BIOGRAPHY
Dr Alan Pithie is a Consultant Physician in Infectious Diseases and General Medicine in Christchurch. Alan trained and worked in the UK before moving to New Zealand in 1999. He has a clinical and research interest in viral infection. He also greatly enjoys going fishing with Dr Jardine, but has yet to catch a fish with a fly.
ABSTRACT
Antibiotic Armageddon – the end of the antibiotic era as we know it?
Antibiotics are key to the management of severe bacterial infection. Acquired bacterial resistance is a natural consequence of antibiotic use, became recognised soon after the introduction of penicillin, and rapidly became widespread in Staphylococcus aureus. Over time a steady progression of new antibiotics were developed to treat bacteria with both natural and acquired resistance. In parallel bacteria have demonstrated the ability to continuously evolve new resistance mechanisms to enable them to evade antibiotics. Infection with resistant bacteria is associated with greater mortality and morbidity, increased length of hospital stay and increased health care related costs. In the past two decades there has been the widespread impact of methicillin resistance in Staphylococcus aureus [MRSA], the recognition of vancomycin resistant enterococci [VRE], and the dramatic emergence of multi—drug resistance in gram negative bacteria, including Extended Spectrum Beta-lactamase producing organisms [ESBLs] and Carbapenem-resistant enterobacteriaceae [CRE]. Antibiotic development has not kept up with the emergence of resistance, and the antibiotic pipeline is almost dry. In some parts of the world infection with near untreatable bacteria is a common occurrence.
I will review the epidemiology and mechanisms of antibiotic resistance, discuss the risk posed to New Zealand, give a clinical overview on identifying and treating infection with antibiotic resistant bacteria, and finally discuss prevention.
|
