John McKenna - Antibiotics – Are They Curing Us or Killing Us?: The Catastrophic Impact of the Over-prescription of Antibiotics on Our Health

Antibiotics

Are they curing us or killing us?

John McKenna BA, MB, ChB

Gill & Macmillan

I wish to dedicate this book to my granddaughter

Abigail, with whom I hope to be able to spend

much more time in the months and years to come.

Contents

Introduction

Case History: James

James was nine years old and was in the childrens oncology ward in hospital. He had been diagnosed with leukaemia and was being treated with drugs (chemotherapy). He seemed to be doing well and his parents were very optimistic. Now that treatment was coming to an end there was hope that James could return home in the coming days.

That night James had a high temperature and was feverish. The doctor was called. He examined James thoroughly and could not find a reason for the fever. He ran some tests, but these did not indicate the reason for his high temperature. Because leukaemia renders many of the patients white blood cells useless, it left James more vulnerable to infection.

The doctor asked for help from his consultant who also could not find the cause of the high temperature. They decided to ask for help from the Professor of Microbiology, who had great experience in hospital-acquired infections.

The Professor suggested it was most likely an infection, given the fact that James had leukaemia, had just finished a course of chemotherapy and was in a hospital setting where there were known to be highly resistant bugs. The Professor suggested that James be isolated and be given intravenous antibiotics immediately.

The next day, James seemed to be improving as his temperature had reduced and he seemed in better spirits. However, by the following morning, his parents expressed concern about him. The doctors decided to do blood cultures as his temperature was rising again, despite his being on antibiotics. The Professor was now gravely concerned and suggested that James was showing signs of a multidrug-resistant bacterial infection. If he was right then there was probably little that could be done.

The blood cultures showed that James had septicaemia (blood poisoning) and the bacteria showed they were resistant to all antibiotics bar one, which would usually be held back for situations such as this. The doctors immediately switched Jamess antibiotic to the one that the bacteria were sensitive to, even though it had a lot of side effects.

The following day, James showed signs of an improvement and everyone was relieved that he was going to pull through. By the next day he had improved further. All in all, things were looking up. His parents looked happier, though they were exhausted by the whole process. They left his side for a few hours to catch up on sleep.

When they returned later that day, the doctors were having a discussion around Jamess bed. His temperature had risen again.

His mother began to cry. The Professor was called again and he explained to Jamess parents that they must now expect the worst as it appeared that the bacteria were now resistant to all antibiotics. However, they would await the results of another blood culture, which were due the following day.

Gradually that evening and night, James deteriorated, and by the following day he was gravely ill. The blood culture confirmed the Professors suspicions the bacteria were untreatable. It was very likely that James would die as he had very few functioning white blood cells with which to defend himself.

Twenty-four hours later, James had passed away. The bacteria were so highly resistant that there was nothing the doctors could do. His parents were distraught with grief. They had lost a child because of a hospital-acquired infection.

Hospital-acquired infections are becoming progressively more common across the world. Cases such as Jamess are all too frequent now in many Western hospitals. In the US, over one hundred thousand people die per year from hospital-acquired infections such as urinary tract infections, surgical wound infections, pneumonia and septicaemia. In the UK the number of such infections is also increasing, as it is in Ireland.

As the chance of contracting an infection in hospital increases, hospitals are becoming more dangerous places. In the near future it may become risky to have simple hospital procedures carried out, such as an angiogram, because of the risk of infection with a highly resistant bug.

Bacteria develop resistance when exposed to antibiotics. They do this by altering their DNA, or genetic material, to allow them to make chemicals that protect them against antibiotics. This is Natures way of facilitating or allowing adaption. Infections caused by antibiotic-resistant bacteria have become more widespread over recent years. Initially they were restricted to hospitals, but now they have found their way into the community as well. This is discussed in more detail in Chapter 3.

What is of most concern is that simple infections such as a sore throat or a urinary tract infection may become untreatable. Many authorities around the world are now predicting such a scenario. In March 2013, Sally Davies, the Chief Medical Officer for England, was reported as saying that antibiotic-resistant bacteria with the potential to cause untreatable infections pose a catastrophic risk to the population (Walsh, 2013).

If tough measures are not taken to control the use of antibiotics and no new ones are discovered, we will find ourselves in a health system not dissimilar to that of the early nineteenth century.

So what are antibiotics? How much do we know about them? What is bacterial resistance to antibiotics? What are the less well-known side effects of these drugs? How can we protect our bodies against infection so that we can reduce our reliance on antibiotics? These are some of the questions I shall discuss in this book. I shall attempt to do this in as simple a manner as possible, keeping technical jargon to a minimum.

This discussion of antibiotics comes at a time when many health authorities and academics around the world are voicing their concerns about antibiotics in the press and on the internet. We have been led to believe that death from an infection is a thing of the past. The above case history indicates that this is far from the truth.

We are losing the battle against infectious diseases. Bacteria are fighting back and are becoming more resistant to modern medicines. In short, the drugs dont work.

PROFESSOR SALLY DAVIES, CHIEF MEDICAL OFFICER FOR ENGLAND

W hy are the authorities painting such a gloomy picture of the future? After all, antibiotics are relatively new drugs. How come they are no longer being viewed as life savers? What has gone wrong? Let us go back several decades in an attempt to answer these questions.

THE PRE-ANTIBIOTIC ERA

Most people and many doctors have no recollection of pre-1940s medicine. There was little in the way of effective curative treatments available. The medicines of the day were mostly lotions and potions, which were designed more to lift the spirits of the patient than to effect a cure.

The book The Youngest Science: Notes of a Medicine-Watcher by Dr Lewis Thomas describes this era very accurately. Dr Thomas grew up watching his father, a small-town physician, administer medicine to his patients. His father instilled in him the idea that there was little that could be done about many of the ailments he encountered. Most of the potions he prescribed were placebos and contained a high level of alcohol.