Two recent reports about antibiotic resistance increase the concern that Penningtons Manches and many other commentators have been voicing for some time.
The first is a recent patient satisfaction survey in the UK which found that patients who are denied antibiotics by their GP are more likely to express dissatisfaction with the quality of the GP care they receive. Part of a GP's earnings is dependent on them achieving a minimum level of patient satisfaction fixed by the Government. There can therefore be a clear conflict between managing patient satisfaction and denying antibiotics when they are inappropriate.
The second report in The Lancet is about the use of antibiotics in the food chain. Many antibiotics are administered prophylactically by farmers to try to protect perfectly healthy animals from any possible risk of infection. In some countries, antibiotics are also used to increase the rate of growth of animals, to speed up food production. The effect is that treatment of some infections is now becoming near impossible.
The report warns of genetic mutation that has resulted in bacteria becoming resistant to collastin, an antibiotic of last resort. This resistance is no longer confined to animals and has been detected in hospital patients. There are fears that the mutation will now spread to other bacteria.
Antibiotic use in farming is more prevalent where animals are kept in cramped, dirty conditions where the risks of infection are higher. The level of antibiotics used in animals varies hugely from country to country. Scientists are calling for some antibiotics to be banned completely from food production and for others to be limited to maximum levels that have already been demonstrated to work effectively.
Andrew Clayton of Penningtons Manches' clinical negligence team comments: "At current rates, global antibiotic use is expected to increase by two-thirds in the next 15 years and human health depends on antibiotics remaining effective to treat patients. It is clear from recent patient surveys that more needs to be done to educate people that antibiotics are not a universal panacea and that there is real danger in using them inappropriately.
“The current association between a GP’s earnings and patient satisfaction needs refining to reward GPs who deliver proper healthcare, rather than simply bowing to patient pressure.
"It is also clear that public awareness now needs to extend to better understanding of the food chain and to developing globally agreed principles for the use of antibiotics in animal husbandry. Farmers use antibiotics far more than doctors prescribe to patients. The latest evidence shows that, unless co-ordinated limits and regulation of antibiotic use are introduced to food production, the efforts to manage antibiotic use in patients will be undermined."