We’ll all wake up dead in our beds tomorrow!

A new report from the World Health Organization (WHO) ­ its first to look at antimicrobial resistance, including antibiotic resistance, globally reveals that this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance ­ when bacteria change so antibiotics no longer work in people who need them to treat infections ­ is now a major threat to public health.
The report goes on, “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security. “Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”
Antimicrobial resistance: global report on surveillance notes that resistance is occurring across many different infectious agents but the report focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhea, pneumonia, urinary tract infections and gonorrhea. The results are cause for high concern says WHO, documenting resistance to antibiotics, especially “last resort” antibiotics, in all regions of the world.
Key findings from the report include:
Resistance to the treatment of last resort for life-threatening infections caused by Klebsiella pneumoniae, a common intestinal bacterium, has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.
Resistance to fluoroquinolones widely used for the treatment of urinary tract infections caused by E. coli ­ is very widespread. In the 1980s, when these drugs were first introduced, resistance was virtually zero. Today, there are countries in many parts of the world where this treatment is now ineffective in more than half of patients.
WHO South-East Asia Region report:
The available data reveal that antibiotic resistance is a burgeoning problem in WHO’s South-East Asia Region, which is home to a quarter of the world’s population. The report’s results show high levels of E. coli resistance to third generation cephalosporins and fluoroquinolones ­ two important and commonly used types of antibacterial medicine ­ in the Region. Resistance to third generation cephalosporins in K. pneumoniae is also high and widespread. In some parts of the Region, more than one quarter of Staphylococcus aureus infections are reported to be methicillin-resistant (MRSA), meaning that treatment with standard antibiotics does not work. There has been growing awareness of the need for appropriate tracking of drug resistance, and all countries have agreed to contribute information to a regional database. Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, has identified drug resistance as a priority area of WHO’s work in the Region.
The problem medically is a ‘damned if you do and damned if you don’t’ situation. This is not just a Thailand problem. Patients do not believe that we have no definitive treatment for viruses. They equate virus and “bug” as one and the same. You take antibiotics for bugs, so they want antibiotics for all infections. If they don’t get some sort of prescription you are considered a bad doctor and they will go to someone who will give them antibiotics, or in Thailand, buy them over the counter.
There is also the scenario where after a viral infection, the patient gets a secondary bacterial infection and needs antibiotics. Do you give antibiotic to ward off the bacteria while they are down with the virus? A difficult question to answer.
The final decision should be made by your treating doctor, so listen to him or her. They are trying to do their best for you.