The growing resistance to the world’s supply of antibiotics is becoming a “catastrophic threat” that will manifest itself over the next 20 years, according to a new report from the British government.
Dame Sally Davies, Britain’s Chief Medical Officer, called for global action in her first annual report to combat spreading antimicrobial resistance, which she said could cause tens of millions of patients to die following even minor surgery within two decades.
Davies said the problem is growing so large and serious that the British government should rank it alongside terrorism and climate change as one of the country’s biggest threats.
Setting medical treatment back 200 years
For years antibiotics have grown increasingly ineffective against key bacteriological strains, a phenomenon that is worsening due to a “discover void” of new, stronger antibiotics, she said. In her report, Davies called for a host of actions to address the threat, which may eventually include tighter restrictions on how doctors prescribe antibiotics for their patients, The Independent reported.
“This is a growing problem, and if we don’t get it right, we will find ourselves in a health system not dissimilar from the early 19th century,” she said.
Davies herself acknowledged that the problem has been a long time in the making, but she said she decided to give it new focus because of the dire implications of inaction.
“I knew about antimicrobial resistance as a doctor, but I hadn’t realized how bad it was or how fast it is growing,” said Davies.
In her report she says:
There is a need for politicians in the UK to prioritise antimicrobial resistance as a major area of concern, including on the national risk register and pushing for action internationally as well as in local healthcare services.
Antimicrobial resistance is a ticking time-bomb not only for the UK but also for the world. We need to work with everyone to ensure the apocalyptic scenario of widespread antimicrobial resistance does not become a reality. This threat is arguably as important as climate change.
Thousands already dying each year
Keith Ridge, the British chief pharmaceutical officer, said though the control mechanism for doling out prescriptions of antibiotics has been strengthened in hospitals, there needs to be tighter, more thoughtful control of antibiotic prescriptions by general practitioners.
In Britain, hospital infections caused by MRSA and C. diff have been reduced by some 80 percent over the past 10 years, but those have been replaced by other tough-to-kill bacteria, such as E. coli and klebsiella, the latter two now the most frequent causes of hospital-borne infections, The Independent reported.
In the U.S., carbapenem-resistant Enterobacteriaceae, or CRE, has become more common in the past decade, according to the Centers for Disease Control and Prevention. Infectious disease specialist Dr. Brad Spellberg, of the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center, compared the worsening problem to the fate of the Titanic.
“We’re not talking about an iceberg that’s down the line. The ship has hit the iceberg. We’re taking on water. We already have people dying. Not only of CRE, but of untreatable CRE,” he told National Public Radio.
In the U.K., about 5,000 people a year die from bloodstream infections – half of them from drug-resistant organisms. In the U.S., the CDC estimates that about 20,000 die from them.
As antibiotic use has increased, so has resistance
As antibiotic use has increased over the past several years, so has resistance, the experts say. That’s because the “pipeline” of new antibiotic drugs is drying up; there has not been the development of a new class of antibiotics since 1987, and no new classes are currently in the global pipeline, The Independent reported. A small number of individual drugs are being developed by a few British companies, the paper said, but that’s about it.
Davies blames part of that development shortage on Big Pharma – there is little profit in antibiotics because they are expensive to develop but are only taken in short courses, unlike, say, blood pressure medications that must be taken for long periods of time.
“We may have to work with the pharmaceutical companies in public-private partnerships, and we may have to do some development of antibiotics on a public basis” in order to fill the “development void,” she said.
Davies pointed to the Innovative Medicines Initiative, which is a joint undertaking between the EU and the pharmaceutical industry which fosters a collective effort towards pharmaceutical innovation, especially when it comes to new classes of antibiotics.
“We are going to have to up our education, so that the doctors and nurses and vets who prescribe antibiotics do it knowing the risks and advantages, and think about that balance, and also spend time with patients explaining why they’re not prescribing them,” Davies said.