Penicillin was discovered by chance in 1928 when Alexander Fleming noticed it had powerful antibacterial properties. Fast forward to the 1940s and penicillin was being commonly used in the fight against deadly infections. But penicillin is not for everyone and some people are allergic to the popular antibiotic. If someone has ever had a reaction to the drug, their medical records usually contain a note of this “fact”. However, new research suggests that many people who believe they are allergic to penicillin may have outgrown their allergy, or they may not have been allergic in the first place. In fact, the research shows that as many as nine in 10 people who think they are allergic to penicillin may not be. Speaking at the ACAAI Annual Scientific Meeting 2019 in Houston, TX, the researchers added that some patient’s penicillin allergies remain on their medical records even if they test negative later in life. “Our study found that of the 52 patients who tested negative to penicillin and were interviewed, 98% understood they were not allergic to penicillin,” said lead author, Dr. Sonam Sani, an allergist, immunologist, and fellow of the ACAAI. “Of those, 29% still had a penicillin allergy label in their electronic medical record, and 24% still carried the label in their pharmacy records,” she added. The research is important because it highlights just how easy it is for someone to assume they have a penicillin allergy when, in fact, they don’t. Many penicillin alternatives are more expensive, have lower efficacy, and risk boosting antibiotic resistance.
Some species of bacteria are stripping off their outer layers in an attempt to evade antibiotics and survive. It’s a reality that could explain why some infections keep coming back. According to researchers at Newcastle University in the UK, the bacteria are “undressing” and removing their cell walls – the very part of them that some antibiotics target. The cell walls of some bacteria are made from sugars and amino acids. While they give the bacteria shape and protection, these walls provide a weak spot that can be exploited by antibiotics. Penicillin, the first antibiotic to be discovered and the most widely used in the world, works by disrupting the cell wall and causing the bacteria to burst. The study, which is published in the journal Nature Communications, found that bacteria associated with recurring urinary tract infections in elderly patients slipped out of their cell walls to avoid the effect of the antibiotics. It’s the first time that research has shown bacteria using this method to survive antibiotic treatment and while not all survive – most get taken care of by the body’s immune system - it does offer some explanation as to why certain infections come back again and again. The discovery could pave the way for new treatments to be developed, including combination therapies that target both the bacteria’s cell wall and inner workings.
Inappropriate prescribing of antibiotics is commonplace in the United States, a new study has found. According to the analysis of prescription data for 19.2 million people by researchers from Northwestern University in Chicago, IL; the University of Michigan in Ann Arbor; and Brigham and Women's Hospital in Boston, MA, 23.2% of all antibiotic prescriptions written in 2016 were inappropriate. The findings of the research published in the British Medical Journal reveal that colds, coughs, and chest infections – all of which are usually caused by viruses - were the top conditions that antibiotics were inappropriately prescribed. Antibiotics are only effective when used to fight illnesses caused by bacteria, not viruses. The problem with taking antibiotics inappropriately is that it can lead to antibiotic resistance. This is where bacteria are able to survive drugs that once killed them. Antibiotic resistance is a growing problem. According to the Centers for Disease Control and Prevention (CDC) approx. 2 million people in the US every year acquire antibiotic resistant infections. As a result, more than 23,000 die. Speaking about the findings of the research, lead author Kao-Ping Chua, M.D., Ph.D., said “Antibiotic overuse is still rampant and affects an enormous number of patients. “Despite decades of quality improvement and educational initiatives, providers are still writing antibiotic prescriptions for illnesses that would get better on their own.”
Coughs can be extremely unpleasant and leave many people in search of fast relief. But newly proposed guidelines from the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE) in the UK say honey and over-the-counter medicines should always be the first port of call. In fact, the new guidelines go as far as to say antibiotics should only be prescribed by doctors on rare occasions, as they actually do little to alleviate symptoms. Most of the time, within two to three weeks, a cough will clear up on its own. The new recommendations for doctors are designed to tackle the growing problem of antibiotic resistance, which is making some infections harder to treat and leading to the emergence of drug-resistant superbugs. Patients are being advised to have hot drinks with honey and ginger, as well as cough medicines containing pelargonium, guaifenesin or dextromethorphan and wait and see if their symptoms improve before going to see their doctor. The bottom line is most coughs are caused by viruses, so antibiotics actually have little to no effect whatsoever. Dr Susan Hopkins, a deputy director at PHE, said: “Antibiotic resistance is a huge problem, and we need to take action now to reduce antibiotic use... “These new guidelines will support GPs to reduce antibiotic prescriptions and we encourage patients to take their GP's advice about self-care.” [Related reading: New Superbug-killing antibiotics found in soil]
Last month, we reported how scientists in the US had found superbug-killing antibiotics in soil. While that might have seemed an unlikely place to find something that has the potential to save countless lives, where scientists have now discovered powerful proteins capable of fighting superbugs is even stranger. Back in 2010, Australian scientists found that platypus milk contains a potent protein which is able to fight superbugs. As if Platypuses weren’t weird enough, what with their duck's beaks, venomous feet and the fact they’re mammals that lay eggs, their potentially beneficial milk only adds to their uniqueness. While it’s been years since scientists made the discovery, it’s only now that they understand why platypus milk is so good at fighting superbugs. Being monotremes, platypuses lay eggs and produce milk. However, they don’t have nipples and instead secrete milk through pores along their stomachs. It is this strange feeding system that is thought to give platypus milk its antibacterial properties, according to scientists. Dr Janet Newman, from Australia's national science agency CSIRO, said: “Platypus are such weird animals that it would make sense for them to have weird biochemistry.” While mammal milk is usually secreted via the animal’s nipples and remains sterile, platypus milk is decidedly dirtier. That’s why scientists think it contains unique antibacterial properties. Scientists hope the milk can be used to develop new antibiotics that can help fight superbugs.
An opinion piece that was recently published in the BMJ has triggered a debate about whether the guidelines for antibiotics should be updated. Advice from doctors has always been that people should continue taking a course of antibiotics until they are all gone, even if they started feeling better a few days in. But now, writing in the BMJ, a team of researchers from across England argues there is not enough evidence to support the idea that stopping a course of antibiotics early encourages antibiotic resistance. In fact, they say that using antibiotics for longer than necessary could increase the chances of antibiotic resistance occurring. Prof Martin Llewelyn, from the Brighton and Sussex Medical School, together with colleagues, says that more research is needed so that antibiotic prescriptions can be given that are tailored to the infection and the person. However, many experts have come out urging people not to change their attitudes towards antibiotics in light of one study. Prof Helen Stokes-Lampard, leader of the Royal College of General Practitioners, said that just because a person’s symptoms had improved it did not necessarily mean the infection had been completely eradicated. "It's important that patients have clear messages, and the mantra to always take the full course of antibiotics is well known - changing this will simply confuse people."