• Question: Hello All, I am interested in AMR and a quite a while, I have been reading a lot of literatures on AMR. My questions are; Firstly, what is the current status about AMR and are scientists winning this war of AMR? Secondly, as we all know that according to the World Health Organization, 80% of the world’s population depend on traditional medicine for their primary healthcare needs, but I hear little of natural product being mention with regards to AMR. My father had wound infection that resisted all antibiotics, but two natural products were combined to treat his wound infection at the space of 8 days. Do you all do not believe it is high time we gave these plants a chance/challenge to see if they could be our treatment remedy, while we continue to elucidate these organisms evolvement and resistance to treatment?

    Asked by Anon to Adam, Alastair, Andrew, Chris, Cliodna, Elizabeth, Jeroen, Martin, Michael, Paul, Rose, Susan, Thamarai, Wendy on 15 Nov 2016.
    • Photo: Adam Roberts

      Adam Roberts answered on 15 Nov 2016:


      Hello
      Scientists are unfortunately not winning the war against AMR. There are many reasons for this and one of the main ones is that we have not found new antibiotics for a while. This is not necessarily that they are not out there we just haven’t concentrated our efforts on looking. This appears to be changing now.
      In terms of natural compounds; most of the antibiotics that we use today are natural compounds produced by bacteria and fungi in the soil. They have evolved the ability to produce these compounds in order to give them a competitive advantage within their environment. By killing surrounding microbes the producers have more of the food and other resources for themselves. This is predominantly where researchers are currently looking for new antibiotics.
      Regarding plant based antimicrobial compounds there are many publications detailing novel chemicals with antimicrobial activity, again this area of research is expanding rapidly.
      What I would add finally is no matter where a naturally produced chemical is produced I would think microbes would eventually be able to develop resistance against it, it is what they do, they are the ultimate adaptable lifeforms.

    • Photo: Cliodna McNulty

      Cliodna McNulty answered on 15 Nov 2016:


      In many countries sadly we are not winning the war on AMR, the most resistant carbapenamase producing organisms are increasing.
      However resistance to some antibiotics in the U.K. has decreased over the last 5 years, through judicious use.
      Avoiding Antimicrobials where at all possible is important- through drainage of abscesses where appropriate, – and increased self-care for uncomplicated infections. Alternatives to antibiotics should also be considered – RCTs of many herbal products is needed.
      An example of a non antibiotic treatment is methenamine for prophylaxis of UTI – which a Cochrane review suggests may be useful

    • Photo: Elizabeth Beech

      Elizabeth Beech answered on 15 Nov 2016:


      I agree with Adam, we are not winning and its real and scary. We are seeing increasing resistant infections in humans across Europe and USA, with 20K deaths associated with AMR each year in Europe happening now. This is why prudent use of existing antibiotics and any new antibiotics, or novel agents is so very important. Starting with preventing infection first – this applies to vaccination as well as very basic IPC like handwashing, avoiding urinary catheters, training the whole health care workforce to improve their IPC practice, and educating the public about infection prevention – more handwashing! e-bug resources promoting these issues are freely available for schools and Cliodna can say more about these.
      As a pharmacist my contribution is to ensure antibiotic use really is appropriate, using all the tools we can to achieve this including behavioural interventions.

    • Photo: Michael Moore

      Michael Moore answered on 16 Nov 2016:


      You are quite right to highlight the potential role of traditional herbal medicines in the fight against AMR. It is less than 100 years since the first antibiotic was isolated and for thousands of years before then folk relied on traditional remedies. At Southampton we are actively looking to try and identify potential remedies to help with symptoms of infection. We are in the final stages of a trial using a herb to manage the symptoms of urine infection in women and are in the set up phase of a new study in acute cough illness. We are also running a study of chinese herbal medicine in recurrent urine infection.
      https://www.southampton.ac.uk/medicine/academic_units/projects/atafutialternativetreatmentsofadultfemaleurinarytractinfection.page

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