40 | NORTH & SOUTH| JUNE 2019
terialinfectiondoesn’tmeanyouneed
antibioticsforit.”
Hesayswhenotherwisehealthypeople
developa sudden,severesepsisthatkills
them,it usuallymeansthedamagehas
alreadybeendonebythetimethecorrect
treatmentstarts,ratherthanthatthe
bacteriais resistant.“Thepersonusual-
lyhasthegermrunningamokintheir
bodybeforetheantibioticsstart.”
Andthesamebugcanwreakhavocin
onepersonandnotanother.“Forsome,
evena fewhoursafterstartingantibi-
otics,youcantelltheyareontheslip-
peryslope...they’resometimescalled
deadmenwalking.”Inmeningococcal
disease,forexample,“oncetherash
begins,youmightbethinking,well,
thereis a 20-50%chancethey are going
to die despite all we do”.GETTYingtofinisha fullcourse,hesays.
“Witha fewinfections– whenthe
doctorlookingafteryoufortuberculo-
sis,forexample,sayskeeptakingyour
antibiotics,youkeeptakingthem.When
thedoctorlookingafteryouforHIV
sayskeeptakingyourantivirals,you
keeptakingthem.Butwhenthedoctor
givesyouAugmentinorAmoxilorDox-
ycyclinebecauseyouhavea coughand
a sorethroatandsaysyou’vegottokeep
takingthemfor 10 days,that’srubbish.
Stoptakingthemwhenyouarebetter.
Themoreantibioticsyoutake,themore
youwillmakethebugsresistant.”
Themostimportantmessage,hesays,
isnottotakeantibioticsifyoudon’t
needthem– badly.“Doyouhavean
illnessyouhadmanytimesbeforeand
you got better? Just because it’s a bac-Afamilyattendsadoctor’sofficelateatnightinNewDelhi,India.
PeopletravellinginIndiahaveabouta50%chanceofpicking
up resistant bacteria if they take antibiotics during the trip.littlecontrolisthenumberoftravellers
andmigrantswhopickupresistantbac-
teriaabroadbeforeenteringorreturning
tothecountry.“IfyoutravelinIndiaand
don’ttakeantibiotics,youhaveabouta
25%chanceofhavinga resistantorgan-
isminyourbowelflorabythetimeyou
comeback.Andif youdotakeantibiotics
whilethere,you’llhaveatleasta 50%
chance,”saysMarkThomas.
Oneofhismostdramaticcasesin-
volvedanIndianmanwhocametovisit
familyinNewZealandafterminorsur-
geryonhistoe.Bythetimehelanded,
thesmallwoundwasdischargingpus,
anda swabfoundit containedanE coli
bacteriaofa typethatcouldbetreat-
edbyonlyoneantibioticthathadto
begivenintravenously.After 10 days’
treatment,hiskidneyfunctiondeterio-
ratedsomuchthetreatmenthadtobe
stoppedandherequireddialysis,but
theinfectionhadn’tbeenhalted.“He
waspersuadedtohavethefootoffso
theinfectionwasremoved.”
Thomasadvisesagainsttakinganti-
bioticsif youcanhelpit whentravelling.
“Youmighthavediarrhoeafora couple
ofdaysandthink,‘That’sterrible,I need
totakesomeantibiotics.’You’rebetter
notto,byandlarge.Inourintestines,
morethananywhereelseinourbody,
wecarrybillionsofbacteriathatare
adjustedtousandwehavebeencar-
ryingfora longtime.Whenwetakean
antibiotic,it clearsouta largepropor-
tionofthosethataresensitivetothat
antibioticandleavesfertilefieldswhere
otherseedsbeingtossedontothemcan
grow.Overseas,youwillbeswallow-
ingenoughofthelocalgermsthatif
theyfinda gap,theywillfillthatgap.So
whenyoucomebacktoNewZealand,
there’sa greaterchanceyouwillhave
antibiotic-resistantgermslivinginyour
bowel.Ifyoudon’thaveanyproblems
overthenextfewmonths,yearormay-
betwoyears,theywillprobablybesup-
plantedagainbyyourlocalnot-so-bad
ones.Butif theygetintoyourkidneyor
intoa woundinyourfootintheweeks
ormonthsafteryoucomeback,yes,
youmaythenhaveaninfectionthat’s
untreatable.”
Thomashastakenantibioticsjust
onceinthepast 20 or 30 years– when
hewasgiveneyedropsaftercataract
surgery.“Iwastoldtotakeit fortwo
weeksandthought,‘Thisisa loadof
rubbish,’andI stoppedaftertwodays.”
Don’t believe what you hear about hav-