Why antibiotics are precious

Image copyright ALFRED PASIEKA/SPL
Image caption Superbug bacterial infections like C difficile are on the increase globally

You need only go back 70 years to a time when a scratch and a common infection could prove deadly.

Routine surgery and childbirth could be a hazardous business.

Penicillin had been discovered in 1928 by Sir Alexander Fleming, but human trials did not begin for over a decade.

The first patient was an Oxford policeman, Albert Alexander, who had scratched his face on a rose bush and the wound became seriously infected (another historical version has him injured in a bombing raid).

He was treated with penicillin and his condition rapidly improved, but supplies ran out before he could be cured and he died.

By the end of the war penicillin was being widely produced, and other drugs quickly followed - marking the start of the antibiotic era.

So most of us have grown up with these miracle drugs readily available.

It's understandable that patients and some doctors simply can't comprehend the concept of a pre-antibiotic world.

But that is what's at stake unless the threat is taken seriously.

Rise of superbugs

Image copyright CDC/SCIENCE PHOTO LIBRARY

Much of modern medicine is now underpinned by antibiotics.

Surgery is more invasive than ever: from hip replacements to cancer treatment and transplants - antibiotics are essential to prevent and treat infection.

There have been repeated calls on doctors to curb the overuse of antibiotics going back many years.

I can remember reporting on a House of Lords committee report in 1998 which criticised GPs for handing out unnecessary prescriptions.

It said patients needed to be weaned off their reliance on antibiotics.

Nearly two decades on, the health watchdog NICE estimates that one in four antibiotics prescriptions is inappropriate.

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Media captionFergus Walsh: "It's nearly 30 years since a completely new class of antibiotics was introduced"

Whilst it is important that the NHS exercises better stewardship of antibiotics, it is worth remembering that this is a global problem that requires global solutions.

Superbug infections respect no borders and have spread from continent to continent with ease.

This is a serious concerns because many developing countries have far poorer controls on antibiotic use.

In my Panorama: Antibiotic Apocalypse earlier this year I investigated the rise of superbugs, and the ease with which last-ditch antibiotics can be bought without prescription in India.

In the past decade India has become the world's largest consumer of antibiotics, and drug resistant infections are rampant in many hospitals.

But this is not just a developing world issue.

Misuse

Last year the World Health Organization found that some antibiotics could be bought legally over the counter in 19 out of 43 European countries surveyed.

Then there is the widespread misuse of antibiotics in agriculture, in farmed animals and fish.

More antibiotics are used in livestock production than for human health and there is widespread concern about the use of long-term, low-dose antibiotics in animal feed in countries like the US, China and India.

Part of the problem is due to simple evolutionary pressure: bacteria are constantly evolving, and resistant strains emerging.

This means there is a constant battle to stay ahead of the germs.

But developing new antibiotics has proved hugely difficult - it's nearly 30 years since the last new class of antibiotics came on the market.

Patients like Graham Gaston are a reminder of how dangerous it can be to catch a superbug infection.

He spent five months this year in hospital in Liverpool after developing a drug-resistant blood infection.

At times he was delirious - the toxins from the bacteria were affecting his brain.

He is now back home, but is still taking some antibiotics, in a bid to prevent the infection returning.

Graham told me he would not be alive but for antibiotics, and, like most of us, had not realised their importance prior to his illness.

The economist Jim O'Neill is heading a review into antimicrobial resistance - which is looking not just at bacterial diseases, but parasitic and viral infections like malaria and HIV too.

Lord O'Neill has already published initial recommendations on solving the crisis, which includes a global fund to boost research.

His final report will be published next year.

Panorama: Antibiotic Apocalypse is available on BBC iPlayer.

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