Not patients’ fault if antibiotics have lost power

Doctors have been dishing them out far too much, and now we're paying for it

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The Independent Online

A friend of mine, frustrated at being forever single, used to joke about how she would have courses of antibiotics that lasted longer than her relationships.

Putting aside what this says about being a thirtysomething woman in London, it shows how commonplace it has become for a quick seven-day prescription from our GP to cure everything from a sore throat to a chest infection.

We are awash with antibiotics. GPs have been over-prescribing them, reducing our immunity to deadly bacteria, which have become increasingly resistant to drugs.

This problem is so serious that last month, Dame Sally Davies, the chief medical officer, likened the threat from antibiotic-resistant infection to climate change and terrorism. Now the Prime Minister has launched a review into why no new antibiotics have been developed in the past 25 years.

This is all very frightening to patients, particularly those whose lives have been saved by antibiotics. When David Cameron talks about medicine returning to the “dark ages” if nothing is done about increasing resistance, he means women dying from what are normally routine, treatable infections after childbirth, or people being killed as a result of a single scratch. Antibiotics are the treatments we take for granted, and that is the core of the problem.

So who is to blame for this ticking time bomb, as Dame Sally called it? When the Prime Minister’s review was announced yesterday, there was a rush to point the finger at patients. A woman representing the Royal College of GPs was on the radio suggesting that patients are in part to blame because they expect a course of antibiotics from their doctor. Theodore Dalrymple, writing in The Times yesterday, said GPs had over-prescribed for fear of litigation from patients who become seriously ill.

 

There are two issues here, it seems: one is that patients can under-dose themselves by failing to finish the course, which allows bacteria to build up more resistance. For that, we patients must shoulder some of the blame. Because antibiotics can make us better within a day or two, it is easy to stop taking the tablets for the full course.

Yet this impending disaster for humans cannot just be laid at the door of patients. To suggest that we “expect” to be treated with antibiotics is just another buck-passing exercise that the medical profession is so fond of.

Just as GPs accuse patients of putting pressure on primary care when they are the ones who refuse to see us in evenings and at weekends, so too are they trying to blame us for the antibiotic crisis that has been, largely, in their control.

It is GPs, not patients, who have been dishing out antibiotics at the first sound of  a cough or sight of a white spot on the tonsils. In the past few years there has been more awareness, on the part of both patients and doctors, of the resistance problem. But antibiotics have continued to be handed out like sweets.

Is it any wonder when doctors seem to want to get rid of us as soon as possible from their consulting rooms? Appointments are supposed to be in 15-minute slots, but you are lucky if you get as much as five minutes. The problem of over-prescription is not about fear of litigation but merely part of a wider culture of patients being treated more like items on a supermarket checkout belt than as sick people needing treatment. And this culture, of course, is down to the dwindling amount of money and time there is to go around in the NHS.

There is also, as ever, a serious case to answer from Big Pharma. Cameron’s review, to be chaired by the economist Jim O’Neill, is about market failure, and why scientists and drug companies have not developed new antibiotics since the late 1980s. To suggest patients are at the heart of this crisis is simply a joke.

Where better to give birth than Primark?

As many heavily pregnant women will know, if you go into labour while shopping at John Lewis the company gives you free vouchers to spend on your new baby. At least this was the case in 2010, when, several days overdue, I would hobble around their maternity department hoping for my waters to break.

It never happened (in the end I went into labour in our local pub, a pretty useless place for waters to break if ever there was one). But I thought of this when I read about the woman who gave birth on a busy shopping street outside Primark in Birmingham this week.

Paramedics and passers-by helped her give birth to a girl as she was shielded by blankets. The first thing I thought was, I wonder if she had been hoping for some Primark freebies? And the second thing I thought was, how unlucky to be just outside the shop. I hope Primark does the decent thing and sends her some vouchers for the free publicity.

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