It is called antibiotic resistance, and it is – as confirmed by the World Health Organization itself – one of the main global health emergencies. The alarm – raised by Matteo Bassetti, full professor of infectious diseases at the University of Genoa on the occasion of the San.ita conference in Bologna – is real. And the numbers are scary: 50 thousand deaths per year in Italy from infections caused by resistant bacteria5 million worldwide. With a forecast of 40 million in 2050.
A cultural issue, not a medical one
Why aren’t we scared then? Because it is a silent pandemic, as the virologist called it. “The definition is correct,” he comments Fabrizio Pregliascoprofessor of Hygiene at the University of Milan and medical director of the Galeazzi-Sant’Ambrogio hospital in Milan. “And it is such because the responsibility belongs to everyoneso unfortunately it becomes “nobody’s”. This is not a medical problem, but a cultural issue.”
Antibiotic resistance is a natural fact, a physiological phenomenon that implies the normal reaction of a bacterium to the substance that tries to destroy it. The decline in the effectiveness of the drugs we have available, however, is another matterwhich involves the entire society at all levels.
Government and companies called into question
Let’s start from the top. The institutions are called into question: they have the duty to invest in prevention plans, promoting vaccination campaigns and supporting research. Then there are the pharmaceutical companies, which should carry out more studies in this direction, to develop molecules capable of standing up to what are now called superbugs. In reality, the offending microorganisms are old knowledge of medicine: we are talking about Escherichia coli, Klebsiella, Streptococcus, nothing new under the sun… and also under the microscope slide.
The risk in hospitals
And in hospitals? «The attention is very high“, replies Pregliasco, “but the risks linked to infections are daily. This is why the IOC, Hospital Infection Committee, exists, a multi-professional body that has the precise task of monitor the use of antibiotics in healthcare facilities». Then there are the animals on farms, often unaware carriers of the problem. The indiscriminate use of veterinary antibiotics has greatly decreased in our countrythanks to strict regulation and a National Control Plan, but we remain on alert.
The duty of family doctors
We have reached the level of doctors: we are not talking so much about specialists, but above all about paediatricians and family doctors. They are the first to have the responsibility of prescribing, avoiding the “easy” one of antibiotics, to eradicate an infection with shock therapy, reassuring apprehensive mothers. «Antibiotics should be used with progression», continues Fabrizio Pregliasco, «appropriately, and above all for each case the right drug must be prescribed, which is not necessarily the most powerful one. Let’s not forget that an antibiotic is like a blade: every time it hits it sinks deep, but loses its edge. Therefore, if used excessively, over time each shot will be less and less effective.”
What can we do
And after the doctors… there are us, no less responsible than the others for this pandemic. We who, if we have an antibiotic at home, left over after a previous therapy, are tempted to use it independently, perhaps for a cold or the flu (instead of reminding ourselves that – being viral diseases – it will not be of any use). «This is why I talk about shared responsibility», says the expert, «Stopping the antibiotic treatment before the days indicated by the doctor, or taking the drug without a prescription, are very serious mistakes which contribute significantly to the spread of the problem. People often don’t realize it, because the important thing is to feel better and heal.” It’s a shame that they don’t know that the next time the same treatment might not have the same effect.
Fleming’s warning
The risk of returning to the past is also real: «Without a more rational use of antibiotics or investments in research into new drugs we may find ourselves in a situation where trivial surgeries or infections become dangerous again», concludes Pregliasco. And to think that Alexander Fleming, the discoverer of penicillin, had already warned us: in the speech he gave on the occasion of receiving the Nobel Prize in 1945 he stated: «The time may come when penicillin can be purchased everywhere in shops. Then there is the danger that ignorant man can easily take a lower quantity and, by exposing microbes to non-lethal quantities of the drug, make them resistant.” It is therefore up to each of us to not be that ignorant man.
