Many years ago I went to visit my grandmother, and let myself into the house to find her bouncing off the walls, having a conversation with her long-dead father, singing a selection of hits from My Fair Lady in a Cockney accent (surprising, given that she was from Leeds) and depositing small quantities of pee in every corner of every room.
Luckily I had some cephalexin in the back of the car, and 12 hours after forcing a tablet down her throat (in between lines from ‘Wouldn’t It Be Loverly?’) she had sobered up, showered herself and was watching the cricket with me. Later she was in such fine fettle that we drove to Morrisons to buy frozen prawns, cakes and stout as usual.
This is a modern miracle. There are two wonderful advances in modern medicine; antibiotics and vaccines. Without them, we GPs would not be all that far from our 18th- century colleagues’ position of only being able to offer placebos, laudanum, bark, quinine, the blue pill and the black pill, leeches and a slime bolus (whatever that was). OK, to be fair, we are still big on offering placebos.
But now, apparently, we are no longer supposed to prescribe antibiotics. Never mind that more than half the antibiotics in the world are poured down the necks of poultry and cattle to make them bigger, more quickly. Never mind that these drugs are available over the counter across most of Europe to anyone with a scratchy throat and five euros to spare. Never mind that the French, the Greeks and the Americans have an antibiotic ingestion rate thrice that of the UK population. We, the GPs of Great Britain, are apparently responsible for all the woes of antibiotic resistance, and must be forced to change.
I feel like Jaime Lannister in Game Of Thrones, just after Vargo Hoat cut his right hand off. Along with the immediate agony comes the instant realisation that life is going to be a hell of a lot more difficult from now on.
Incorrigible recidivist that I am, I have continued to prescribe antibiotics this last week, where I thought it appropriate. But I have also been asking patients what they thought about my reckless foolishness. Most of those I asked were aware that antibiotics are suddenly irresponsible and dangerous, but all expressed an opinion identical to my stance on public transport (yes, it’s a wonderful thing for other people… but you’re not getting me out of my car!) ‘Yes, doctor, you shouldn’t be prescribing antibiotics non-stop… but my ear really hurts!’
Technology is the answer to many of the world’s ills. No new antibiotics have been developed for decades, and the reason is obvious. Drug companies are interested in developing drugs patients will take for decades on end – statins, for example. A drug taken for five days at the most does not hold the same commercial attraction. Fix that problem and we have solved the antibiotic resistance problem.
But in the meantime, don’t blame GPs for using the best tools we have to hand.
Dr Phil Peverley is a GP in Sunderland.
