Wonder drugs becoming more and more ineffective

Antibiotics, once hailed as a panacea to combat infections, risk becoming more and more ineffective. The human body is responding less and less to these miraculous drugs. New, more dangerous diseases, stubbornly resisting their power, are developing which threaten to reverse the clock to the era before Sir Alexander Fleming's wondrous discovery when even simple infections could be life-threatening.

Infectious diseases have the potential, like no other group of diseases, to spread rapidly over large distances in a short time. If no effective tools for treatment and prevention are available, they can dramatically change the lives of people and destabilise societies. The first antibiotic drugs became available in the wake of World War II, to save soldiers from deadly wounds. These powerful drugs soon became known as "wonder drugs" and were generously prescribed against minor bacterial infections or even viral infections, against which they have never been and will never be effective. Today, we pay the price for this complacency. In a Eurobarometer survey undertaken some years ago, Europeans were asked about their "antibiotic habits": 38 per cent of EU citizens had taken antibiotics in the last 12 months (in Malta we believe that this level exceeds 50 per cent), out of whom 93 per cent had a prescription.

Irresponsible use of antibiotics has accelerated the development and spread of bacteria which are resistant to antibiotic treatments. This applies to both bacteria responsible for infections in the community (outpatients) and in health care settings (hospitalised patients), as well as to bacteria found in other areas such as animals, food and the environment.

Previously effective antibiotics have lost their powers against a steadily growing list of resistant pathogens. As a result, the arsenal against severe, and often lethal, infectious diseases, like tuberculosis and pneumonia, are rapidly diminishing. If the misuse and overuse of antibiotics continues, antibiotics will no longer be effective against these bacteria and we will lose the appropriate means required to treat serious, potentially life-threatening, infectious diseases.

Significant variations between countries are apparent in both antibiotic consumption and antibiotic resistance. People in southern European countries (including Malta) consume on average up to three times more antibiotics than those in northern Europe and have up to 10 times more resistant infections both in hospitals and in the community. This suggests that all too often antibiotics are being used for the wrong reasons, a trend that is accelerating the development and spread of dangerous resistant bacteria. There is clearly a need for public awareness across Europe about antibiotic use to address this health threat.

For this reason, starting this year, November 18 will be designated as European Antibiotic Awareness Day. This European public health initiative aims to raise awareness about the problem of antibiotic resistance, and to provide information on how everyone can contribute to ensure a healthy future with antibiotics. This year European Antibiotic Awareness Day is focusing specifically on the need for everybody to stop any unnecessary use of antibiotics. Unnecessary use includes taking antibiotics without a prescription from a doctor or demanding antibiotics to treat a viral infection such as a cold or flu. Unfortunately, local research has shown that both these practices are among the highest in Europe. When prescribed antibiotics, people need to follow the precise instructions from their doctor on how to take them and always complete the course - even when they start to feel better.

A poster has been published to encourage more sensible use of antibiotics together with a leaflet in both Maltese and English containing answers to frequently asked questions about antibiotic use, especially for colds and other common infections. The leaflet is available from pharmacies, local councils as well as the Ċentru Tagħrif dwar Saħħtek in St John Street, Valletta. Further information about the campaign as well as more leaflets can be obtained by contacting the National Antibiotic Committee on 2545 4557 or by e-mail on peter.zarb@gov.mt.

Dr Borg is the chairman of the National Antibiotic Committee.