The world before antibiotics, 70 years ago, could be a dangerous place in which to suffer even common infections or minor injuries. A post-antibiotics era, in which they can no longer be relied upon to save lives, is a real possibility, according to the World Health Organisation. If bacterial resistance to antibiotics continues to develop at the current rate, the WHO says, everyday complaints such as urinary tract and bloodstream infections could become killers again. In Hong Kong, the Health Authority says public hospitals are now reporting a drug-resistant infection every 18 minutes.
Warnings about the consequences of over-prescription and abuse of antibiotics leading to drug resistance are not new. But the latest, based on a study of data from 114 countries including China, concluded that antibiotic resistance is now a global emergency. For example, on the mainland, the most frequent cause of bloodstream and urinary tract infections is drug-resistant in as many as 70 per cent of patients. In Hong Kong the three major types of superbug infections have increased by an average of 15 per cent in three years. Hong Kong University microbiologist Ho Pak-leung says the reasons include overcrowding and the increasing number of elderly, who are more likely to develop infections and need more antibiotics.
Root causes of resistance include unrestricted use in agriculture to increase production and overprescription. Ho says the latter problem is compounded in Hong Kong by "very limited access" to rapid diagnostic testing facilities for public hospital doctors. This inhibits their ability to prescribe precise treatments in emergencies, so many try to err on the safe side and overprescribe.
Diagnostic test reports on more than a third of 232 fatal bloodstream infections at Queen Mary Hospital last year arrived after the patients had died. This is not good enough. The government should expand testing urgently for the sake of public confidence in the hospital system.
The pharmaceutical industry needs financial incentives to undertake development of new, effective antibiotics. The financial returns from developing drugs that are used for only a few days and may be held in reserve as a last line of defence, do not compare with those from drugs taken long-term for chronic diseases like cancer and heart ailments.
But without new antibiotics, the transformation of medicine they wrought could be reversed.