Colleagues
I’ve been wading through the UK #governments second 5-year anti-AMR action plan, “Confronting #AntimicrobialResistance 2024-2029, that was launched last week. It is rich in rhetoric and packed with policy plans and ambition. but unfortunately lacks operational details for clinicians needing to treat patients with infections.
It warns #AMR continues to be dangerously on the rise, that we should reduce #antibiotic use and prescribe them appropriately, e.g by avoiding them with viral and fungal infections and preventing their disposal from polluting the environment. Such important information and guidance have been espoused since I was a medical student in the 1970s - hardly new thinking.
Responsible #clinicians are highly sensitive to AMR risks when prescribing and would welcome any pragmatic initiatives for minimising them at the clinical “coal face.” The document’s lack of operational details for confronting bacteria reinforces that we are left to find such solutions ourselves.
#AlexanderFleming, in his 1945 Nobel Lecture warned presciently that, “it is not difficult to make #microbes resistant to #penicillin in the laboratory by exposing them to concentrations not sufficient to kill them,” …. yet we do precisely that with every oral antibiotic treatment for #cystitis. We drip-feed the #drugs over many hours through ureters into infected #urinary pools while the bugs multiply within minutes. The inevitable delays offer them opportunities to secrete biofilms and #mutate. Pharmacology has long advocated direct targeting as the best approach for drug treatments. Implementing these preachings in treating cystitis and #CAUTI is a long overdue and very practical way to help meet the goals set by the governments strategy.
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