Back to basics call to fight bug threat

By Robin McKie

Scientists call for revamp of hospitals and new generations of effective antibiotics.

Only a handful of new antibiotics are in production. Photo / AP
Only a handful of new antibiotics are in production. Photo / AP

Hospital wards need to be redesigned to provide urgently needed defences against the spread of deadly, antibiotic-resistant superbugs.

That is the stark warning from scientists who say the danger now posed by drug-resistant infections has reached crisis level.

In the long term, governments must encourage the pharmaceuticals industry to develop new generations of antibiotics, said a group of leading British experts. But these new drugs will take so long to reach the market that short-term measures must also be introduced to hold back the flood of resistant diseases that now threatens to overwhelm health professionals.

The call comes amid growing global concern at levels of antibiotic resistance. A group of senior scientists - including Dame Sally Davies, the UK's chief medical officer, and Professor Jeremy Farrar, director of the Wellcome Trust - told the Royal Society that the planet faced the prospect of people dying from routine infections because effective antibiotics no longer existed.

Changes to be made to hospital wards should, they said, include greater distances between beds, lower bed occupancy rates, improved staff-patient ratios and large, openable windows.

"We are talking about returning hospital wards to the type we had 100 years ago," said microbiologist Professor Kevin Kerr, of Hull York Medical School. "They had huge windows that let in sunlight, which helped kill bacteria, and let in fresh air, that swept bacteria away from patients. Beds were far apart. All these things restrict the spread of drug-resistant bacteria."

The crucial point of such "old school" measures is to buy time, said fellow microbiologist Professor Mark Fielder, of Kingston University in Surrey, southeast England.

"We need to hold back the spread of resistant bacteria while finding ways to persuade pharmaceuticals [companies] to improve their output of new generations of antibiotics - for we are facing a future in which there might be no effective antibiotics left on the planet."

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Kerr said: "In the near future it is possible that a scratch from a garden rose thorn could become septic. Without effective antibiotics, septicaemia could easily set in and result in death. It is a terrible prospect but a very real one. We are facing a return to the state of affairs that existed before antibiotics were discovered."

Resistance to antibiotics arises as a consequence of the processes of natural selection. In a population of bacteria, some are more resistant to drugs than others. Occasionally these resilient strains survive, multiply and become progressively more resistant to antibiotics. This is how superbugs such as MRSA have evolved.

Scientists estimate there are now about 5000 deaths a year in the UK due to strains of bacteria that have evolved resistance to antibiotics. The continuing rise in resistance could have even wider repercussions. Surgery, and treatment for diseases such as leukaemia, would be very hard to carry out if there were no means to kill off random infections in patients.

"This is the crisis of all medical crises."
Professor of Microbiologie Kevin Kerr

Yet only a handful of new antibiotics are in development.

The major problem for medicine is that antibiotics, which are usually taken for about a week, do not offer good returns to shareholders in pharmaceuticals companies. Drugs that are taken long-term, such as those to tackle diabetes or high blood pressure, offer a much better prospect of good profits.

The urgent issue of persuading drug companies to develop new antibiotics should be tackled by the medical equivalent of a body like the Intergovernmental Panel on Climate Change, Davies and Farrar said. They suggested companies be given tax breaks for making new antibiotics.

- Observer

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