Antibiotics ‘The Ticking Time Bomb’ Lucy Reid Head of Medicines Management NHS Halton CCG

3 “There are few public health issues of potentially greater importance for society than antibiotic resistance” 2013 CMO Prof Dame Sally Davies

What do we mean ‘The Ticking Time Bomb’? 4

A short Video … 5

Fact or Fiction? Antibiotics are essential medicines for bacterial infections in both humans and animals  Antibiotics are losing their effectiveness at an increasing rate  Bacteria can adapt and find ways to survive the effects of an antibiotic = ‘antibiotic resistant’  Appropriate use of antibiotics will have no effect on the development of antibiotic resistance  6

Fact or Fiction? The more you use an antibiotic, the more bacteria become resistant to it  There are lots of new antibiotics in the development pipeline  Antibiotics are prescribed and used for viral infections because they should be  Infections caused by antibiotic resistant bacteria are more difficult to treat  Some infections are likely to become impossible to treat 

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The Time Bomb ……What does that really mean for me? Potentially increased levels of disease or death; Longer hospital stays Routine operations e.g. bone or heart surgery, and treatments like chemotherapy all require antibiotics to be successful – without antibiotics these procedures will become impossible without risk of infection; Can impact on anyone across all age groups – not just the really sick Antibiotics wont be there when we need them! The wait and see approach will be the only option for some patients! 9

What do we mean by ‘inappropriate’ antibiotic usage? Prescribing antibiotics for viral infections Not prescribing antibiotics for infections that do require treatment Use of a ‘broad spectrum’ agent over the use of a ‘narrow spectrum’ agent Too long or too short a duration Incorrect doses Taking someone else’s antibiotics Stockpiling antibiotics purchased abroad Saving antibiotics for future use

A little quiz! 11

12 Antibiotics are not effective against coughs, colds, flu and most sore throats… A. since these are mostly caused by viruses, which antibiotics do not work against B. but antibiotics sometimes work against viruses, so I should take them just in case C. however antibiotics work against everything Answer: A

13 When I have a cough, cold or sore throat, I should… A. book an appointment with my GP for all mild symptoms or illness B. seek immediate emergency medical attention C. check with a pharmacist about how to treat my symptoms Answer: C

There are lots of colds going around. I’ve been told taking antibiotics ‘just in case’ can drive up the number of drug-resistant infections, but… A.taking antibiotics when you don’t need to allows bacteria to develop a resistance to the antibiotic B.only older people can get drug-resistant infections C.taking antibiotics will help build up your defences and stop you getting a cold in the first place Answer: A 14

15 My GP has only given me a short prescription of antibiotics but I think I need them for longer. Should I… A.use some of my friends antibiotics as they didn’t use all the ones they were given last year B.take one less a day than prescribed, to make them last longer C.take the antibiotics exactly as prescribed – or they may not clear the infection Answer: C

16 Drug-resistant infections, also known as antibiotic resistant infections are serious because… A.antibiotics may not work against resistant bacteria B. without effective antibiotics many routine treatments or operations like chemotherapy, surgery and Caesarean sections will become increasingly dangerous or impossible C. overuse of antibiotics means that antibiotic resistance will spread faster and faster D. drug-resistant infections affect both humans and animals E. all of the above Answer:E

17 My GP wouldn’t prescribe me antibiotics even though I know that’s what I need. I think it’s because they want to save money. This is… A.Correct. GPs need to find ways of reducing costs. B.Wrong. GPs will only prescribe antibiotics when they are needed. C.Partly correct. I’ve had antibiotics in the past and always used to get them from my GP, so why not now. Answer: B

What are we doing locally? Work with GP practices and prescribers to audit and review their own prescribing Locally formulary in place and being promoted Posters, leaflets and display stands Videos for clinics and waiting rooms Local radio Work with pharmacies to promote the messages Promotion of Minor Ailments Scheme and Choose Well/ ‘Ask your Pharmacist’ 18

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Patient Awareness 20

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Become an Antibiotic Guardian by choosing a pledge to undertake a simple action that can help prevent the development and spread of antibiotic resistance 22

23 Ask your pharmacist: Community pharmacists are well placed to help provide advice on over the counter medicines to treat symptoms and help with self-care