06 May Jonathan Cartu Declares: Antibiotic Resistance: The Patient Perspective
An interview with Arlene Brailey from Antibiotic Research UK, discussing the impact of antibiotic-resistant infections on everyday life and the steps that need to be taken to overcome this issue.
Why is antibiotic resistance considered to be a global health threat?
The use of the word ‘global’, indicates that it is a worldwide problem. The widespread availability of affordable flights has meant that thousands of people are able to travel around the world, and the bacteria they are carrying travel too.
We have seen this clearly demonstrated through the coronavirus pandemic – and bacteria are no different. On top of this, the bacteria we are carrying are sometimes resistant strains that do not respond to the antibiotics we already have.
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No country is immune from this problem, and no single country has the power to stop it from occurring. The World Health Organization estimates that 10 million people will die of antibiotic-resistant infections by 2050, and figures released this year show that drug-resistant infections have risen by about 9% in the last year.
If we do not solve this problem, we will return to an age where people die from something as simple as a cut or scratch, and routine operations such as hip replacements must be cancelled as the risk is too high.
This is why we call it a global health threat.
Why is the search for new antibiotics a big challenge for the pharmaceutical industry?
The pharmaceutical industry is governed by the market and they need to make a profit. The bottom line is that there is simply no real profit in developing antibiotics anymore. The reason for this is because when a powerful new antibiotic is developed, it is saved for those rarer occasions where bacterial resistance has already developed to every other antibiotic.
Unlike medications used for chronic illness, where companies make a profit from their long-term use, antibiotics are the opposite.
Some small pharmaceutical companies have actually gone out of business when they have tried to develop an antibiotic because they can’t recuperate the cost of development once the drug goes to market.
The model just does not work. To solve this, we need to somehow incentivize pharmaceutical companies to use a different financial model to develop new antibiotics.
How is Antibiotic Research UK working to reduce the prevalence of antibiotic-resistant infections?
As a charity, our aim is to beat the world’s biggest health problem; antibiotic resistance. We believe we deliver remarkably good value for money in terms of the research programs that we fund.
We are tackling antibiotic resistance from all angles. We work with academic researchers to develop discovery programs, and we are also the leading campaigner in the media about antibiotic resistance.
Working with our partners, we have encouraged a shift in the way that patients see antibiotics.
We are educating patients about the issue to prevent them from demanding antibiotics and educating healthcare professionals about good stewardship of the precious antibiotics we have remaining.
We also support patients with recurring or resistant infections through our patient support program, which is the first of its kind. The program aims to support patients and their families who are living with resistant infections and the challenges that this brings to their daily lives.
Why was Antibiotic Research UK created and what is the vision for the charity?
The charity was created to bring experts together to try and find alternatives to current antibiotics and prevent the apocalyptic situation that WHO has predicted. We bring scientists and clinicians together to share their expertise and see what we can achieve together.
There are three elements to our vision. The first is scientific discovery; new antibiotics, new combinations of antibiotics, and even new antimicrobial treatments that offer an alternative to antibiotics. We have already shown success with a non-antibiotic treatment that we developed against travelers’ diarrhea.
The second part of our vision is about improving health literacy for the public and healthcare professionals in relation to antibiotic resistance.
We educate people about antibiotic resistance and how to prevent it. The final element is our patient support program, which provides reliable information and support to patients and their families at a time when they can feel incredibly isolated.
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At BioInfect 2020, you presented a talk on the impact of antibiotic-resistant infections on patients. Please can you tell us about the case studies you presented?
BioInfect welcomed a group of professionals from various industries, all focused on solving the issue of antibiotic resistance. As the representative for Antibiotic Research UK, I felt it was my role to impress upon these individuals just how important research and development is for patients.
I described the experiences of five patients with infections resistant to antibiotics and the impact that their condition has on everyday life. It is easy to lose sight of the patient at the end of the research, so I wanted to remind all of the important stakeholders at the conference that there are patients desperately waiting for a new antibiotic or new combination treatment to be found.
Through all of the stories that I told, the aim was to explain that every patient is hoping that somebody is going to do something to make the future better, both for themselves and for the patients emerging after them with resistant bacterial infections. One of the things that encourage patients most is knowing that this research is happening, and new drugs are actually being developed and tested.
It is also important for them to know that scientists, clinicians, and those working in the pharmaceutical industry are coming together to try and solve the problem at conferences like this. Often, patients never hear about these types of events and they feel hopeless and fear for their future.
How does the charity support patients who are suffering from antibiotic-resistant infections and their families?
This is a project that has been building up over the past year. We have been developing a whole raft of measures to support patients and their families, but the most important part of my role is listening to patients describe what they are living through and dealing with.
Many of these patients feel incredibly isolated. Sadly, the impact of antibiotic resistance on everyday life is not well-publicized so patients’ friends, colleagues, and families struggle to understand or empathize.
For example, they may have to cancel a day out with their friends because they feel so fatigued or feverish, or just listless. These friends may see them a couple of days later and they appear fine, giving the impression that they made an excuse.
I myself have experienced the effects of chronic illness within my own family, and as a carer, you often feel quite helpless and alone. I have been through the frustration of not being able to get an accurate diagnosis or treatment for that family member.
This is compounded by the fact that information available online is highly variable and rarely trustworthy, and there is a distinct lack of reliable forums for patients going through the same struggles with infection.
When I talk to patients, I listen and try to distill the story. Often, they have questions that they can’t find the answers to, or they have been given misinformation online. When we get to that point, I help them to outline the main issues, provide informative leaflets or web information that we have created, or signpost them to other sources of help.
We have leaflets on managing infections with specific bacteria and even guides for those who are living with resistant bacteria such as ESBL E. coli, a common source of antibiotic-resistant urinary tract infections (UTIs).
We have built sections of the website around certain conditions where we know there is a lack of reliable information…