ANTIMICROBIAL RESISTANCE
antibiotics being prescribed is great news but we cannot become complacent; there is still a lot of work to be done.” Professor Dame Sally Davies, Chief Medical Officer, commented: “Antimicrobial resistance is the biggest threat to global health – it could halt the progress of over a century of modern medicine. Before antibiotics and vaccines, around 40% of all deaths were due to infections, now it is just 7%. We do not want to see this reversed so we must do all we can to fight drug resistant infections. “Reducing inappropriate antibiotic prescribing is a key element in the fight against drug resistant infections and I am really pleased to see staff across the entire NHS making positive changes. We all have a role to play, and preventing infection through good hygiene and not demanding antibiotics when they are not clinically justified are just two of the ways we can help.” Dr Mike Durkin, NHS national director of patient safety, said: “These results are a fantastic step in the right direction in the fight against antimicrobial resistance and are testament to the huge efforts of healthcare staff and local commissioners across the country, who must be congratulated for this achievement. “To help continue this trend we are working with our partners to introduce new national incentive schemes for 2017/19 that will further support healthcare providers and commissioners to ensure antibiotics are used responsibly and appropriately, and further prevent the infections that require antibiotic treatments. We are fully committed to supporting the NHS to meet the Government’s antimicrobial resistance ambitions of reducing both gram-negative bacteraemia and inappropriate prescribing by 50% by 2020.” Professor Gillian Leng, deputy chief
MRSA: a new approach?
Microbiologists have identified how MRSA may be more effectively treated by modern-day antibiotics, if old-fashioned penicillin is also used. The team from the National University of Ireland Galway and the University of Liverpool have shown that, although penicillin does not kill the bacteria, it does weaken their virulence, making it easier for our immune system and other antibiotics to eradicate the infection. The research findings, funded by the Health Research Board and the Medical Research Council, were published in the Journal of Infectious Diseases. Professor James O’Gara of the National University of Ireland Galway commented: “Our findings explain the anti-virulence mechanism of penicillin-type antibiotics and support the re-introduction of these drugs as an adjunct therapeutic for MRSA infections. MRSA can be extremely virulent, which is part of the challenge in treating it. Our laboratory research shows that when exposed to penicillin, the bacteria switches off its toxin genes and instead concentrates on thickening its cell wall to resist the antibiotic. Our immune systems can then take advantage of this compromised state to destroy the bacteria.” This new treatment strategy for MRSA infections has the potential to change the
executive at NICE, added that establishing better ways of using current antibiotics is vital, and this is being informed by new NICE guidance on managing common infections. She explained that NICE will be producing prescribing summaries for all new antimicrobials, with advice on how
current clinical guidelines for treatment of patients with MRSA infections in both hospital and community settings. A recent randomised controlled trial in Australia involving 60 patients led by Menzies School of Health Research showed that the beta-lactam antibiotic flucloxacillin in combination with vancomycin significantly reduced the duration of MRSA sepsis from 3 days to 1.9 days. “The clinical findings in Australia are
very important and now we have the key laboratory data that help explain why the combination of two antibiotics is better than one. The beauty of this approach is that penicillin type antibiotics are not only widely available and safe, but can potentially and more easily be included in clinical practice without the need for long and expensive clinical trials needed for new drugs,” added Professor O’Gara.
Reference
1 James P. O’Gara, J P, et al, ‘Redeploying ß-Lactam Antibiotics as a Novel Antivirulence Strategy for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections’, The Journal of Infectious Disease, 14 November 2016, doi: 10.1093/infdis/jiw461
http://jid.oxfordjournals.org/cgi/reprint/jiw461? ijkey=XElqGdBnz0CwYq3&keytype=ref
they should be used in practice. “The new data published by PHE shows that our attitudes are changing for the better. Now we must work hard to maintain this momentum – new NICE advice will help protect new antimicrobials for future generations,” said Prof Leng.
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FEBRUARY 2017
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