become more prevalent, more and more people are now being treated with “last-resort” antibiotics, warns a new report by Public Health England, an agency within the British Department of Health.
The report also showed an increase in the number of people suffering a “significant antibiotic-resistant infection” between 2010 and 2014.
Antibiotic resistance develops as a natural consequence of antibiotic use. Because viruses are a diverse and ancient group of organisms, many of them have some degree of resistance to the chemicals used to kill them. When antibiotics are used, these naturally resistant organisms survive, while the vulnerable ones are killed.
The surviving bacteria then reproduce, passing on their resistance to the next generation. The more widely antibiotics are used, the more rapidly resistance genes spread through bacterial populations.
The problem is made even worse by the bacterial ability to swap genes with each other, even between species.
Doctors increasing use of “last-resort” drugs
The British report found an increase not just in general antibiotic resistant infections between 2010 and 2014, but in two varieties in particular: E. coli and Klebsiella pneumoniae.
Infectious forms of E. coli can cause vomiting, stomach cramps, diarrhea (often bloody), and even kidney failure and death. K. pneumoniae causes both pneumonia and urinary tract infections, and can also cause blood poisoning.
The study found that rates of bloodstream infections with E. coli increased by 15.6 percent over the period studied. Notably, the proportion of E. coli bacteria with antibiotic resistance did not seem to increase in the same time. This means that more people are becoming infected with drug-resistant E. coli, even without the bacteria becoming more drug-resistant.
Rates of bloodstream infections with K. pneumoniae increased by 20.8 percent over the same time period.
The researchers found that 74 percent of antibiotics are prescribed in doctors’ offices by general practitioners, while 18 percent are prescribed in hospitals. Hospitals significantly increased their antibiotic use between 2011 and 2014, prescribing 8.5 percent more antibiotics to outpatients and 11.7 percent more to inpatients.
Hospitals were also more likely to use the broad-spectrum antibiotics, which are effective against a wide range of bacterial species but are also more likely to contribute to the development of antibiotic resistance.
Nationwide, the use of the “last-resort” antibiotics carbapenems and piperacillin/tazobactam increased by 36 percent and 55 percent, respectively. The use of both drugs continues to increase, though at a slower rate.
The report highlights important challenges for health care systems, suggested Dr. Mike Durkin, director of patient safety for NHS England – which oversees the National Health Service (NHS).
“As one of the largest healthcare providers in the world, it is vital the NHS is seen to lead that fight against the global problem of antimicrobial resistance so these immensely important medicines can be preserved for now and future generations,” Durkin said.
The end of modern medicine
The report came just as the World Health Organization (WHO) launched a campaign titled “Antibiotics: Handle with care,” designed to help stem the practices that lead to antibiotic resistance. The campaign urges patients to take antibiotics only when prescribed, and to follow the prescription instructions exactly. It also urges doctors to be more sparing in their antibiotic use.
“Doctors need to treat antibiotics as a precious commodity,” said WHO head, Margaret Chan.
If antibiotic use does not become more responsible, Chan warned, antibiotics will eventually become useless, which “will mean the end of modern medicine as we know it,” and “a post-antibiotic era, in which common infections will once again kill.”
Effective antibiotics are needed to preserve patients’ lives during routine surgery and chemotherapy, and to keep premature infants alive, among other uses.
“The rise of antibiotic resistance is a global health crisis,” Chan said. “More and more governments recognize (it is) one of the greatest threats to health today.”
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