LIVING

She often has patients who come to her after having bought and taken antibiotics, simply to ask her to prescribe them officially so that they can claim the money back. She said that most of the time she refuses to do this; it makes her feel like a ‘secretary’, but it is more or less tolerated at her surgery.

Doctors should use the lowest dose of antibiotics first, and progress to the stronger drugs if there is no improvement, but Garrell is also seeing abuse of the new generation antibiotics that should be saved for extreme cases. “For example, someone goes to the emergency room and they get prescribed a new generation drug. It works, so next time they feel ill they go straight to the pharmacy and buy it again, regardless of whether it’s good for them or not.”

Using the strongest ones initially is like using your last line of defence first, because if bacteria become resistant to them there is nowhere else to go. But why do chemists still have the power to recommend antibiotics when we now know it’s so dangerous? “Probably a question of money,” Garrell told Metropolitan.

“The law needs to change but big pharmaceutical companies would lose a lot. They are the same pharmaceutical companies that fund extra training courses for general practitioners. It’s a political question.”

As long as bacteria have existed they have been evolving resistance to anything that will try to kill them. Like any living organism, they evolve through natural selection. The weakest die while the strongest live and pass on their genes to the next generation. The problem for us is that if we want to fight infection efficiently, we have to try to keep up with this ‘evolutionary race’; the new generation of antibiotics needs to evolve at least as fast as the bacteria’s resistance.

Lluis Ribas, of the Barcelona Science Park, is a researcher trying to keep us ahead, or at least neck and neck, in this race. He said that in the big picture of antibiotic resistance, the main culprits are overuse in farming and proliferation of multiresistant bacteria, or superbugs, in hospitals. “Before EU regulation kicked in five years ago, antibiotics were being used in vast amounts in animal feed and were filtering into the environment, water, and people. The more widely distributed antibiotics are, the more likely it is that resistant strains will form.”