Kimberley Lloyd-Rees: The “hidden pandemic” of antibiotic resistance: it’s time to refocus
At the end of 2021, health officials warned of a “hidden pandemic” of antibiotic-resistant infections. Although data showed that the recorded total number of bloodstream infections fell in 2020, the actual proportion of infections grew. In the UK, antibiotic-resistant infections are now at a higher level than they were six years ago.
The WHO described antimicrobial resistance (AMR) as a global threat that will lead to more serious and prolonged illness, increased hospital admissions, and a huge strain on health systems and economies. Notable in the 2020 data was an increase in antibiotic prescribing by dentists during the pandemic. It should also be noted that in many countries outside the UK, antibiotics are freely available to buy without a prescription – to echo the WHO, this is a worldwide problem.
Antibiotics are vital in the prevention or treatment of certain, often serious or life-threatening bacterial infections, such as pneumonia, meningitis and sepsis. In 2018, a campaign was launched to increase dental teams’ awareness of sepsis, which can be triggered by an infection in the mouth. Antibiotics can also protect patients who are having chemotherapy, those at risk of endocarditis and some patients’ post-surgery.
But, as has been constantly pointed out, antibiotics have little or no effect against most indications of a cold such as coughs and sore throats, as well as other symptoms of flu-like viruses, which are not bacterial, making responsible prescribing fundamental to addressing the issue of AMR.
NICE states that its guidelines do not “override the responsibility (of practitioners) to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian” – but people must also understand their role in protecting themselves.
The bottom line is, should they ever have an infection that requires treatment with an antibiotic they need their medication to work. The COVID crisis raised important questions about empowerment, accountability and patients’ decision making. As healthcare practitioners, we can inform, educate and support, but people must be self-motivated. Our job, then, is to encourage them to have faith in us, be willing to work with us, to listen and to learn.
Antibiotics are not always the answer. If people are feeling unwell, they should stay home and try simple things to feel better, such as drinking plenty of water and resting before calling their GP. They should be vigilant about any symptoms that are unusual for them, then take positive action. A preventive approach to healthcare means being aware of your body, including your mouth, so take notice of any changes, especially those that don’t go away.
Effective hygiene is the first line of defence against viruses and bacterial infections. The value of regular, correct handwashing will forever be tied to the COVID pandemic, but thinking beyond Covid, effective prevention includes oral hygiene, with many dental conditions fully preventable if a good oral hygiene routine is followed.
Meanwhile, the overuse and misuse of antibiotics has been a problem for some time. We must help our community understand what antibiotics can do and what they can’t, which, hopefully will lead to people developing a new understanding of prevention and protection.
Kimberley Lloyd- Rees was writing on behalf of Tandex. She adds: “Elevated homecare routines are key, so instruct people in how to achieve a thorough clean every time they brush, including interdentally. A new tool for comfortable and effective interdental cleaning is the TANDEX WOODI, which comes in a range of sizes and with a responsibly sourced birchwood handle, to tick the sustainability box.”
Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in dental hygiene and therapy as well as working in practice. For more information about Tandex products, visit https://tandex.dk/ or the Facebook page https://www.facebook.com/TandexUK