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Dr Fidelma Fitzpatrick: Return to pre-antibiotic era will be a very bitter pill to swallow

Dr Fidelma Fitzpatrick, RCPI and HSE Clinical lead - Prevention of Healthcare-associated Infection, writes about the rise of antibiotic resistance ahead of our public meeting, Good bugs, bad bugs and super bugs - Protecting you and your family from infection.

It's every parent's worst nightmare. Mary was a happy, little girl, but now she's in hospital. Yesterday she suddenly got a high temperature, a rash and became very drowsy. Her worried mum brought her to the GP, who suspected meningitis, and she was rushed to hospital where she was given antibiotics. She's on the road to recovery now, but 70 years ago Mary would have died.

Although meningitis is still a very serious condition, 95pc of people who get it will survive, thanks to one of the greatest medical miracles of the last hundred years -- antibiotics.

Antibiotics were the major medical advance of the last century. They are crucial for treating infections and also play an important role in preventing infections, for example, following surgery. A recent review of the 1900-05 death records from Sir Patrick Dun's Hospital indicate that the majority of Irish people died of 'simple' infections such as skin, chest and throat infections that are now treatable with antibiotics.

Antibiotics were quickly recognised as miracle drugs, and the possibilities they offered seemed endless. In the 30 years after penicillin was discovered, many different antibiotics were rapidly developed and because antibiotic resistance was not understood, there was no attempt to use antibiotics wisely. As soon as resistance to one antibiotic emerged; a more effective antibiotic was produced.

However, it is in the nature of these bugs to protect themselves against the antibiotics that are designed to kill them. Antibiotic resistant bugs -- the so-called 'super bugs' -- may aid our return to the pre-antibiotic era when little Mary would have died.

At a time when half the country is coughing and spluttering after the Christmas holiday, it is important for us to understand bugs and how ordinary bugs become super bugs.

Using antibiotics when they are not needed or not taking them exactly as prescribed, gives bugs a chance to get used to the antibiotics and to adapt so that the bugs can't be killed anymore. These super bugs can then go on to cause serious illness and even death.

Everybody has bugs that live harmlessly on our skin and inside our body and many of them protect us against more harmful bugs. However, taking antibiotics when they are not needed can kill off the good bugs and stimulate those left behind to become resistant to that antibiotic.

Let's say Mary had a cough instead of meningitis and the doctor gives her an antibiotic. The antibiotic would be useless against this because her cough is caused by a virus which is a type of germ that can't be killed by antibiotics.

Mary won't get better any faster. Instead, bugs that live inside her will adapt to the antibiotics and can't be killed off, while often many of the more useful bugs do get killed. With the useful bugs out of the way, the more harmful ones can take over.

The golden era of the modern antibiotic miracle is potentially drawing to a close. The production of new antibiotics has slowed in recent years, with the last new class of antibiotic produced 12 years ago.

The use and misuse of antibiotics in human and veterinary medicine has resulted in the emergence of resistance. Indeed, in some countries, common infections in hospitalised patients are now untreatable.

We can all play a part in preserving antibiotics for future generations. One in three Irish people expects an antibiotic when they visit a doctor.

However, most common infections such as colds and flus are caused by viruses. Antibiotics don't work against viruses. Your doctor or pharmacist can advise you on over-the-counter remedies that can help to treat many common viral infections. Antibiotics that work against one infection, such as a kidney infection, don't necessarily work against a chest infection. Don't buy antibiotics over the counter when on holiday and don't store them at home for use at a later stage. Definitely don't share your antibiotics with family members.

If your doctor decides that you do need an antibiotic, make sure you take it exactly as prescribed. This includes finishing the course, even if you feel better. If you don't finish the course, the bugs can either regrow (which means you may get an antibiotic resistant infection) or lie dormant ready to cause trouble later.

By taking these simple steps we can help preserve these precious medicines for future generations.

(This opinion piece was published in the Irish Independent on 3 January 2014.)

Find out more at our public meeting, Good bugs, bad bugs and super bugs, on 14 January 2014

As part of ongoing efforts to tackle the global health risk posed by antibiotic resistance, leading Irish health experts will discuss bugs, infections and antibiotics at a free public meeting on Tuesday 14 January 2014.

We will look at the history and evolution of antibiotics, the rise of antibiotic resistance, how bugs spread and how to protect you and your family from infection during the annual flu season.

Read more or register your attendance

Related Links

Read this article on the Irish Independent website