(Photograph by Michael Mortensen)
Antibiotic resistance, where drugs used against bacterial infections cease to be effective, is a terrifyingly large problem. The World Health Organization’s (WHO) 2014 report on antimicrobial resistance, a term which includes antibiotic resistance, is a frightening read. Extremely high rates of resistance have been observed in all WHO regions in common bacteria causing a variety of infections.
Perhaps the most concerning form of antibiotic resistance is that occurring in Mycobacterium tuberculosis. According to WHO 2013 saw around 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB). MDR-TB requires treatment courses that are much longer and less effective than those for non-resistant TB.
There are also significant concerns for a number of other bacterial diseases. Only last month a ‘Super-gonorrhoea’ outbreak was reported in Leeds. This interactive map confirms such antibiotic resistance is far from a UK only problem.
One of the major difficulties in counteracting antibiotic resistance is that there is not a large burden for the individual in misusing antibiotics, yet simultaneously there is an extremely large burden for society. In a similar manner to global warming, whereby there is no immediate and personal disadvantage to using fossil fuels, there is no immediate personal disadvantage to only taking part of an antibiotic prescription once one feels better. This makes the task of communicating the importance of action on antibiotic resistance complex.
The significance of such communication has been recognised in a global action plan to tackle the growing problem of resistance to antibiotics and other antimicrobial medicines, endorsed at the World Health Assembly in May 2015.
Improving awareness and understanding of antimicrobial resistance, including antibiotic resistance, is a key aim of the plan. So how can this best be done?
Communicating for Behaviour Change
This terrifying blog is a typical introduction to the dangers of antibiotic resistance. It details how losing effective antibiotics could send us back to a time when a scratch on the knee could become infected and kill. It is an accurate and fascinating article, but indicative of a general approach to antibiotic resistance, highlight the terrifying implications of not doing anything, and then briefly mentioning a couple of things that one might do to help. This makes a lot of sense, present the problem and then the solution. However there has been recent evidence that positive public health messages can be a lot more effective in establishing the behaviour change we so desperately need.
This is why campaigns such as the upcoming World Antibiotic Awareness Week are so important. It is the first global campaign of its kind and as well as raising awareness of the issue of antibiotic resistance it aims to promote best practices amongst the public and beyond. Such practices are simple for an individual: preventing unnecessary infections by washing hands and getting vaccinated, as well as using antibiotics wisely when an infection has occurred, for example not using them for viral infections (which do not respond to antibiotics) and finishing the entire course irrespective of whether one feels better.
The future of modern medicine depends on the communication of these simple messages. Without each of us playing our part on a day-to-day basis, we do face a future where simple cuts regularly kill and certain operations are simply too risky to perform due to risk of incurable infection. However there is still a lot we can do, and for this to happen we must communicate this effectively. If we continue painting an apocalyptic future without any effective antibiotics we may be writing a self-fulfilling prophecy.