Saturday 20 January 2018

Cure or kill? Ireland's abuse of antibiotics could leave us without our most powerful drugs

Parents often demand antibiotics for their sick child, but Dr John McKenna warns Ailin Quinlan that unless we preserve them for serious cases, they will lose their potency.

Antibiotics: for years we've been abusing them and we're going to pay for it
Antibiotics: for years we've been abusing them and we're going to pay for it

Ailin Quinlan

Parents often demand antibiotics for their sick child, but Dr John McKenna warns Ailin Quinlan that unless we preserve them for serious cases, they will lose their potency.

Your child is spiking a temperature, so you get an antibiotic for him - fast. Right?

Wrong, says Dr John McKenna, a former GP and practitioner of nutritional medicine for nearly 30 years.

Treat an infection within the first 48 hours, he warns, and you expose your child to a two-to-eight times higher risk of developing a recurrence of the infection. Why? Because you're not allowing the child's body to fight off the infection with its own immune system.

This may sound risky to a worried parent, but, warns McKenna, according to research, the right thing to do is to hold off treatment for 48 hours.

This allows your child's immune system to recognise the threat and develop resistance - the over-prescription of antibiotics to children is making them more vulnerable to multi-resistant bacteria, warns McKenna who has recently published a book on why we need to reduce our dependency on antibiotics as a matter of urgency and how to do it.

About 90pc of infections in children are viral, not bacterial, he points out, so if the infection is viral and an antibiotic is prescribed, it won't work.

However, when parents bring a sick child to the doctor, instead of opting for an antibiotic straight away, McKenna recommends controlling the temperature with paracetamol and tepid sponging for the first 48 hours of the illness.

Because only 10pc of infections in children are bacterial, doctors should take samples and send them to a laboratory to check whether the child's condition is, in fact, caused by a bacterial infection, he says.

"If you or your child has an infection, the best course of action in the first instance is to use antiviral measures: large doses of vitamin C, zinc, and in some cases, vitamin A," he says, adding that a range of homeopathic remedies is available. Yet, he says, doctors examining a young child with a suspected infection in the emergency department can often cover the possibility of a bacterial infection by prescribing a broad-spectrum antibiotic.

"Family doctors also have to guess and very often prescribe when they are in doubt.

"This is bad medicine, as it is compromising us all," he says, adding that the old proverb, 'when in doubt, do without', is highly relevant in this context.

However, he acknowledges, denying an antibiotic to a frightened mother with a sick child can be difficult, because a mother will expect her GP to do something 'interventional' - and this is why he wants a government information campaign on the risks inherent in the overuse of antibiotics to be specifically targeted at the public in a bid to counteract the widespread ignorance regarding the correct usage of these drugs.

Although often referred to as the 'anti-antibiotic doctor', McKenna, the author of several books and a recognised expert on nutrition, is a firm believer in the power of the drugs - they saved his son's life when, as a child, he contracted peritonitis.

However, he warns, for years we've been abusing them and we're going to pay for it. "Superbugs used to be limited to hospitals; today, they're in the community.

"Common infections are proving more and more difficult to treat. Soon we will regress to pre-penicillin days when people died from ear infections, sore throats, abscesses, etc.

"Because so much of modern care depends on the use of antibiotics, many routine procedures such as endoscopy and common operations such as hip replacements will become too risky. We are in this mess for a number of reasons. First, we have misused these drugs and continue to misuse them, despite all the public warnings not to do so.

"We have grossly underestimated the so-called enemy, pathogenic bacteria. They have been around on the planet for a lot longer than humans and have learned many innovative survival tactics such as creating resistance genes and sharing these genes with other bacteria."

We have also, warns McKenna, made "the gross error of not advising patients to take a probiotic at the same time as using an antibiotic".

Bacteria are critical to life on this planet - yet he points out, the approach of the medical profession to bacteria is "when in doubt, wipe them out".

This attitude has also been adopted by the general public. "The mental framework of the public is that bacteria are bad, and that we must kill them.

"There's this concept in the human psyche that bacteria are bad for you, but in fact, they are critical to our survival on earth."

This, he says, is "why the World Health Organisation and the chief medical officers of different countries are fighting with doctors to try to get them to stop overprescribing antibiotics."

We have gotten ourselves into a medical 'cul-de-sac' where antibiotics are becoming useless, he observes. "Antibiotics are still widely available over the counter in many countries.

"I spent many years in Africa and it is very easy to get any antibiotic you want.

"Research by the University of Barcelona found that antibiotics were given out on the basis of customer request by a large number of pharmacies."

However, he says, research in South Africa has shown that when a particular antibiotic goes out of use, bacteria will, within a few years, again become sensitive to it.

Awareness of antibiotic abuse is growing, he observes, but it needs to become more widespread.

To achieve this, there needs to be a concerted effort to change public attitudes - what is required, he believes, is an effective, community-orientated government information campaign similar to that run in France in 2002.

Within five years of the French 'antibiotics are not automatic' roadshow, there was a 25pc fall in antibiotic prescriptions. "Antibiotics are not automatic. There is a clear need to educate the community," he declares, adding that as a priority, any government information campaign should be directed at the community and not at GPs.

He suggests the distribution of a leaflet which clearly explains why patients are not getting an antibiotic, and gives effective advice on natural treatments.

There are two crucial messages which needed to be imparted to the public, he believes.

The first is about how to boost the immune system and protect from infection by eating well: "It's about boosting your immunity - there are billions of good bacteria in your digestive and respiratory tracts and they are your first line of defence.

"A probiotic is very much involved in preventing infection, and certain substances like echinacea are known to boost immunity.

"Vitamins and minerals - a high dose of vitamin C, for example, is really good for fighting infection and oranges, lemons, grapefruit, are rich in vitamin C."

Avoid sugary foods and drinks which weaken the immune system, but include curds and whey in your diet, such as live yoghurt - and take a daily probiotic, he recommends.

"It's about eating properly and about changing thought patterns around antibiotics. We have to realise that they should be preserved for serious, not common or garden infections

"It's got to the point where we have been killing so many bacteria that they have fought back," he warns.

This is the reason, says McKenna, "why chief medical officers in different countries are screaming their heads off that we're going backwards to times like the 1920s and 30s when antibiotics were not available. We've abused them so much that we're rendering them useless."

Another issue people should be aware of, he says, is that antibiotics can cause infections because they disturb the balance of bacteria in the body.

"Research published in 1991 showed that antibiotics can cause changes in the flora of the urethra of children. The article suggest that this may predispose children to a urinary tract infection, he says, adding that antibiotics are known to alter the bacterial population of the body in adults and cause infections such as vaginal thrush and intestinal candidiasis.

"Candida albicans is one of the organisms that will overgrow, and you can start to develop a yeast infection which can cause urinary tract infections and other conditions.

"However, unless you acknowledge the side effects of antibiotics, you won't connect the appearance of a yeast infection with a previous course of antibiotics."

What we can do:

Don't rush to your doctor for an antibiotic at the first sight of an infection. Wait to see if your body can fight off the infection, as early use of an antibiotic not only encourages the recurrence of the infection, it also encourages bacterial resistance. Avoid an antibiotic until a swab has been collected and the results show conclusively that the infection is bacterial.

Educate children about health and antibiotic misuse - visit www.e-bug.eu

Protect yourself from infection by eating well and drinking lots of water

Doctors can help by giving their prescription pads a rest, and adopting a wait-and-see approach to most infections, says McKenna.

"It is wiser to wait for 48 hours to see if the body can fight an infection or not," says McKenna who points out that in this 48-hour period, laboratory test can confirm the presence or absence of a bacterial infection.

Anti-biotics: Are They Curing Us or Killing Us? by John McKenna BA, MB, CHB is published by Gill & Macmillan €14.99.

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