Children's Health: Resistance To Antibiotics
Alexander Fleming’s accidental discovery of Penicillin in 1928 marked the start of modern antibiotics. At the same time, Fleming discovered that bacteria developed antibiotic resistance whenever too little Penicillin was used or when too little was used for a short period. Antibiotic resistance has been called one of the world’s most pressing public health problems. Almost every type of bacteria has become stronger and less responsive to treatment.
I would like to focus on a common reason for people to come for medical care, namely sore throats. Although a sore throat usually clears up by itself, primary care doctors commonly prescribe antibiotics for it. Antibiotics can reduce bacterial infections but they can cause diarrhoea, rashes and other adverse effects and communities build local resistance to them. When considering the benefi ts of treatments, all existing trials are reviewed by an organisation called the Cochran Database. This review showed that when antibiotics were used, they only reduced symptoms by an average of one day when compared to not using antibiotics for throat infections. In order to pay heed to Fleming’s initial concerns and also to acknowledge the most up to date evidence, it
is important that we don’t overuse antibiotics for simple conditions such as throat infections.
Ultimately, the relationship between the doctor and patient is paramount. Doctors need to be sterner and patients need to accept that antibiotics are not always an appropriate treatment.
Antibiotics need to be reserved for serious infections. Operations that happen every day would not be considered routine if we were unable to treat post-operative infections.
A hot debate was triggered by a recent British Medical Journal article which challenges the rigid advice that a full course of antibiotics must be completed. Some researchers claim we should stop antibiotics as soon as we feel better rather than completing the course. Much more needs to be considered regarding this possible U-turn. For now, you should continue to complete the treatment as prescribed. But it’s a case of watch this space!
Dr Mark Bridgman Hadleigh Lodge Surgery
www.thehadleighpractice.nhs.uk
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