The health secretary’s blasé attitude towards taking and sharing antibiotics is foolish, uninformed and dangerous.
In The Times, the UK’s Health Secretary Thérèse Coffey recently revealed that she has handed out her own supplies of prescribed antibiotics to friends and family who are feeling unwell. This behaviour, which is explicitly condemned by the NHS and health organisations such as the WHO, weakens our arsenal of pathogen-fighting drugs and contributes to a growing global crisis of antibiotic resistance.
But why is sharing antibiotics a bad idea? And why are antibiotic-resistant diseases so dangerous?
How antibiotic resistance could render modern medicine useless
Bacteria, like almost every other form of life on our planet, can adapt to its environment and pass on favourable traits. Random mutation means that there is always a chance antibiotic resistance can develop and be passed on to a larger population of bacteria.
Using (or overusing) antibiotics makes it easier for antibiotic-resistant bacteria to thrive by eliminating competition. These new antibiotic-resistant bacteria can then pass on their ability to defend against antibiotics to future generations or other living bacteria.
Once a bacterium becomes resistant, it becomes much harder for us to kill it. Sometimes, the body’s immune response or other antibiotics can be effective, but it makes our conventional means less potent.
The issue is further complicated by bacteria’s ability to share genes with each other. Through a process called horizontal gene transfer, bacteria – of the same or different species – can transfer genetic code to one other, passing on valuable traits.
This phenomenon, which helps foster genetic variation in populations of bacteria, means that antibiotic resistance can sink its claws into a wide range of bacteria once initially developed.
Horizontal gene transfer can occur through a variety of ways.
Conjugation is where two bacteria connect through their outer layers, known as the cell membrane, and transfer DNA from one cell to another.
Transformation, which only some bacteria can do, is where genes released from nearby cells can be ‘picked up’ and incorporated into their genetic code.
Transduction is where viruses known as bacteriophages infect bacteria and ‘pick up’ bits of genetic code which they then pass on to other bacteria they infect.
Through the transference of these genes, bacterial populations are becoming increasingly resistant to antibiotics as more and more acquire the means to defend against them.
A growing crisis with no obvious solution
Post-World War 2 generations born in countries with access to antibiotics have been extremely privileged. For the first time in human history doctors could neutralise infectious diseases, many of which strike during childhood, and save people from the pain and heartache of losing a loved one. They have since evolved to become our first line of defence against infections.
However, six decades of widespread use is finally having an effect.
Over prescription of antibiotics to both humans and animals has fostered resistance across the world.
In 2019, antibiotic resistance was associated with nearly 5 million deaths. Hospitals in India – one of the countries worst hit by the crisis – have found that some of the main antibiotics are now less than 15% effective in treating infections. Across the world, familiar infections, such as pneumonia, tuberculosis and gonorrhoea are becoming harder to treat.
It’s true that resistant infections also appeared in the early days of antibiotic use, but a steady supply of novel treatments meant that switching treatment course was a viable option. The latest antibiotic class that reached the market was in 1987 and we have faced a dearth of discoveries since.
In the long term, humanity will probably have to move beyond antibiotics and find alternative ways to treat bacterial infections. But, for now, we need antibiotics to remain effective in the medium and short-term to avoid needless death.
Using antibiotics when they are not necessary, not finishing your prescribed course of antibiotics, or sharing antibiotics with people who might not need them only raises the chance that a population of bacteria could develop resistance to antibiotics. Humanity needs to act responsibly and save antibiotics for when they’re actually needed.
“Monumentally stupid”
It may not be surprising to discover that the health secretary’s comments about sharing antibiotics have been described as ‘monumentally stupid’ by the medical community.
Ms Coffey’s has also revealed plans to make antibiotics more freely available to the UK’s population, allowing patients to bypass the requirement to see a doctor before obtaining them. Like her comments, this policy is seemingly at odds with the medical consensus that antibiotics should be more restricted to slow the rise of antibiotic resistance.
Misuse and overuse of antibiotics is precisely what has created the global crisis and it’s dismaying to see a government cabinet minister, let alone the health secretary, admit to such irresponsible behaviour.
We can all do our part though. Just remember:
- Only take antibiotics when prescribed.
- Always take the full prescription – even if you feel better.
- Never use leftover antibiotics outside your prescription.
- Never share antibiotics with others.
Together, we can preserve the effectiveness of antibiotics and save lives.