24 | NewScientist | 20 April 2019COMMENT
Prescription for trouble
We are using drugs to treat common infections far too often
and it is making the antibiotic crisis worse, says Colin GarnerWHEN it comes to prescribing
antibiotics, doctors are in a jam.
Giving them too often risks
perpetuating the development
of resistance to these drugs in
bacteria. That is a serious threat
to society. But withholding them
is also risky. If the decision is
wrong, a patient could develop
a life-threatening infection.
Even if the doctor is right, this
decision often upsets people. I
have heard stories of medics being
threatened with everything from
bad online reviews to physical
violence unless they dish the pills.
One of the most dangerous
areas of medicine in this regard is
urinary tract infections. Many fit
and healthy people recover from
UTIs without antibiotics. But if
drugs are needed, they must be
administered quickly, or sepsis
might set in. That is why doctors
often err on the side of caution and
give antibiotics for UTIs beforethey are sure drugs are needed.
Previous estimates from the
US and Australia suggested that
about 30 per cent of antibiotic
prescriptions given out for UTIs in
hospitals and outpatient settings
are inappropriate. Now research
presented at a conference by
Laura Shallcross of University
College London suggests the
true figure is much higher:
between 60 and 70 per cent. This
is based on real test results from
patients entering an emergency
department in a UK hospital,
so there is reason to think the
shocking figure is accurate.
How do we fix this? The
charity I lead, Antibiotic
Research UK, aims to help fund
the development of one new
antibiotic treatment and have
it on the market by the early
2020s. But this is a tall order.
The pharmaceutical industry
isn’t putting enough resourcesMilitary intelligence
As the US drops key advisers, scientists need
new ways to speak up, says Audra J. WolfeREPORTS circulated last week that
the US Department of Defense
has terminated its contract with
JASON, a cold war-era scientific
advisory committee.
The group was created in the
late 1950s, when the department
sought help from some ambitious,
entrepreneurial academic
physicists in the hopes of catchingup with the Soviet Union,
which had just launched the
first artificial satellite, Sputnik.
Instead of studying a topic
identified by a specific defence
patron, JASON received briefings
from various government
agencies and then its scientists
decided what to study. It also
chose its own members.JASON enjoyed remarkable
independence compared with
in-house defence advisory boards
and proved a particularly useful
check on big, expensive ideas. Its
reported demise creates a vacuum
in a system that too often relies
on technical expertise provided
by groups more interested in their
next multimillion-dollar contract
than in supplying sound advice.
Yet much of the hand-wringing
about the end of JASON has
confused this important fiscalrole with ethical oversight.
JASON members have traditionally
justified their weapons research
by invoking scientists’ special
responsibility to advise on the
implications of their work.
History shows that this is
a false premise. From the
Manhattan Project physicists
who later opposed the
development of hydrogen bombs
to the JASON scientists whose
recommendations for limiting
the war in Vietnam inadvertently
created the modern, electronic
battlefield, scientific advisers
have often overestimated their
ability to control how the military
uses their ideas.“ Scientific advisers have
often overestimated their
ability to control how the
military uses their ideas”JOSIE^ FORD