The World Health Organization calls antibiotic resistance a “major public health problem” – one that has spread to all corners of the world. Multidrug-resistant tuberculosis, for example, is now a major threat in many places, and mainly driven by the improper use of antibiotics given to patients. Despite this consensus, a new report published by Public Health England shows that in the U.K. the use of antibiotics considered as a “last resort” has significantly increased during the past five years.
The "last resort" antibiotics, also known as broad spectrum, target multiple different types of bacteria. Their indiscriminate use means that they are more likely to drive antibiotic resistance since, although they kill lots of different types of bacteria, they often do so incompletely, leaving some that are then resistant. When the infection then reemerges, the original antibiotics are often no longer effective. The report details how in the U.K. the use of two broad spectrum antibiotics – carbapenems and piperacillin/tazobactam – has increased by 36 and 55 percent, respectively, between 2010 and 2014.
“Antimicrobial resistance is a major threat to the delivery of healthcare across the globe and these findings clearly show the need for both clinicians and patients to act now and do all they can to behave as responsible stewards of the use of antimicrobial medications,” says Dr. Mike Durkin, National Health Service (NHS) England director of patient safety, in a statement.
According to the U.S. Centers for Disease Control and Prevention, every year in America at least two million people are infected with antibiotic-resistant bacteria, causing the deaths of around 23,000 people. Health professionals are now in a constant arms race, with some bacteria such as Staphylococcus developing resistance to some drugs within just a few years of their introduction. With this increasing rate of resistance, and researchers finding it harder and harder to develop new drugs, the future could see once routine infections from common bacteria become much more serious.
While there has been an increase in the use of antibiotics in the U.K., the rate is slowing. Worryingly, though, this hasn’t stopped an overall increase in antibiotic infections during the same period. Bloodstream infections caused by E. coli and Klebsiella pneumoniae were up by 13.5 and 17.2 percent respectively. And while generally the number of prescriptions for antibiotics are down across the country, the consumption of the drugs is actually up.
This suggests that doctors are either prescribing them for longer periods of time or at higher dosages. Public Health England recommend that doctors only give broad spectrum antibiotics for a period of a few days – in order to reduce the chance that bacteria will develop resistance – and only when absolutely necessary, before using more targeted drugs.
“As one of the largest healthcare providers in the world,” explains Dr. Durkin, “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.”