In The Reasoner: Antibiotics

Antibiotics play a crucial role in modern medicine by controlling bacterial infection. For instance, much surgery would be life-threatening without an ability to control infection. However, antibiotics are becoming less effective due to antimicrobial resistance. The overuse of antibiotics gives bacteria that happen to be resistant a greater chance of spreading. In the words of a Public Health England report: ‘Antibiotics are unlike other drugs used in medicine, as the more we use them the less effective they become.’

Antimicrobial resistance would not be a great a problem, were new antibiotics being discovered and made available. Unfortunately, recent decades have seen a so-called discovery void. The reason behind this void may be that the development of new antibiotics is not as profitable as targeting chronic diseases, so far as pharmaceutical companies are concerned.

Now, the Longitude Prize is offering a £10 million incentive to help tackle the problem. This prize will reward the development of a diagnostic test which would allow for a more targeted use of antibiotics. News relating to the prize is available at the prize blog.

Other steps are also being taken. Antimicrobial stewardship is defined as ‘an organisational or healthcare-system-wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness’. Last month, NICE released an antimicrobial stewardship guideline on the use of antibiotics and antimicrobials more generally. This new guideline aims ‘to change prescribing practice to help slow the emergence of antimicrobial resistance and ensure that antimicrobials remain an effective treatment for infection.’ The guidance puts forward best practice recommendations on the effective use of antibiotics, and the evidence for the recommendations is detailed in the full guideline.

The recommendations include reviewing prescribing practices and using feedback to change these practices where necessary. It was reported in the BBC as a call to punish GPs over antibiotics. Readers might be interested in the lively debate this sparked in the comments section.

The Reasoner is a monthly digest highlighting exciting new research on reasoning, inference and method broadly construed. It is interdisciplinary, covering research in, e.g., philosophy, logic, AI, statistics, cognitive science, law, psychology, mathematics and the sciences. Each month, there is a column on Evidence-Based Medicine. This month’s issue includes the following: