Respiratory infections: bacteria are the resistance

Since the 80s, respiratory infections are becoming more complicated to treat. Why? The bacteria responsible for some of these diseases have become resistant to antibiotics. How to solve this problem? From sinusitis to chronic bronchitis, new recommendations try to change the habits of doctors ...

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The problem of bacterial resistance to antibiotics is a growing concern in the treatment of many diseases. And respiratory infections are no exception to the rule ...

An adaptation of bacteria ...
Darwin said: "This is not the strongest species and the most intelligent that survive but those that adapt to changes. The bacteria apparently understood that. They have adapted to the increasing use of antibiotics. Thus, in the early '80s, the resistance among the pneumococci were close to zero. 20 years later, this rate is around 50%! It is therefore essential not only to identify new molecules, but to encourage doctors to good requirements in order to avoid to maintain or even aggravate this phenomenon.

Respiratory infections in primary
Respiratory infections are a leading cause of consultation at the GP. And so it is difficult for the practitioner to determine if the cause is bacterial or viral. As a correct diagnosis depends on whether the prescription of antibiotics. Because these drugs are only effective on bacteria. And the administration's "anything goes" antibiotic that is pointed to the emergence of resistance. To help the doctor make the right decisions, there are several trials of setting up rapid diagnostic tools to help detect the presence or absence of bacteria. For now, the first rapid test set up is that of angina. It works well and is increasingly used. But unfortunately the only currently.

The very strong resistance in France
Besides the development of rapid tests, it is urgent for France to change physician behavior. Because the hexagon is one of the European countries most affected by the problem of resistance. Looking pneumococci example, there are 60% reduced susceptibility to penicillin in France or Spain. This represents 10 times more than Germany or Italy! But it is true that in Italy the situation is paradoxical: it is one of the world's largest consumer of antibiotics. But as the administration is generally done intravenously, the emergence of resistance seems less easy.

The hope of new molecules?
So far, we relied heavily on the development of new drugs to eradicate this phenomenon of resistance. But the search for new antibiotics decreases. And if new molecules are still coming on the market today, they are less numerous in the years to come. Moreover, we must emphasize the disturbing emergence of cross-resistance: more and more bacteria become resistant to an antibiotic will be able to resist those of another class.

Changing physician behavior
To solve this problem is therefore to encourage appropriate prescribing. Thus, the French Agency for the Safety of Health Products has issued numerous recommendations for practitioners. But it is clear that they are generally not followed. Because we ask the doctor to thoroughly change its behavior: it must go behind the symptoms, to perform further tests before making a decision. For example, in cases of sinusitis, it will differentiate colds affect the sinuses with the purulent sinusitis, which it requires antibiotic treatment. Similarly, in cases of chronic bronchitis or COPD, prescription of antibiotics should depend on the level of bronchial obstruction. All these changes will do so only with clear explanations and teaching. Hopefully these measures will bear fruit and will overcome the resistance, finally breathing easy!

 

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