When an antibiotic is used to fight an infection, there is a chance that some of the bugs causing the infection may develop a resistance to the drug, meaning that it is no longer effective against them. The more often antibiotics are used, the more this happens, and it can result in strains of infectious bugs that are immune to many different antibiotics and are therefore very hard to treat.
Dr Keith Brownlee, Director of Impact at the Cystic Fibrosis Trust, who has over 30 years of experience caring for children and families with cystic fibrosis, discusses the consequences of antibiotic resistance and what the Trust is doing about it.
“The increasing prevalence of bacteria that are resistant to antibiotics is a potential problem for everyone. However, for people with cystic fibrosis (CF) it is a matter of life and death. Long-term and acute bacterial infections cause damage to the lungs of people with CF, resulting in gradual respiratory failure and the eventual need for a lung transplant, or even death. Antibiotics are essential for fighting these infections, preventing or delaying damage and prolonging survival.
What is bacterial resistance?
“Bacterial resistance to antibiotics (also called microbial resistance) means that the bugs do not respond to commonly used antibiotics, making it much harder to treat serious infections. Combinations of antibiotics need to be given at higher doses and over longer periods of time, or older antibiotics are used, which have more side effects. Because of this, complications such as antibiotic allergies, kidney damage and hearing loss are becoming more common in people with cystic fibrosis.
“Chronic infection with bacteria that are resistant to antibiotics, such as methicillin-resistant Staphylococcus aureus (MRSA), can also make accessing care more difficult. To reduce the risk of MRSA spreading to other patients, people with the infection often have to be treated away from others, which can add to feelings of isolation.
“Over the coming years it is essential that antibiotics are used appropriately and with care to reduce the number of opportunities for bacteria to develop resistance. Measures that are essential for reducing the problems caused by antibiotic resistance include:
- minimising cross-infection,
- research to develop new antibiotics and discover the most effective doses of combinations of drugs to prevent chronic infection developing, and
- the discovery of new methods to target antibiotics promptly and accurately.
What is the Cystic Fibrosis Trust doing to help with antibiotic resistance?
“In our fight for a life unlimited, the Cystic Fibrosis Trust is funding research into these areas, which is why we are supporting World Antibiotic Awareness Week, a global action plan started by the World Health Organisation (WHO) that aims to increase awareness of antibiotic resistance and encourage best-practice in professionals and members of the public alike.
“The Trust is investing £750,000 into a Strategic Research Centre led by Professor Jane Davies that is investigating Pseudomonas aeruginosa. This SRC is focussing on finding non-invasive ways to detect the infection, understanding how the infection becomes chronic and testing non-antibiotic forms of therapy. To tackle this final issue, the SRC will investigate molecules that break down the ‘biofilms’ that chronic Pseudomonas use to protect themselves from treatments like antibiotics.”
What else needs to be done?
“There needs to be a global reduction in the use of antibiotics. They are frequently used in agriculture, and are often prescribed for conditions that are not treatable with antibiotic drugs. As understanding of the problem increases, steps need to be taken to reduce these practices. If you don’t have cystic fibrosis, you can help by not asking your doctor to prescribe antibiotics for conditions for which they won’t work, such as flu or the common cold.”
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