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Unnecessary prescription of antibiotics causes an increase in the types of bacteria which are resistant to antibiotics which are known as superbugs. The inappropriate use of antibiotics is the main cause of antibiotic resistance as stated by the WHO. Due to the increase in antibiotics resistance from unnecessary prescriptions the number of new antibiotics being introduced each year has decreased as when new antibiotics are released resistance to the antibiotics almost occurs immediately. This has also led to a loss for pharmaceutical companies are they are not longer investing in antibiotics as a 5 day course of amoxicillin is 56p where as the minimum cost for a prostate cancer treatment is £747.

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Maizey

Innapropriate prescribing causes genetic alterations to bacteria (antibiotic-induced gene expression) and mutations which leads to a reservoir of antibiotic resistant bacteria

Decrease in developments of new antibiotics due to low profits

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Overprescribing antibiotics allows more antibiotic-resistant infections to develop WHY? This is because the bacteria has more exposure to the antibiotics and increases the likelihood of a mutation for antibiotic-resistance.

Development of new antibiotics has decreased leading to least treatments being available against antibiotic-resistant bacteria. This is due to antibiotic development now not being considered an economically-wise investment, unlike treatments for chronic conditions. WHY IS THERE LESS INVESTMENT IN ANTIBIOTIC RESEARCH? There is less investment in antibiotic research because manufacturers who invest large amounts of money into research and development projects can have a reduction in profits when resistance towards the new antibiotic develops.

Not completing a prescribed course allows antibiotic-resistant bacteria strains to stay untreated inside a patient. These bacteria can then reproduce by binary fission creating a reservoir of antibiotic-resistant bacteria.

Campaigns such as 'keep antibiotics working' aims to reduce overprescribing of antibiotics by promoting the safe, effective and economic use of antibiotics through an app they developed. This pushes people to take accountability for their own antibiotic use.

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Developing antibiotics is show to not be economically wise investments for pharmaceutical companies due to the fact that antibiotic resistance is quick to develop and also they are used for short periods of time making them less profitable than developing drugs for chronic conditions

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Sophia

• The over-prescribing which may be prescribing too often or may be unnecessarily (like for any illness); is the largest factor in contribution to antibiotic resistance. This is causing more and more antibiotic resistant infections and several bacteria strains that people are then going to get antibiotics for, creating a dangerous cycle.

• A smaller factor contributing to antibiotic resistance is that in the 20th century when antibiotic resistance first started to circulate; there were a few new antibiotics made to fight it but none after. Which caused numbers of antibiotic infections to rise.

• A third factor is people who are prescribe antibiotics and do not complete the full course, this leads to and increased number of mutations in bacteria.

• Finally, a large factor is how cheap and accessible antibiotics are to someone who is ill but doesn’t want to spend large sums of money on extensive, quality care. This causes more and more people to just take a course of antibiotics and hope they get better and if not they may then take and extended course of antibiotics which creates an even higher risk.

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the article highlights the problem which is that infections are now killing millions of people due to antibiotic resistance. antibiotic resistance is where antibiotics are not longer effective due to factors such as over prescription. this causes the strains of infection to develop mutations against antibiotics making them much harder to treat. the article states many factors which are contributing to antibiotic resistance. the main factor is inappropriate prescription, this is where health advisers prescribe antibiotics for infections which the body can fight off on its own. it is estimated that approximately 50% of cases are given antibiotics when they are not needed, this increases the exposure to antibiotics, increasing the chances of mutation. factors like inappropriate prescription is making antibiotic resistance worse, making it harder to combat. another factor that the article mentions is failure to complete to prescribed course. this is where patients fail to take the antibiotic’s for the time told, leaving strains of the bacteria (which may already be resistant) in the body, exposing more strains / genes to mutate. however, the article mentions ways in which health organisations are trying to combat resistance. for example, the number of antibiotics prescribed has decreased steadily in the past six years. in addition, another factor is providing public education about the danger of antibiotic resistance. the public health england created an app which members of the public can download, this app provides education and information about ways that resistance can be stopped. they also campaigned aims to reduce factors such as inappropriate prescription. finally another way that antibiotic resistance has been tackled, is that antibiotic use in agriculture has been prohibited since 2006 in Europe. However, one of the main issues in trying to combat antibiotic resistance is that pharmaceutical companies are not investing money into developing antibiotics, it is not considered economically wise. this is because antibiotics are only used for short periods of time, money should be spent on developing drugs which treat chronic conditions. drugs used for chronic conditions are more profitable (the average cost of treating an infection with antibiotics is 50p, whereas drugs needed for chronic conditions, the cost is minimum £700). this makes companies invest more in chronic diseases rather than antibiotic development

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Failures to complete the prescribed course has contributed to genetic alterations in bacteria populations. This includes gene expression and mutations. Resistance to the antibiotics is due to genetic alterations which can make the antibiotic ineffective for the form of treatment for the individual. These resistant bacteria can then now survive and reproduce in different environments and can spread to different people within a community meaning a reservoir of antibiotic resistance bacteria has been created. This can put individuals life at risk. Additionally to this, if several strains of bacteria have been found they are known as ‘superbugs’ which are bacterial infections resistant to different antibiotics causing them harder to treat. An example of this would be MRSA (methicillin resistant staphylococcus aureus). These super bugs can have long term effect on patients.

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Many bacterial infections can often treat themselves but people don’t want to be sick and seek treatment regardless of the severity of their illness. As a result GP’s and local doctors become strained and tend to prescribe antibiotics as a treatment without fully acknowledging whether it is necessary or not. Because of the misuse of the antibiotics, the bacteria can mutate and become resistant to the antibiotics prescribed. Then, through natural selection, the resistant strain survives and becomes significantly harder to treat. So a disease that could’ve been treated with some bed rest now becomes potentially fatal, because of something as avoidable as inappropriately prescribed antibiotics. Soon, the resistant strain spreads and those who are vulnerable and rely on herd immunity are now at a significantly higher risk. And reverts back to putting a larger strain of healthcare services.

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Prescribing antibiotics unnecessarily is causing antibiotic resistant infections this leads to superbugs (MRSA) which are challenging to treat as they contain strains of bacteria which are resistant to antibiotics. This can be dangerous for children, elderly and people with underlying health conditions as they have weaker immune systems and need more support in fighting off bacterial infections which can be life threatening for them.

antibiotic resistance means that our first line of fence against infections won’t work in the future, which can cause people to be at risk. Result in people not being able to afford health care. - WHAT DO YOU MEAN HERE?

Failing to complete courses can contribute to genetic alterations in bacterial populations resulting in mutations, which can cause bacteria to be resistant to antibiotics which can lead to ineffective treatment.The resistant bacteria can survive and spread to other people causing them to become infected.

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Inappropriate prescribing can contribute to genetic alterations in which bacteria populations. The resistance to the antibiotic making the antibiotic ineffective form of treatment. The resistance bacteria survive to reproduce and can then spread to other people within the community. The average cost of treating an infection with a 5 day course of amoxicillin is 56p whereas the minimum cost for a prostrate cancer treatment is £747. This means that all the antibiotic are generally cheap and effective which is good for the public however it is often expected that all antibiotic should be priced the same, even ones that even without decisive global action including strengthening health systems improving the access of vaccines and antibiotics, curbing anti microbial resistance. Because antibiotic are used for relatively short periods they are not as profitable as dry that treat chronic conditions.