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Antibiotics and Barnacles

15 Jun

Antibiotics and Barnacles
When I attended a week-end GP revision course  in 1980 in Falmouth, a beautiful coastal town in Cornwall I remember we were in group, discussing how we introduced ourselves to patients. A local GP said “I don’t know about anyone else but I always say ‘how’s your barnacles?’because that is what is most important to people in Falmouth.”
Hence, when I read this week about antibiotics being used in painting the hulls of ships to eliminate barnacles  I thought the people in Falmouth will be much happier but at a price!

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Antibiotics are being painted onto the hulls of ships to them clear of barnacles in a practice that is helping to drive the appearance of drug resistant bacteria, ministers from the world’s richest nations have been warned.
Dame Sally Davis, the British Chief Medical Officer, told the ministers that the common antibiotic Tetracycline, which is used to treat common infections in patients, was being added to paint for use on the hulls of ships to prevent the build up of algae and barnacles, known as fouling.
However, bacteria in the water can develop resistance to the antibiotic and it can be passed onto other organisms such as Escherichia coli and Salmonella.
What are barnacles?
Barnacle is a small saltwater animal with a protective shell-like covering. There are more than 1,000 species. Barnacles attach themselves permanently to ships, wharves, and rocks, and to other marine animals.(look at mussel shells on the fish counter) Barnacles on the hull of a ship increase friction and can reduce the vessel’s speed
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If you clean a ship or put a new ship to sea, it’s coated with microbes within a day,” said Van Mooy. “Not enough to see, but the first microbes are starting to lie down. And then the slime begins to grow over the course of weeks. That is essentially a gateway community to the barnacles and other things.”

“The slime” is a biofilm, a thin sheet of bacteria that stick to each other and to a matrix of molecules they exude to communicate with each other and to provide a hospitable environment for themselves. Once the slime forms, the rush is on, as algae and the larvae of creatures such as barnacles attach and begin to grow over the course of weeks. That is essentially a gateway community to the barnacles and other things.”

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The use of antibiotics to keep ships clear of barnacles is the latest case of antibiotics being overused that is causing alarm among the medical community.
Some 80 per cent of gonorrhoea is now resistant to the frontline antibiotic tetracycline. I do recall many years ago discovering that if I prescribed a course of antibiotics it was frequently sold or given to family,friends or contacts. I am aware that this still goes on despite constant reminders to patients.
Doctors have been criticised for prescribing antibiotics for viral infections.
I along with my GP colleagues are aware that if we refuse antibiotics for a viral infection that our patients are attending walk-in centres, going to A&E when getting the antibiotics they want, which then sends them back to us the next morning. What a waste of resources, with each out-of-hours attendance for a self-limiting viral illness attracting a fee to the NHS.
We know that if we prescribe antibiotics unnecessarily and especially if the patients fail to complete the course that there we will be nothing available for post operative infections
Eg.in the near future it may be too risky to carry out a hip replacement as implanted materials, like those found in a joint replacement, can allow infections to persist. Our immune system is unable to attack bacteria that live on these implants, and these infections can become serious problems. If an infection of an implant goes untreated, the problem can worsen, and the bacteria can gain such a foothold that they can become a systemic problem and potentially fatal. However, implanted materials, like those found in a joint replacement, can allow infections to persist.
We have been aware of superbugs such as MRSA for some time and the horrors of what happens if someone contracts an overwhelming infection with this bug.
There were almost 43,000 patients who caught so called “superbugs” in NHS hospitals last year.
It has now become such a concern that it was brought up at the G8 conference as a serious global problem.
David Willetts, the British science minister who led the meeting this week, said the soaring levels of antibiotic resistant infections was now one of the greatest threats facing the world.
Doctors must think not once but twice before prescribing antibiotics and patients must think not once but twice before demanding antibiotics and always where possible to complete the course and do not give to anyone else.
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Posted by Dr Bayer

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Posted by on June 15, 2013 in Current affairs

 

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