INTERVIEW. “No longer being able to cure an infection because of antibiotic resistance is not science fiction!”

For the second year in a row, the alliance of independent Occitanie clinics Clinavenir is organizing a day to raise awareness of the proper use of antibiotics. Drs Camille Fourcade and Lydie Porte, infectious diseases doctors, raise the issues.

Antibiotic resistance could cause the death of 10 million people worldwide in 2050, what is this health threat?

When bacteria become resistant to antibiotic treatments, we speak of antibiotic resistance. Of course, the use of antibiotics is sometimes necessary but the more we use them in quantity or incorrectly (high doses, long duration for example), the more we increase the risk of antibiotic resistance and therefore the risk of no longer being able to treat infections. . If we do nothing, in 2050, antibiotic resistance could become the leading cause of death in the world, ahead of cancer and cardiovascular diseases.

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Six weeks of treatment at €880 per day

Today, are you faced with cases of antibiotic resistance?

As part of our hospital practice, this can happen to us three or four times a year. Resistance to certain staphylococci has declined but we are seeing more and more multi-resistant or highly resistant bacteria, particularly in people who have traveled to areas where these bacteria are present (India, South-East Asia, Greece, Maghreb) or who have took a lot of antibiotics. When a patient is infected with one of these bacteria, the treatments implemented are very expensive. For example, we have the case of a person who has triggered a post-operative infection with a highly resistant bacteria: they will have to be treated for six weeks at a rate of €880 per day. If this treatment does not work, there will be no solution and if in three months she contracts a urinary infection, we will not be able to treat her either… It's not science fiction!

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How to deal with the problem?

Remember that antibiotics are not always necessary! France is in the top 5 largest consumers in Europe. We must therefore educate the doctors who prescribe and the patients who, very often, are unhappy if they are not given treatment. But we have difficulty getting the message across, false ideas are stubborn, too many people think that flu or nasopharyngitis can be treated with antibiotics when they are viral infections on which antibiotics have no effectiveness. Same thing for tonsillitis which is only bacterial in 10% of cases. Half of prescriptions are unnecessary or inappropriate.

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“The antibiotic, an anxiolytic for the doctor and the patient”

Is research progressing to find alternatives to antibiotics?

For the moment no, there is no equivalent apart from phage therapy (treatment with phages) for certain osteoarticular infections. We must therefore really fight against the misuse of antibiotics which have become anxiolytics for patients who think they will solve everything and for doctors who prescribe them “just in case”. But we also know that general practitioners, prescribers of 80% of antibiotics in community medicine, cannot always apply good practices, namely reassess the patient's condition 48 hours or 72 hours after taking an antibiotic. which would make it possible to deliver the right family of antibiotics in a targeted time.