Infection ? The drugs won't work !

[Doc Alan]

• Only use antibiotics when prescribed by a doctor.

• Don’t demand them against clinical advice ( such as for common colds in UK ; antimalarials for any fever in Africa without first confirming the cause ).


• Obtain them from a reliable pharmacist.

• Complete the full prescription, even if you feel better.


• Don’t share antibiotics or use left-over prescriptions.


• Take my advice or read more … although you may well not wish to read over 350 pages written in a new World Health Organization report and by the English Chief Medical Officer !



http://apps.who.int/iris/bitstream/1...564748_eng.pdf


http://www.amazon.co.uk/Drugs-Dont-W.../dp/0241969190

.


• Both make the point that resistance to our current range of antibiotics is happening – in England, the Philippines, and every region of the world. It can affect anyone, any age, in any country.


• Not your problem ? Inappropriate use of antibiotics, wrong antibiotics, fake antibiotics, or not completing a course of the “ right “ antibiotics, can lead to resistance which may affect an individual when they genuinely need treatment.



• No new class of antibacterial drugs has been discovered for over a quarter of a century, and the bugs are fighting back. They mutate / change naturally. The process is speeded up by using antibiotics inappropriately. It’s not just bacteria like “ MRSA “, but also other causes of infection, like parasites, viruses and fungi – in community and hospitals.



• Each new anti-infective drug has been followed by resistance to it. Drug companies are not well motivated to find new drugs - in part because they are not as lucrative as, say, anti-cancer drugs.


• In the Philippines :-

1. Whether or not antibiotics should be “ prescription only “ they may still be available over-the-counter and online.


2. Generic drugs ( containing the active ingredient but cheaper than the branded drugs ) are – with some justification – not always trusted by patients, doctors or pharmacists. Branded drugs are relatively more often bought and prescribed than in other countries such as the UK, USA and India. Even generic drugs are relatively expensive.


3. Filipinos may prefer other remedies, and / or can’t afford a health professional and the drugs they might recommend.


4. There’s a growing threat of counterfeit / fake drugs – not only antibiotics, but also anti-cancer agents and others like “ Viagra “ ( not only in the Philippines ).




• We’ve been abusing antibiotics because we take them for granted – as patients, healthcare workers, travellers, and in our food ( overuse in agriculture, feeding animals / fish ) . Common ailments and operations are becoming more serious and difficult, if not fatal. Bloodstream infections ( sepsis ), diarrhoea, pneumonia, urinary tract infections and sexually transmitted diseases like gonorrhoea are cause for concern - in all regions of the world.


• Antibiotic resistance causes people to be sick for longer, increases risk of death, and increases healthcare cost ( whoever is paying ), length of stay in hospitals, and intensive care requirements.



• Of concern, each probably under-reported, are :-


1. Multidrug-resistant TB.


2. Poor-quality antimalarial drugs.


3. Anti-HIV drug resistance.


4. Antibacterial resistance in food-producing animals ( a link between antibiotic use in farm animals and antibiotic-resistant human infection is not proven ).



• Measures - such as declaring non-prescription antibiotics illegal ; access to clean water; infection control in hospitals and surgeries; more vaccination ; reducing antibiotic use in agriculture ; public health campaigns ; basic systems to track and monitor the problem - may all help and reduce the need for antibiotics. But the problem needs to be taken more seriously – not just in my opinion !

[marksroomspain]

As you know, a dental abscess can be very painful, so make sure you have painkillers such as ibuprofen and / or paracetamol.


It will have been explained that the only way to cure a dental abscess is by the dentist or dental surgeon cutting into it to drain away the pus ( fluid containing the bacteria / bugs ).


Antibiotic resistance ( including MRSA ) is a worldwide problem. It's more so in the Philippines than the UK. This is because antibiotics have been, and may still be, purchased " over-the-counter ", or online ( although they should be prescribed, as here ). They may be wrong / inappropriate ( or fake ) for a particular infection. Even if genuine, the course may not be completed.


However, antibiotics may not always be needed for dental abscesses unless there are complications ( like local spread ). If they were needed, amoxicillin ( a type of penicillin ) or metronidazole would be appropriate , so resistance to methicillin ( as in MRSA ) would not usually be an issue.

A follow up to my dental abscess, after not bearing the pain anymore and after a week on amoxicillin and maximum dose painkillers a trip to the emergency dentist I made today.

As the doc said the dentist cut into my abscess (god, the pain even though my gum was numbed, was excruciating for those couple of seconds) and drained the pus out but the almost instant relief was a godsend.

A cost of just £18.50 and 2 lots of antibiotics £16.10 was worth paying 10 times more just for the relief.

A 5 day course of more amoxicillin and metronidazole and then a follow up for root canal treatment cost of £50.50 then all in all I am pleased to get change out of £100 more for the relief I have now...

[Doc Alan]

Thanks for the update Mark, and best wishes to you

Rather than distract Slip on this thread I thought a separate thread on antibiotics and the worldwide problem of resistance might be of interest. It's on the " Health Issues " section .

[marksroomspain]

Thanks for the update Mark, and best wishes to you

Rather than distract Slip on this thread I thought a separate thread on antibiotics and the worldwide problem of resistance might be of interest. It's on the " Health Issues " section .

Thanks Alan,

Could I ask one of the moderators to move my post to that section thank you...

[Arthur Little]

Thanks Alan,

Could I ask one of the moderators to move my post to that section thank you...

Mark ... in accordance with your request, I have duly transferred the two posts relating to your dental abscess to the appropriate thread of Alan's in the Health Issues Section.

[Dedworth]

Good informative post Doc

I read this related article in the Mail the other day

http://www.dailymail.co.uk/health/ar...rk-report.html

[Michael Parnham]

• Only use antibiotics when prescribed by a doctor.

• Don’t demand them against clinical advice ( such as for common colds in UK ; antimalarials for any fever in Africa without first confirming the cause ).


• Obtain them from a reliable pharmacist.

• Complete the full prescription, even if you feel better.


• Don’t share antibiotics or use left-over prescriptions.


• Take my advice or read more … although you may well not wish to read over 350 pages written in a new World Health Organization report and by the English Chief Medical Officer !



http://apps.who.int/iris/bitstream/1...564748_eng.pdf


http://www.amazon.co.uk/Drugs-Dont-W.../dp/0241969190

.


• Both make the point that resistance to our current range of antibiotics is happening – in England, the Philippines, and every region of the world. It can affect anyone, any age, in any country.


• Not your problem ? Inappropriate use of antibiotics, wrong antibiotics, fake antibiotics, or not completing a course of the “ right “ antibiotics, can lead to resistance which may affect an individual when they genuinely need treatment.



• No new class of antibacterial drugs has been discovered for over a quarter of a century, and the bugs are fighting back. They mutate / change naturally. The process is speeded up by using antibiotics inappropriately. It’s not just bacteria like “ MRSA “, but also other causes of infection, like parasites, viruses and fungi – in community and hospitals.



• Each new anti-infective drug has been followed by resistance to it. Drug companies are not well motivated to find new drugs - in part because they are not as lucrative as, say, anti-cancer drugs.


• In the Philippines :-

1. Whether or not antibiotics should be “ prescription only “ they may still be available over-the-counter and online.


2. Generic drugs ( containing the active ingredient but cheaper than the branded drugs ) are – with some justification – not always trusted by patients, doctors or pharmacists. Branded drugs are relatively more often bought and prescribed than in other countries such as the UK, USA and India. Even generic drugs are relatively expensive.


3. Filipinos may prefer other remedies, and / or can’t afford a health professional and the drugs they might recommend.


4. There’s a growing threat of counterfeit / fake drugs – not only antibiotics, but also anti-cancer agents and others like “ Viagra “ ( not only in the Philippines ).




• We’ve been abusing antibiotics because we take them for granted – as patients, healthcare workers, travellers, and in our food ( overuse in agriculture, feeding animals / fish ) . Common ailments and operations are becoming more serious and difficult, if not fatal. Bloodstream infections ( sepsis ), diarrhoea, pneumonia, urinary tract infections and sexually transmitted diseases like gonorrhoea are cause for concern - in all regions of the world.


• Antibiotic resistance causes people to be sick for longer, increases risk of death, and increases healthcare cost ( whoever is paying ), length of stay in hospitals, and intensive care requirements.



• Of concern, each probably under-reported, are :-


1. Multidrug-resistant TB.


2. Poor-quality antimalarial drugs.


3. Anti-HIV drug resistance.


4. Antibacterial resistance in food-producing animals ( a link between antibiotic use in farm animals and antibiotic-resistant human infection is not proven ).



• Measures - such as declaring non-prescription antibiotics illegal ; access to clean water; infection control in hospitals and surgeries; more vaccination ; reducing antibiotic use in agriculture ; public health campaigns ; basic systems to track and monitor the problem - may all help and reduce the need for antibiotics. But the problem needs to be taken more seriously – not just in my opinion !

Glad to see, you've hit the nail on the head again Alan, when in the Philippines I noticed many young ladies buying antibiotics at pharmacy, even Maritess used to buy them and it took me a long time to get her to understand that under no circumstances should she take antibiotics randomly and only if prescribed by a doctor or dentist. Eventually it sunk in and then she started educating her friends about the use or none use of antibiotics, so some of my advice turned out useful!

[marksroomspain]

Mark ... in accordance with your request, I have duly transferred the two posts relating to your dental abscess to the appropriate thread of Alan's in the Health Issues Section.

Thanks Arthur...

[Doc Alan]

Thank you for your interest in a topic which concerns us all .


AstraZeneca is resisting Pfizer’s hostile take-over by claiming 10 new medicines in its development pipeline which might each generate over $ 1 billion of annual revenue – for cancer, asthma, Alzheimer’s disease, diabetes, arthritis and others … but no antibiotics .


Medicines account for over 12% of the NHS budget. It’s vital that they are used properly. Up to half of patients taking medicines for chronic conditions don’t take them as directed, leading to avoidable ill health and economic loss.


Developing new medicines is a costly and lengthy process. Most potential drugs never reach market. Failure in clinical trials may cost many millions of pounds. The cost and time taken to bring a medicine to market needs to be reduced.


The need for new incentives is especially true for antibiotics ! The main problems are that they are taken for a short period of time, and are either curative or don’t work because of resistance .



There’s yet another new publication on the topic of “ new medicines, better medicines, better use of medicines “ (http://www.rpharms.com/promoting-pha...ull-report.pdf ).


In this we’re again reminded that the world urgently needs new ways of treating infections to fight the increasing resistance to medicines now available. Some infections can now only be treated with antibiotics that have not been used for decades. Plants, animals, the sea, and even microbes themselves might be sources of new antibiotics classes ( for bacteria / “ bugs “ ) and antimicrobials ( including viruses and fungi ). Other possibilities include bacteriophages ( viruses which infect and kill bacteria ), or immune treatment ( using antibodies ).


At the very least, it’s worth remembering :-

• Use prescribed antibiotics ; don’t demand them against clinical advice ; obtain from a reliable pharmacist ; complete full prescription, even if you feel better ; don’t share antibiotics or use left-over prescriptions .