to be really annoyed about antibiotics?

[WaterfallsOver]

Or rather their misuse. I have parent friends who run to the GP every time little Billy has a cough, demanding antibiotics, so many people see them as a panacea. I'm not medically trained but I know they don't work on viruses and many illnesses need to run their course with no medical intervention.

The news is telling us antibiotics won't work in a few years due to over/misuse. I feel really angry that selfishness and stupidity mean in a few years people may die from infections resistant to antibiotics :( if they were only used for serious illness perhaps we'd have a chance. There was a guy who died from resistant infection on the news :(

Oh that's interesting Lueji - does that vary from antibiotic to antibiotic?

"The DSs get fevers with swollen tonsils - as a previous poster said, I think that this can be viral or bacterial and the doctors don't want the delay/cost of doing a swab and growing a lab culture to find out"

Very strange. DD's paediatrician quickly swabs & tests to see if the infection is bacterial. No lab culture necessary.

YANBU but it's often not the parents. My son had 15 antibiotic prescriptions in one year for chronic ear infections. He was in agonising pain and burst eardrums several times. In the end was put on a permanent rolling prescription for antibiotics. I begged for him to be given grommets as that would do away with the need for antibiotics but was refused several times over the course of the year because he was not yet 2 and had not ticked several other NICE boxes. In fact I argued that he should have the op because it was not good to be using antibiotics in this way and was told that this was not a valid criterion for the op. So in that instance it was effectively the NHS insisting I rely on antibiotics rather than put in place a long term solution.

FWIW I eventually got my way (after much sobbing in the consultant's office) and he has not had a single antibiotic since the op was done - nearly two years ago.

So don't blame selfishness etc. There are also some very poor policy decisions being made out there.

Suggestions that researchers "aren't doing enough" strike me as pretty audacious, BTW.

The rate of drug discovery is alarmingly slow, actually.
It takes years from identification of a compound to the market, and it's incredibly expensive.
There are already thousands of compounds in databases, which have been analysed, and not particularly promising.
Besides, most current drugs have not been "designed" or developed, but they have been identified from plants, or fungi (many antibiotics), or even bacteria.

The fight against diseases is a Red Queen race, unfortunately. There is no definitive winner.

In addition, it has been a struggle to develop effective vaccines for non-viral diseases.
Although, quite a few diseases can be effectively controlled through hygiene and preventative measures. But will hardly disappear.

I dont know whether to trust all that was being said yesterday by experts on antibs . Is there an AGENDA?

Oooh an AGENDA! What sort? To wipe out all the proles so there will be Tory governments for evermore? What sort of agenda?

Yes, I think the agenda is to spead awareness, and to drum up support for the pan-European initiative which will support (fund?) research into new generation ABs.

richmanpoorman I don't think this is to do with the "free at the point of use" aspect of the NHS. The European countries that I have lived in (France, Belgium, Switzerland - but especially France) are much more free and easy with antibiotics.

"France was the highest consumer of antibiotics; in comparison, Northern Ireland was ranked 8th, Scotland was 16th, Wales was 18th and England was 24th out of 28 European countries. Total antibiotic use was 20.4 DID in Northern Ireland, compared to 14.9 in England."
www.nelm.nhs.uk/en/NeLM-Area/News/2008---October/08/Outpatient-antibiotic-use-in-the-four-administrations-of-the-UK-cross-sectional-and-longitudinal-analysis-/

Oh that's interesting Lueji - does that vary from antibiotic to antibiotic?
The time?
Not sure, it depends on the dosage given at each time.
The point is that in the same way that things like paracetamol stop working in, say, 4 hours, antibiotics do too, because they are excreted and metabolised. When the amount present in the body is too low, they stop working effectively.

We have to have in the body enough antibiotic that kills ALL relevant bacteria. As soon as it's lower than that, we open a window for resistance.

The Bang Goes the Theory episode (on iPlayer) was very good at explaining some of the issues so that idiots (like me!) could grasp it.

They had a very good visual experiment with bacteria growing across bands of increasingly strong antibiotic. Each band stopped the bacteria for a while but then some started to break through to the next band. The same thing happened again with the stronger bacteria breaking through each band of AB. This was to show why it is important to a) have the right dose b) keep that level up and c) finish the course. Otherwise you get left with the strong, resistant bacteria.

There are 'natural' antibiotics; they are foods like garlic and ess. oil of T tree which is the only way that MRSA can be killed. You wouldn't know it though would you?

"There are 'natural' antibiotics"

No there aren't.

I work in drug discovery and development and the rate of discovery is very low. Often you find a compound with very good antimicrobial activity but it's also scarily cytotoxic which makes it unsuitable or at least more difficult for drug development.
There is also very little incentive for pharma companies to develop antibiotics. The cost of bringing a novel compound to the market are horrendous and there is just not that much money to be made from a drug which people take for 5-10 days. It is much more lucrative for them to develop a drug which patients have to take long term e.g against heart disease.

drjohnsonscat I dont believe that it's the overriding/only factor in prescribing, but I do still think it's probably a factor in the decision making process. GPs have budgets and lab tests are pretty expensive. Kid comes in, has cold that he/she just can't kick. Prescribe antibiotics. They'll either work or they won't. Cost to budget: about £1. The lab test would probably cost closer to £25.

seeker The experiments done by scientists involving petrie of dishes of bacteria and garlic killing it are not real then? Sorry I can't link. T tree DOES kill MRSA so that's made up as well is it?

Especially if they somehow get statins recommended for everyone above a certain blood cholesterol level (how did that happen, I have yet to meet a single clinician who thinks it's appropriate).

A review of tea tree oil here Looks promising

What we do in the UK is futile in this global world. ABs can be bought over the counter in the 2nd and 3rd world countries and are not controlled at all. Combine this with a much higher population, less literacy and understanding of completing the course, worse sanitation and closer proximity to animals I would say the next killer bacteria with no cure will come from one of those places.

paper on garlic here

Interesting stuff.

seeker there's nothing wrong in being open to new ideas , garlic was used against the plague in the middle ages very successfully. Of course as Gracelo says the powers that be don't want anyone to help themselves to get better they can't make any money out of it.

I was reading about this recent study just the other day Natural antibiotic derived from sweat

Thanks saintly

I guess the other thing to bear in mind is that there has been no real incentive for major drug companies to spend the bulk of their research monies developing new ABs -although they are widely used in hospitals and surgeries,- but usually only for limited periods of time. The drug companies invest most of their R and D in drugs related to ongoing chronic diseases, where they know people may need them for many years - particularly pertinent to our ongoing ageing population who will keep them in business for the foreseable future.

The drug companies go where the money is to pay their shareholders, simple as that.

But mindosa it has been known for medics to be threatened and actually beaten up by patients\parents who were demanding ABs.

ppeat - should we not expect them to stand up and say no. If they are assaulted then that person will be prosecuted. Thats like saying that if a burglar threatens and policeman then the policeman should let them go.

They have a duty to do what is right

Tea tree oil is toxic when ingested so not sure how it's supposed to replace antibiotics in treatment of bacterial infections except when they are on the skin.