Tag Archives: prescription

Antibiotic dangers

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Taking antibiotics can mean you become more prone to secondary infections, but why, and what can be done about it?

Even if you’ve been blessed with the constitution of an ox, you’re likely to have been handed a prescription for antibiotics at some stage in your life. And you’ve probably felt better for taking them. But going on a lengthy course of broad-spectrum antibiotics can bring problems of its own. While the initial problem may clear up, taking the antibiotics can mean you become more prone to severe secondary infections.

For a long time scientists have been wondering why taking a medication that knocks one infection out, invites others in. Now research from the University of Pennsylvania School of Medicine may have given us an explanation.

The research has shown that the good bacteria in the gut keep the immune system at the ready to fight off infection from invading pathogenic or disease-causing bacteria. For senior author Jeffrey Weiser, MD, professor of Microbiology and Pediatrics, it’s rather like starting a car: It’s much easier to start moving if a car is idling than if its engine is cold. In the same way, if the immune system is already warmed up, it can better cope with the bad bacterial invaders. The implication of these initial findings in animals, he says, is that prolonged antibiotic use in humans may effectively throttle down the immune system, so that it is no longer working at peak levels.

Antibiotics

Antibiotics

It’s down to white blood cells known as neutrophils, and how well they’re working. “Neutrophils are being primed by innate bacterial signals, so they are ready to go if a microbe invades the body,” Jeffrey Weiser explains. “They are sort of ‘idling’, and the baseline system is already turned on.”

“One of the complications of antibiotic therapy is secondary infection,” says Jeffrey Weiser . “This is a huge problem in hospitals, but there hasn’t been a mechanistic understanding of how that occurs. We suggest that if the immune system is on idle, and you treat someone with broad-spectrum antibiotics, then you turn the system off. The system is deprimed and will be less efficient at responding quickly to new infections.” The study was carried out with mice, so further research needs to be done, but findings so far show that it may be possible to find a way of giving antibiotics to humans with just the beneficial effects and not the drawbacks.


So how do you keep the immune system ready to fight off infection if you have to take antibiotics? The first step is to live well before you need medical treatment. “Try to stay as healthy as possible,” says dietitian Sian Porter, spokesperson for the British Dietetic Association (BDA). “Stay physically active, get enough sleep and have a good diet. If you’re eating plenty of different types of fruit and vegetables, oily fish, whole grains and calcium, this should help to keep you healthy.”

Sometimes though, even this isn’t enough to keep us well and antibiotic-free. Elizabeth Weichselbaum, of the British Nutrition Foundation, has carried out a study of research into probiotics and how well they work. Probiotics are designed to provide us with good bacteria and help recreate balance in the gastro-intestinal tract.

Clot inhibitor Clopidogrel cleared for UK use

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A clot-busting drug that can reduce the chance of dying from a second heart attack by 20 per cent has been given the all clear by an NHS watchdog.

Clot inhibitor Clopidogrel had been considered the ‘gold standard’ for current treatment regimes.

However research shows that new drug, Ticagrelor, cuts the overall risk of dying from heart disease by 21 per cent, and reduces the risk of suffering a further heart attack within 12 months of the first by 16 per cent.

Doctors estimate that it could prevent 1,500 heart attacks every year if survivors and unstable angina patients take the new pill.

It works by preventing the formation of new blood clots and maintaining blood flow to the heart.

Thanks to the ruling Ticagrelor can now be prescribed on the NHS to thousands of patients.

Taken with aspirin it is suitable for people who have had a heart attack or a condition called unstable angina, according to the National Institute for Health and Clinical Excellence (NICE).

Clopidogrel

Clopidogrel

Doctors expect more than 180,000 people a year to benefit from the treatment – 70,000 with unstable angina and around 113,000 who have suffered a heart attack.

About 136,000 people are admitted to hospital every year in England and Wales following a heart attack or unstable angina.

People who have suffered a heart attack are at greater risk of suffering a second.

The new drug currently costs £54.60 for a pack of 56 tablets – compared to just £3.40 for Clopidogrel.

The European Union cleared the drug for general use in December last year while the U.S. Food and Drug Administration has not yet concluded its assessment of the clot inhibitor for prescription.

Dr Carole Longson, NICE health technology evaluation centre director, said: ‘Ticagrelor is the latest in an ever-increasing number of important new drugs and interventional techniques that have been shown to reduce deaths in patients with acute coronary syndromes.

‘From the evidence considered, the independent appraisal committee concluded that, compared with Clopidogrel, reductions in heart attack and death from vascular causes were significant – 16 per cent and 21 per cent respectively – for patients randomised to the Ticagrelor group.’


Patients stay on the drug, made by AstraZeneca, for up to a year.

Side-effects can include gastrointestinal, hematoma and bleeding along with nosebleeds and shortness of breath, although there was no difference between ticagrelor and clopidogrel when it came to risk of major bleeding.

Rash and itching was also observed in one per cent of those patients who took the drug.

Kausik Ray, professor of cardiovascular disease prevention at St George’s research centre in London, said: ‘Despite current treatment options, one in seven patients will die within 12 months following a heart attack.

‘Ticagrelor has been demonstrated to reduce a patient’s likelihood of dying from an acute coronary event, or having another heart attack or episode of unstable angina in comparison to the current standard of care, Clopidogrel.

‘The provisional recommendations issued by Nice means that we are one-step closer to ensuring this life-saving medicine is available for the thousands of patients in England and Wales who could benefit from its use.’