The British Dental Association (BDA) has said prescribing antibiotics without ever seeing patients in a face-to-face consultation is indefensible, following a BBC investigation revealing a boom in online pharmacies selling antibiotics like “sweeties”.
The BDA joined with leading medical organisations to express concern that antibiotics are being prescribed to patients online often with no medical checks, and against National Institute for Health and Care Excellence (NICE) guidelines.
Although the World Health Organization has identified antimicrobial resistance (AMR) as a serious threat to public health worldwide, the investigation highlighted how easy it is to get antibiotics online and the difficulty of regulating online providers. The journalist/GP investigating, Faye Kirkland, posed as a 16-year-old girl, who was able to get three different antibiotics for three different conditions, including a 'dental' problem, all within 24 hours. These were all from the same site and prescribed by the same doctor and, as far as the doctor was concerned, for the same patient.
Speaking to BBC Radio 5 Live Lord Jim O’Neill who carried out a government review into AMR, warned that if effective controls are not put in place to curb inappropriate prescribing, diseases which are resistant to antibiotics will overtake cancer as the leading cause of death. In the absence of such controls, he predicts that 10 million people will die annually around the world by 2050.
The General Medical Council has launched an investigation into the programme's findings, while the Care Quality Commission says it is looking into bringing in new rules next year to regulate online pharmacies.
Commenting on the investigation, BDA scientific adviser, Professor Damien Walmsley, said:
“This BBC investigation highlights an urgent need to raise public awareness of AMR, and the importance of seeing a dentist if people are concerned they might have a dental infection, rather than going online for antibiotics.
"Patients may be surprised to learn that antibiotics won’t cure their dental abscesses and analgesia is more often the treatment of choice for tooth-related pain. It doesn’t help that some online pharmacies are dishing out antibiotics like smarties for dental problems, which sends out completely the wrong message to patients.
"As dentistry accounts for around 10 per cent of antibiotics prescribed in the UK, the BDA has been in the forefront of ensuring that dentists are aware of the need to prescribe antibiotics judiciously
“In a collaboration with national and international experts, the BDA launched a consensus reportin 2015 to help dentists play their part in the global fight against AMR.”
The Chair of the BDA's General Dental Practice Committee, Henrik Overgaard-Nielsen, said:
“The health risks presented by AMR require a change in gear from patients, practitioners, and policymakers.
Warning given over children using complementary therapies
Doctors at St Bartholomew's Hospital have warned of the dangers of giving children complementary therapies after a four-year-old boy ended up in A&E.
The boy had been taking 12 different holistic supplements from a naturopath (natural health practitioner) supposedly to help treat his autism.
The supplements included vitamin D, camel's milk, silver and Epsom bath salts.
He developed a potentially fatal condition but made a full recovery.
Dr Catriona Boyd and Dr Abdul Moodambail, writing in the British Medical Journal Case Reports, said it was not until the boy had been in the London hospital for several days that his mother told them about the holistic supplements, which he had been taking for a number of months.
They said the parents were "devastated that something they had given to their son with good intent had made him so unwell".
"The situation was stark because the child developed vitamin D toxicity leading to very high calcium levels, making the child quite unwell and this can even be fatal as well," Dr Moodambail told the BBC.
The boy had been suffering from symptoms for three weeks including vomiting, weight loss and excessive thirst. He had lost 6.6lbs (3kg) in weight in three weeks and was very dehydrated.
He was treated with hyperhydration and medications to reduce his calcium level and made a full recovery in two weeks.
Woman's giant 'Rapunzel syndrome' hairball cut out of stomach
real life moved from Grimm to gruesome for one 38-year-old woman in the US who had a giant 15cm hairball in her stomach.
She is one of only a handful of documented cases of "Rapunzel syndrome", which is caused by people plucking and eating their own hair.
Their once glorious locks build up in the digestive system where they can eventually have a devastating effect.
The woman, who is has not been named, developed sudden vomiting and constipation. Meanwhile, her stomach swelled as it filled with liquids and gas.
She had gone off food for a year, lost 15lb in the previous eight months, and by the time she reached hospital, was unable to keep down any food.
Doctors in Arizona, writing in the BMJ Case Reports, initially gave her donor blood to tackle her anaemia.
But when they performed abdominal surgery they uncovered a 6inx4in (15cmx10cm) ball of densely packed hair in the stomach and then another 1.5inx1in (4cmx3cm) hairball in the small intestines.
The two elements of Rapunzel syndrome
- Trichotillomania - the irresistible urge to pull out hair
- Trichophagia - compulsively eating hair
The blockages were safely removed and the woman was given a diet high in protein to help her recover.
There have only been 88 other reported cases of Rapunzel syndrome.
In some the hair snakes all the way through the digestive system from stomach to large intestines.
Most cases are in childhood - with 40% of Rapunzels under the age of 10.
“Dentists are willing to take responsibility for their share in combatting this risk.
“What we don’t have is a contract that provides adequate time for dentists to treat emergency cases. So we call on the government to recognise AMR and factor this into any reformed package.”