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 :(

Interesting weary - thanks

Thanks gracelo- as I suspected-why on earth put penicillin in a cleaning spray when alcohol will do the job just as well?

weary does that then compute that, if our antibiotic use goes down, so then will bacterial resistance? (hopeful)

I have dc aged 12 and 9. They have both have one course of anti biotics (dd at birth as I had been left with leaking waters for 5 days ) in their whole lives.

I had some last year, legitimately, for an infected insect bite.

They are terribly over-used but ... why??

My GP would not prescribe them for a minor condition and I wouldn't ask her for them. And even if I did ask, I wouldn't expect her to just give them to me because I'd asked nicely.

I'm with you, Mintyy.....DS1 only every had antibiotics ones until he was 8 then as a teenager and went through a stage of picking his toenails, to the point he ended up with a huge swollen toe twice in one year. I was with him, as it was totally avoidable. So DS1 has had antibiotics 4 times, DS2 has had them twice (once for a splinter in his hand) and DD once, for an ear infection.

I'm convinced most ham is full of antibiotics, but DH still offers it to the DC.

I have know a family and their GP (was in France so pediatrician) abouse antibiotics, by giving them constantly to children...10 days on 5 days off, 14 days off 10 on...for months this went on for ear infections, ect. Seriously.....the parents were both lawyers, so not stupid people, but not medics either. I found the whole thing

weary does that then compute that, if our antibiotic use goes down, so then will bacterial resistance? (hopeful)

Yes, to some extent, though it will take time and a very serious global change in how antibiotics are used. Once there aren't so many antibiotics being used, there won't be so much selective pressure for them to develop resistance. So not only will the non-resistant strains be able to compete with the resistant stains on a more equal footing, the fast-forward evolution I talked about will also remove the resistance from some strains as there is no reason for it to be there any more.

That being said, the very low-level use of antibiotics will need to be kept up constantly - as soon as antibiotics become common again, the resistant strains will pop right back up and we'll be back to square one.

There is a new blood test that is being developed and trialled in a couple of areas that will identify whether a patient has got a bacterial/viral/no infection. This can be turned around in 2 hours. It is hoped this technology will be in GP surgeries in the future. So far the trials have shown a significant decrease in the use of ABs.

XBenedict, well I can safely predict it won't be used routinely in the UK. I have never once had swabs taken and cultured here using the NHS. We just have to guess.

The genetics of antibiotic resistance are very complex and so , while the basic view that reducing antibiotic selective pressure should decrease resistance is true, what we don't know is what the timescale for that reduction would be and how long it would be maintained (antibiotic resistance evolved long before humans started using antibiotics, in response to substances produced by other microbes).It is clear from work done over many years on samples from the Gambia for instance, that, despite antibiotic use being virtually zero, antibiotic resistance genes were acquired by a common bacterium, Haemophilus (which only lives inside humans) and maintained in the bacterial population despite obvious selective pressure.
Also, zero antibiotic use is neither achievable nor desirable. Although I deplore the apocalyptic tone of a lot of this week's coverage ,it is certainly true that without effective antibiotics, chemotherapy and transplant would be impossible, childhood mortality would rise and common surgical procedures would have much higher risks.

An additional problem, regarding finding new drugs, is that, often, resistance is due to increased excretion of the drug from the cell (in bacteria or parasites).
That is one reason why resistance to one drug (antibiotic, whatever you want to call it) often leads to resistance to other drugs too.

Tis the plan but we will have to see.

I guess the difference is time, a swab would take days to culture by which time you would have started taking the ABs whether you needed to or not whereas the blood test currently has a 2 hour turn around.

Something has to change!

wearymum - what bit of science do you work in?

XBenedict, is it the plan for the NHS in the UK? If so that will be a major difference.

Yes I think it's currently in a Hampshire NHS hospital.

There are lots of blood tests in various stages of trial for predicting whether a patient has an infection or not. However, it is unlikely that any of the ones I have looked at will be available in GP surgeries as there are huge issues around how you control quality of tests, let alone those which require expensive kit, as well as cost benefit needing to be demonstrated. A number of UK hospitals do use such tests and seem to find them helpful ,but not so overwhelmingly better than routine practice that testing is used everywhere.
Xbenedict; is this an assay with data in the medical literature (curious and keen to eye up anything new)

It looks for levels of procalcitonin which as you probably know weary, rise in bacterial infections. Not a standalone test more of an additional test that might influence earlier treatment selection.

I believe that in the US they routinely actually find out a) if it's viral or bacterial and b) if bacterial what type of bacteria before they prescribe. In the UK the GP guesses.

How do they do that Lady do you know?

Which, the guessing or the cultures?

How do they find out? Using blood cultures? Swabs?

I thought the USA use ABs fairly intensively although I think the usage has declined in recent years but without looking it all up I could be hideously wrong and very out of date with my comment

Drug companies don't make enough money out if antibiotics so they don't spend much time researching them.

YANBU to be annoyed with people who 'demand' them, but I'd be more annoyed with professionals who 'give in' based on behaviour rather than need.

Serious illness is relative though, so I am personally wary about judging the individual who appears to be at the doc lots without the full facts.

Having said that, when I was on antibiotic number 4 for a recurrence of pneumonia that just would not go, I was shitting the proverbial brick about 'antiobiotic resistant strains' and had to go on a self-imposed medical website ban & get DP to do the googling

The irony is that while there are some people who feel cheated if they come away from the GP surgery without a prescription, there are others who would prefer to have a diagnosis from the expert - and then self-manage their illness using common sense. The latter tend to get short shrift however. I personally would never say to a doc: no thanks to the anti-biotics, I'm going to use a cut onion. I would just say: I'm going to tough it out, thanks; and then they would look at me like I'm crazy.

And they never ask patients: are you a patient who takes every pill going, or are you a patient who would prefer not to take a pill if at all possible?

I don't think antibiotic resistance works like that, SeniorWrangler. They don't make you personally resistant to the drugs, they make bacteria in general more resistant to them.