Antibiotics are one of the most important therapeutic discoveries in medical history. They have revolutionised the way we treat patients with bacterial infections and have contributed to reducing the mortality and morbidity from bacterial diseases. They are also an essential tool for modern medicine and common procedures such as transplantation, chemotherapy for cancer and even orthopaedic surgery could not be performed without the availability of potent antibiotics.
Unfortunately, antibiotics have been liable to misuse. They are often unnecessarily prescribed for viral infections, against which they have no effect. Similarly when diagnoses are not accurately made, more often than not, broad-spectrum antibiotics, i.e. antibiotics that kill a large proportion of various bacteria and not only the bacteria responsible for the disease, are prescribed because the causative micro-organism is not known.
Misuse of antibiotics leads to the emergence and selection of resistant bacteria. Doctors in Europe and worldwide now are sometimes facing situations where infected patients cannot be treated adequately because the responsible bacterium is totally resistant to available antibiotics.
Three strategic areas of intervention should be prioritised:
- Prudent use of available antibiotics, i.e. only when they are needed, with the correct dosage, dose intervals and duration.
- Hygienic precautions for the control of cross-transmission of resistant strains between persons (infection control), including hand hygiene, screening for carriage of resistant strains and isolation of positive patients.
- Research and development of antibiotics with a novel mechanism of action.