Bacteria Are Fighting Back and the Only Solution We Have at This Time Is to Control Our Antibiotic Usage; in the 90 Years since Fleming Discovered Penicillin, Antibiotics Have Revolutionised Modern Medicine. but with the Emergence of Potentially Lethal Antibiotic-Resistant Bugs and a Lack of New Antibiotic Discoveries, Health Editor Madeleine Brindley Asks Whether the Revolution Is Over

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Byline: Madeleine Brindley

"WHEN I woke up just after dawn on September 28, 1928, I certainly didn't plan to revolutionise all medicine by discovering the world's first antibiotic, or bacteria killer," Alexander Fleming said. "But I guess that was exactly what I did."

Fleming's discovery of penicillin - or rediscovery, as French medical student Ernest Duchesne is credited with first noticing it in 1896 - is regarded as the start of the antibiotic age. But it would be almost 20 years before penicillin began to be used regularly.

The discovery of antibiotics revolutionised modern medicine, with the introduction of effective drugs to treat common and life-threatening infections.

In their early years antibiotics were heavily marketed as cures for almost everything - billboards proclaiming that "antibiotics cure gonorrhoea in four hours" were common on street corners.

But as the discovery of new antibiotics has slowed to a trickle and antibiotic-resistant bacteria are becoming more prevalent in our hospitals and in the wider community, our love affair with antibiotics could spell the end of the revolution.

There is increasing concern throughout the world that the more we use antibiotics, the less effective they could become, ultimately leading to the Armageddon scenario where even the most common infection is untreatable because all bacteria have become resistant to our arsenal of antibiotics.

The European Centre of Disease Prevention and Control has warned that if current usage and resistance trends continue it will make it harder for hospitals to carry out operations.

Dr Tony Jewell, Wales' chief medical officer, said: "Antibiotics are important medicines used to treat infections caused by bacteria and the use of antibiotics has saved countless lives since they were developed.

"However, taking antibiotics when they are not needed or not taking them correctly will lead to more bacteria becoming resistant to them.

"We therefore need to reduce our reliance on the prescription of antibiotics for common ailments that could be managed in other ways."

Dr Robin Howe, head of the National Public Health Service for Wales' (NPHS) antimicrobial resistance programme, said: "Antibiotics are victims of their own success because they are generally very effective in treating infections.

"They have totally changed the treatment of infections - previously, before antibiotics, patients would invariable die from meningitis or other serious infections, like endocardititis. But now, with antibiotics, they generally do very well.

"People who used to die of infection now no longer die of infection. Complications are much less an issue than previously.

"Antibiotics have had a massive success and the public knows that they are effective for treating infection. Allied to that they are generally very safe and generally free of side effects and you only take them for a very short time so they are, therefore, very easy for patients to take.

"All this means is that people are going to have a low threshold for taking antibiotics - the public doesn't think it is a big thing and, until very recently, medics had not thought that giving antibiotics was a big thing."

Wales' first report into the use of antibiotics in primary care, which was published last week, reveals that 2.4m prescriptions for antibiotics were dispensed last year - almost enough for one course for every person in Wales. About 80% are prescribed in primary care.

Although the number of antibiotics prescribed and dispensed to patients has remained relatively stable during 2007 and 2008, there was a 5.8% increase in 2006, despite growing awareness about the problem of antibiotic resistance.

COLD COMFORT: antibiotics are not The figures also raise the spectre that some GPs are continuing to prescribe antibiotics contrary to the latest guidelines issued by the National Institute for Health and Clinical Excellence and inappropriately for coughs and colds. …