Cystitis resisting antibiotics

Cystitis resisting antibiotics Marie Corman was far from worried when she experienced the first symptoms of cystitis.‘I’d had it once before a few years ago, and knew a quick course of antibiotics would clear it up ,’ says the 36-year-old account manager from London.
So Marie, whose real name has been changed, took the week-long course of antibiotics prescribed by her GP, and her symptoms disappeared.
Cystitis is a urinary tract infection, most often caused by bacteria. Around half of all women suffer from it at some time — in fact, cystitis is one of the main reasons for GP antibiotic prescriptions.
But, in Marie’s case, the treatment didn’t seem to have worked, because just a few weeks later her symptoms returned.
She was given another course of antibiotics, only for the infection to flare up a month later. ‘I was getting worried by then,’ she says. ‘The doctor kept handing out antibiotics, but they didn’t seem to be working.’
She went privately to see a specialist, who identified the culprit — a type of E.coli resistant to a range of common antibiotics.
Most people associate antibiotic resistance with deadly hospital superbugs such as MRSA.
Last month, Professor Laura Piddock of the Anti-Microbial Agents Research Group at the University of Birmingham warned that without new weapons against these dangerous pathogens, we face the threat of untreatable infections.
But what many people don’t realise is that resistant strains exist outside hospital, and they can make otherwise innocuous ailments very difficult to treat.We’ve become used to the idea that bacterial infections, such  as ear or lung infections, can be stopped in their tracks by antibiotics. But as Marie’s case shows, that isn’t always true.
Her antibiotics had some effect on the bug causing the infection, but enough resistant ones were left for it to flare up again.
\'I spent 10 days in hospital getting an infusion three times a day\'
Once Marie’s drug-resistant bug had been identified, ‘things started to get frightening’. She had to go into hospital for tests to check if the infection had reached her bladder — and the surgeon accidentally cut her bladder wall, so it had to be stitched and she needed a catheter while it healed.
Then, the only treatment that could tackle her resistant bug was a powerful penicillin that had to be delivered directly into a vein. ‘I spent ten days in hospital getting an infusion three times a day,’ recalls Marie. ‘I had tubes coming out of me and was terrified I would catch something else resistant.
‘It’s frightening how fast a resistant bug can take you from healthy to very sick.’
Around 20 per cent of urinary tract infections cases seen by GP Dr Alastair Hay, a specialist in primary health care at the University of Bristol, don’t respond to the first-line antibiotic, although they do then respond to other antibiotics.
But urinary tract infections are not the only conditions triggered by drug-resistant bugs. Nearly 100 cases of resistant pneumonia have been reported in the UK so far. And recently there were reports that a strain of the bacteria that causes gonorrhoea had emerged in Japan that was resistant to all known antibiotics.
So why aren’t there any new drugs to target such bugs? Well, they don’t make enough profit, so drug companies have stopped researching them. There are just four new antibiotics in development worldwide, and none targets resistant bacteria (861 more profitable drugs and vaccines are being tested against cancer).
The very things that patients like about antibiotics — they work quickly after being taken for only a short time — are what makes them unprofitable. Blockbuster drugs such as statins make billions because people have to take them for years.
Professor Piddock’s solution is to subsidise drug companies to develop new antibiotics. She is also heading a campaign to raise awareness among GPs and patients, which could result in less antibiotic prescribing.
GPs give out around 80 per cent of antibiotics — all too often for viral infections such as colds and flu, which the drugs can’t treat; they are also hardly effective against infections such as tonsillitis and sinusitis.
When you treat an infection with an antibiotic, it kills off the  harmful, non-resistant bacteria, leaving the resistant ones room to expand.
There may be other options, according to George Lewith, professor of Health Research at Southampton University. ‘Cutting back on antibiotics doesn’t mean leaving patients with nothing,’ he says.
‘We’ve found that aspirin-type anti-inflammatory drugs and corticosteroid can be very effective in treating symptoms such as fever, aches and pains.’
Another approach is better hygiene. Some years ago MRSA was infecting 2,000 people every three months in the UK, but the number has dropped below 100 a month thanks to better hygiene.
‘Improved hygiene can make a big difference,’ says Dr Yoon Loke of the University of East Anglia medical school, and an expert in harmful drug effects.
‘We also need better, quicker ways of identifying which bacterium a patient is infected with so they can be given an effective drug rather than a broad spectrum antibiotic. It is less glamorous than new wonder drugs but it could make a big difference.’
It could also save many like Marie a lot of misery.