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Urgent action needed to tackle 'catastrophic' rise in antibiotic resistance

CMO warns of threat that could push healthcare back 200 years

Mark Gould

Monday, 11 March 2013

Global action is needed to tackle the catastrophic threat of antimicrobial resistance, which in 20 years could see any one of us dying following minor surgery, England’s Chief Medical Officer, Professor Dame Sally Davies warned today.

Writing in advance of publication of the second volume of her annual report she calls on politicians to treat the threat as seriously as MRSA, and she speaks of a “discovery void” with few new antibiotics developed in the past two decades.

She makes 17 recommendations including calling for new infection control measures which should go beyond hospitals and be applied to home and community care settings.

She says the national approach to tackling antimicrobial resistance should not just focus on humans and the risk of antimicrobial resistance in animals should be managed closely by the Department for Food, Environment and Rural Affairs.

She wants Public Health England to work closely with the NHS Commissioning Board to make sure that advanced testing facilities are available to treat infections brought into the country from abroad:

Other recommendations include:

  • Further promotion of the benefits of vaccination and encouragement of vaccine uptake during pregnancy to prevent diseases such as flu and whooping cough should be undertaken;
  • Directors of Public Health should work with schools to ensure the school nursing system is well-placed to deliver new immunisation programmes;
  • A call for antimicrobial resistance to be put on the national risk register and taken seriously by politicians at an international level, including the G8 and World Health Organization;
  • Better surveillance data across the NHS and worldwide to monitor the developing situation;
  • More work carried out between the healthcare and pharmaceutical industries to preserve existing drugs and encourage the development of new antibiotics to fill the “discovery void” of the last 20 years; and
  • Building on the success of the NHS in cutting MRSA rates, which have fallen by 80 per cent since a peak in cases in 2003 through better hygiene measures, which should be used when treating the next generation of healthcare associated infections such as new strains of harder-to-treat klebsiella.

The Department of Health says it is soon to publish the UK Antimicrobial Resistance Strategy setting out how it will meet the challenge that the Chief Medical Officer has outlined.

It says the action plan set out to foster more responsible use of antibiotics – by ensuring NHS staff have the skills, knowledge and training to prescribe and administer antibiotics appropriately. Part of this will include reviewing and updating the curricula for medical undergraduates.

It will also strengthen surveillance by improving the recording of data on the numbers of antibiotics prescribed and trends in antibiotic resistance, which can be used by clinicians to change patterns of prescribing. This will help reduce the level of resistance and help ensure patients respond to treatments.

And it will encourage the development of new diagnostics, therapeutics and antibiotics, for example by continuing to support the Innovative Medicines Initiative (IMI) and other initiatives that encourage scientific research.

Dame Sally says that while a new infectious disease has been discovered nearly every year over the past 30 years, there have been very few new antibiotics developed leaving our armoury nearly empty as diseases evolve and become resistant to existing drugs.

In addition to encouraging development of new drugs, the report highlights that looking after the current arsenal of antibiotics is equally important. This means using better hygiene measures to prevent infections, prescribing fewer antibiotics and making sure they are only prescribed when needed.

She said: “Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics. And routine operations like hip replacements or organ transplants could be deadly because of the risk of infection.

“That’s why governments and organisations across the world, including the World Health Organization and G8, need to take this seriously.

“This is not just about government action. We need to encourage more innovation in the development of antibiotics – over the past two decades there has been a discovery void around antibiotics, meaning diseases have evolved faster than the drugs to treat them.

“In some areas, like cutting rates of drug resistant MRSA, the NHS is already making good progress so it’s important that we use that knowledge across the system and I hope my recommendations will prompt people to do that.”

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