Antibiotics 'greatest medical advance'

THEY have saved the lives of millions around the world, changed the way we treat disease and cured illnesses in a way scientists once never thought possible.

Now antibiotics have been hailed as the most important medical development of the past 50 years in a new survey of doctors.

With body scanning techniques, tobacco control and tuberculosis treatment also appearing in the top ten, Scotland makes its own presence felt in the run-down of medical achievements.

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As medics gather in Edinburgh this week to discuss the advances that have so dramatically shaped our times, there were also warnings that such achievements should not be taken for granted and that further investment was needed to allow for future breakthroughs.

After antibiotics, vaccination was named the second most important medical development in the poll of more than 650 doctors. This was followed by the use of CT and MRI scans to help detect disease and the development in Edinburgh of an effective treatment for TB.

The research was carried out ahead of the Royal College of Physicians of Edinburgh's (RCPE) 50th St Andrew's Day Festival Symposium, Five Decades of Medical Progress, later this week.

Although Scottish scientist Alexander Fleming made his discovery of penicillin in 1928, it was not until the 1960s that antibiotics really took off.

• Top 20 discoveries made in Scotland

Used to treat diseases caused by bacteria, such as TB, syphilis and pneumonia, the drugs have led to a dramatic decrease in death rates and serious illnesses.

But antibiotics have also had an unwanted side-effect, with the emergence of hospital infections such as MRSA, which is resistant to the main antibiotics, and Clostridium difficile, which can be sparked by inappropriate use of the drugs.

Dr Neil Dewhurst, president of the RCPE, said: "From the results of this survey it is clear that doctors throughout Scotland, the UK and internationally believe the most important developments to be in relation to the availability of effective antibiotics and vaccination.

"While agreeing with this point, it is also vital that doctors and patients are aware of the dangers of over-using antibiotics and that antibiotics are prescribed safely and wisely in order to reduce the risk of drug resistance and problems like MRSA and C. difficile."

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Dewhurst also said it was interesting to note how significantly Scottish doctors and scientists had contributed to medical global developments.

The tobacco control movement was spearheaded in Edinburgh, with Sir John Crofton - who also developed TB treatment - founding ASH Scotland and highlighting the dangers of cancer and lung problems linked to smoking.

In 1960, the first successful kidney transplant in the UK was performed in Edinburgh.More than 2,600 are now carried out each year.

In total, eight of the 20 most important medical developments have links to Scotland.

Dewhurst added: "For centuries Scotland has had a reputation as a leader in medical innovation and we are gratified that this tradition continues to this day."

Alistair Douglas, a consultant in acute medicine and nephrology in Dundee, and lead organiser of the meeting, said that globally antibiotics and vaccination have saved the greatest number of lives, helping ensure their place at the head of the key developments.

He said it was difficult to predict what advances would come in the next 50 years, but progress seemed to be accelerating rather than slowing down.

But Douglas said a key challenge would be ensuring universal access to new treatments so the whole population could benefit.

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"The technological and new drug development challenges are all very exciting, but one of the big moves in the last ten to 20 years has been to make sure the best treatments are available to all," he said.

"In the past, a select lucky few had the best treatments, but in the UK, and Scotland in particular, it is about making sure there is access and equity for all."

Aberdeen-based microbiologist Professor Hugh Pennington agreed with the findings of the poll. "Antibiotics are one of the few drugs that actually cure patients," he said.

But Pennington said, for future progress to be made, investment in medical science needed to be maintained, even in the face of economic difficulties.

"It is absolutely vital that funding continues to go into searching for the next big developments," he said.

"You have to give people the right environment to have the freedom to follow their ideas and through that I think we will probably make progress in brain research and possibly with stem cells.

"There are all sorts of fantastic possibilities out there."