e-bug is operated by public health england debate kit ... · of the e-bug team. the kit has been...

4
Learning notes Learning notes Learning objectives: • To practise discussing and debating issues and expressing an opinion. • Understand more of the technical, social and ethical issues around antibiotics and antibiotic resistance. Other learning outcomes: • Consider social, ethical and factual issues in an integrated way. • Think about different points of view. • Learn to back up their opinions with facts. Curriculum points covered: Working scientifically • Societal aspects of scientific evidence • Developing an argument Substantive • Explore the issues around the use of antibiotics to control infection, and the spread of antibiotic resistance. This kit has been produced by the award-winning I'm a Scientist team and funded by e-Bug operated by Public Health England. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/. Facilitation tips Ensure pupils know there is no right or wrong answer. Be observant of those who want to speak and are not getting a chance. Encourage students to give a reason for their opinions. For groups who may need extra support you can put the following prompt sentences upon the board: “I think we should/shouldn’t tell GPs to give back-up prescriptions because………………….” “I think ……………… is the most important point to think about.” You can use all eight characters, or fewer, as you wish. The minimum is the four essential characters (in bold), this gives two for and two against. Debate Kit: Antibiotic Resistance Should the NHS tell GPs to give back-up prescriptions instead of immediate antibiotics wherever possible? A structured practice debate on a controversial topic. The different ‘rounds’ of the debate help students think through the issues and reconsider their opinions. The structure also shows them how to build a discussion and back up their opinions with facts. Characters For back-up prescriptions • Rowena Brown – GP • Glen Rosewell – Medical Historian Rekha Prasad – Granddaughter Jeremy Smart – Farmer Against back-up prescriptions • Angie Smolenska – Antibiotic Researcher • Barry Ashdown – Business Owner Martin Upton – Computer Programmer Sarah Manse – Retired GP Science Debate Kit: Science Debate Kit: Antibiotic Resistance For more activities and debate kits in this series go to debate.imascientist.org.uk e-Bug is operated by Public Health England Kit N 7 Designed for 11-18 years Supported by

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Page 1: e-Bug is operated by Public Health England Debate Kit ... · of the e-Bug team. The kit has been produced by the award-winning I’m a Scientist team and funded by e-Bug, a project

Learning notes Learning notes Learning objectives:• To practise discussing and debating issues and expressing an opinion.

• Understand more of the technical, social and ethical issues around antibiotics and antibiotic resistance.

Other learning outcomes:• Consider social, ethical and factual issues in an integrated way.

• Think about different points of view.

• Learn to back up their opinions with facts.

Curriculum points covered:Working scientifically• Societal aspects of scientific evidence• Developing an argument

Substantive• Explore the issues around the use of antibiotics to control infection, and the spread of antibiotic resistance.

This kit has been produced by the award-winning I'm a Scientist team and funded by e-Bug operated by Public Health England.This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

Facilitation tipsEnsure pupils know there is no right or wrong answer. Be observant of those who want to speak and are not getting a chance. Encourage students to give a reason for their opinions.

For groups who may need extra support you can put the following prompt sentences upon the board: “I think we should/shouldn’t tell GPs to give back-up prescriptions because………………….” “I think ……………… is the most important point to think about.”

You can use all eight characters, or fewer, as you wish.

The minimum is the four essential characters (in bold), this gives two for and two against.

Debate Kit: Antibiotic ResistanceShould the NHS tell GPs to give back-up prescriptions instead of immediate antibiotics wherever possible?A structured practice debate on a controversial topic. The different ‘rounds’ of the debate help students think through the issues and reconsider their opinions. The structure also shows them how to build a discussion and back up their opinions with facts.

CharactersFor back-up prescriptions

• Rowena Brown – GP• Glen Rosewell – Medical Historian• Rekha Prasad – Granddaughter

• Jeremy Smart – Farmer

Against back-up prescriptions

• Angie Smolenska – Antibiotic Researcher• Barry Ashdown – Business Owner• Martin Upton – Computer Programmer

• Sarah Manse – Retired GP

Science Debate Kit:Science Debate Kit:Antibiotic Resistance

For more activities and debate kits in this series go to debate.imascientist.org.uk

e-Bug is operated by Public Health England

Kit N7

Designed for 11-18 years

Supported by

Page 2: e-Bug is operated by Public Health England Debate Kit ... · of the e-Bug team. The kit has been produced by the award-winning I’m a Scientist team and funded by e-Bug, a project

This

wor

k is

lice

nsed

und

er th

e C

reat

ive

Com

mon

s A

ttrib

utio

n-N

onC

omm

erci

al-S

hare

Alik

e4.

0 In

tern

atio

nal L

icen

se. T

o vi

ew a

cop

y of

this

lice

nse,

visi

t http

://cr

eativ

ecom

mon

s.or

g/lic

ense

s/by

-nc-

sa/4

.0/.

Que

stio

n: S

houl

d th

e N

HS

tell

GPs

to

give

bac

k-up

pre

script

ions

inst

ead

of

imm

edia

te a

ntib

iotic

s w

here

ver po

ssib

le?

Teac

her N

otes

Less

on p

lan

The

diffe

rent

‘rou

nds’

of t

he d

ebat

e he

lp s

tude

nts

thin

k th

roug

h th

e is

sues

and

reco

nsid

er th

eir o

pini

ons.

The

st

ruct

ure

also

sho

ws

them

how

to b

uild

a d

iscu

ssio

n

and

back

up

thei

r opi

nion

s w

ith fa

cts.

Star

ter:

5 m

inut

es.

Has

any

one

in th

e cl

ass

ever

take

n an

tibio

tics?

Wha

t did

th

ey ta

ke th

em fo

r? C

an th

ey s

ay w

hat a

ntib

iotic

s ar

e?

Wha

t illn

esse

s ca

n th

ey b

e us

ed to

trea

t? (Y

ou m

ay w

ant t

o re

cap

the

diffe

renc

e be

twee

n vi

ruse

s an

d ba

cter

ia h

ere)

. A

re th

ere

any

disa

dvan

tage

s of

taki

ng a

ntib

iotic

s?

Do

stud

ents

alre

ady

have

an

opin

ion

on w

heth

er th

e N

HS

sh

ould

tell

GP

s to

giv

e ba

ck-u

p pr

escr

iptio

ns?

Ask

thei

r on

line

surv

ey

(deb

ate.

imas

cien

tist.o

rg.u

k/an

tibio

tic-r

esis

tanc

e-re

sour

ces)

Mai

n A

ctiv

ity: 3

5 m

inut

es.

1) S

plit

stud

ents

into

as

man

y gr

oups

as

char

acte

rs y

ou

wan

t to

cove

r.

Des

igne

d fo

r 11-

18 y

ears

Bac

k-up

pre

scrip

tions

A ba

ck-u

p pr

escr

iptio

n (s

omet

imes

als

o ca

lled

a de

laye

d

pres

crip

tion)

is w

hen

the

GP

advi

ses

the

patie

nt th

at th

ey

will

pro

babl

y ge

t bet

ter w

ithin

a fe

w d

ays

anyw

ay, e

xpla

ins

th

e pr

oble

ms

with

ant

ibio

tic u

se, g

ives

them

som

e ad

vice

on

ta

king

car

e of

them

selv

es in

the

mea

ntim

e, B

UT

give

s th

em

a pr

escr

iptio

n fo

r ant

ibio

tics

whi

ch th

ey c

an u

se if

they

don

’t ge

t bet

ter s

oon,

or t

hey

feel

wor

se, a

nd th

ey th

ink

they

nee

d

it. T

his

save

s th

e pa

tient

hav

ing

to m

ake

a se

cond

vis

it to

th

eir G

P su

rger

y or

out

of h

ours

ser

vice

, put

s bo

th th

e

doct

or’s

and

pat

ient

’s m

inds

at r

est,

and

allo

ws

the

patie

nt to

st

art t

reat

men

t im

med

iate

ly if

they

get

a lo

t wor

se (s

o

prev

entin

g co

mpl

icat

ions

).

Com

mon

mis

conc

eptio

nsA

ntib

iotic

s ca

n be

use

d to

trea

t a c

old

– an

tibio

tics

can’

t hel

p w

ith v

iral i

llnes

ses,

onl

y ba

cter

ial o

nes.

Viru

ses

have

a d

iffer

ent

stru

ctur

e to

bac

teria

l cel

ls a

nd s

o an

tibio

tics

do n

ot a

ffect

them

.

As

they

got

bet

ter l

ast t

ime

with

ant

ibio

tics

they

nee

d th

em th

is ti

me

– ho

wev

er m

ost r

espi

rato

ry tr

act i

nfec

tions

bette

r on

thei

r ow

n w

ithou

t the

nee

d fo

r ant

ibio

tics,

ev

en m

any

of th

e on

es c

ause

d by

bac

teria

.

It’s

the

pers

on w

ho b

ecom

es re

sist

ant –

rese

arch

has

sho

wn

that

man

y of

the

publ

ic h

ave

a ve

ry h

azy

unde

rsta

ndin

g of

w

hat a

ntib

iotic

resi

stan

ce m

eans

. Som

e th

ink

that

the

pe

rson

bec

omes

resi

stan

t to

the

antib

iotic

, so

they

can

’t ta

ke it

an

ymor

e. In

fact

it is

the

bact

eriu

m w

hich

bec

omes

resi

stan

t.

cour

se, s

ome

of th

e ba

cter

ia in

fect

ing

you

and

also

som

e of

th

e ‘fr

iend

ly’ b

acte

ria th

at w

e ca

rry h

arm

less

ly in

our

gut

, will

be

resi

stan

t to

the

antib

iotic

. So

anyo

ne w

ho’s

take

n an

tibio

tics

in

the

last

yea

r will

prob

ably

hav

e a

few

resi

stan

t bac

teria

livi

ng

on th

eir b

odie

s. T

his

isn’

t usu

ally

a p

robl

em fo

r the

m, a

s

mos

t of t

he b

acte

ria th

ey w

ere

infe

cted

with

hav

e be

en

kille

d, a

nd th

eir i

mm

une

syst

em is

abl

e to

dea

l with

the

rest

of

them

. The

se re

sist

ant b

acte

ria c

an h

owev

er b

e a

prob

lem

fo

r pre

gnan

t wom

en, a

nd th

ose

with

repe

ated

infe

ctio

ns o

r ot

her c

hron

ic il

lnes

ses.

Ant

ibio

tics

are

pain

kille

rs –

Ant

ibio

tics

only

kill

bact

eria

and

Taki

ng a

ntib

iotic

s m

eans

you

can

’t dr

ink

alco

hol –

m

ost a

ntib

iotic

s ar

e sa

fe to

com

bine

with

alc

ohol

. Onl

y

met

roni

dazo

le th

at is

use

d fo

r par

ticul

ar g

ut o

r too

th in

fect

ions

ca

uses

a p

robl

em w

ith a

lcoh

ol.

Sup

porte

d by

:

All

fact

s in

this

kit

have

bee

n re

sear

ched

. Ref

eren

ces

can

be

foun

d on

line

at: d

ebat

e.im

asci

entis

t.org

.uk/

antib

iotic

-res

ist-

ance

-res

ourc

es

Spe

cial

than

ks to

Dr M

icha

el M

oore

, fro

m U

nive

rsity

of

Sou

tham

pton

; Ste

ve E

ldrid

ge, f

rom

Vet

erin

ary

Med

icin

es

Dire

ctor

ate;

Dr M

ark

Web

ber,

from

Uni

vers

ity o

f Birm

ingh

am;

Rut

h D

ale,

from

NH

S D

evon

; Dr A

lun

With

ey, f

rom

Uni

vers

ity

of E

xete

r; an

d D

r Vic

ki Y

oung

and

Dr C

liodn

a M

cNul

ty, l

eade

rs

of th

e e-

Bug

team

.

The

kit h

as b

een

prod

uced

by

the

awar

d-w

inni

ng I’

m a

S

cien

tist t

eam

and

fund

ed b

y e-

Bug

, a p

roje

ct o

pera

ted

by

Pub

lic H

ealth

Eng

land

.

Kit N

o 7

6pp

A6

Inst

ruct

ions

She

ets

(Ant

i Res

) (Fi

nal 1

5th

oct).

indd

1

15/1

0/20

14

20:0

3

We

spok

e to

an

expe

rt in

ant

ibio

tic p

resc

ribin

g, h

e sa

id, “

Peop

le

talk

abo

ut th

e po

st-a

ntib

iotic

era

, but

for s

ome

bact

eria

, in

som

e pl

aces

, it’s

alre

ady

here

.” Th

ere

are

patie

nts

toda

y in

UK

ho

spita

ls w

ho h

ave

infe

ctio

ns th

at n

one

of o

ur a

ntib

iotic

s ca

n tre

at. A

ll do

ctor

s ca

n do

is k

eep

them

com

forta

ble

and

hope

that

th

eir i

mm

une

syst

em k

icks

in. T

he s

ituat

ion

is fa

r wor

se in

par

ts

of th

e de

velo

ping

wor

ld a

nd in

Chi

na; w

here

ant

ibio

tic-re

sist

ant

bact

eria

are

mor

e co

mm

on. P

atie

nts

ther

e ar

e al

so u

nlik

ely

to

be a

ble

to a

fford

the

spec

ialis

ed s

econ

d an

d th

ird li

ne a

ntib

iotic

s w

e m

ight

take

her

e.

The

econ

omic

s of

new

ant

ibio

tics

Ant

ibio

tic re

sist

ance

is g

ener

ally

rega

rded

as

a gr

ave

thre

at

to h

uman

ity, (

in fa

ct, i

t was

vot

ed b

y th

e pu

blic

as

the

long

itude

priz

e.or

g), h

owev

er, m

ost d

rug

com

pani

es a

re n

ot

be

caus

e th

e ec

onom

ics

of it

don

’t st

ack

up fo

r the

m. I

f so

meb

ody

disc

over

ed a

new

ant

ibio

tic, w

hich

cou

ld b

e us

ed

to tr

eat i

nfec

tions

resi

stan

t to

our e

xist

ing

drug

s, th

en w

e

wou

ld h

ave

to u

se it

ver

y sp

arin

gly

– to

pre

vent

resi

stan

ce

spre

adin

g. S

o th

e dr

ug c

ompa

ny w

ould

n’t m

ake

muc

h m

oney

fro

m it

. It c

osts

hal

f a b

illio

n po

unds

to g

et a

new

dru

g to

in b

acte

ria h

ave

alre

ady

been

exp

loite

d. It

’s h

ard

to k

now

2) G

ive

them

thei

r cha

ract

er c

ards

– o

ne p

er g

roup

, and

gi

ve th

em a

few

min

utes

to re

ad th

em o

ver.

3) G

et o

ne s

tude

nt in

eac

h gr

oup

to re

ad o

ut th

eir

se

ctio

n to

the

rest

of t

he c

lass

. Wha

t are

the

clas

s’s

initi

al

thou

ghts

? Is

ther

e on

e po

sitio

n th

ey id

entif

y w

ith o

r rej

ect?

4) T

ake

it in

turn

s to

read

out

thei

r fac

t. D

oes

it ch

ange

the

way

on

line

surv

ey.

5) R

ead

the

issu

e. A

ny d

iffer

ent f

eelin

gs?

6) E

ach

team

ask

s th

eir q

uest

ion

to th

e ch

arac

ter o

f th

eir c

hoic

e.

Plen

ary:

10

min

utes

Vote

for w

hich

pos

ition

they

agr

ee w

ith m

ost (

if th

ere

is o

ne).

onlin

e su

rvey

.W

hy?

Whi

ch a

rgum

ents

wer

e th

e m

ost p

ersu

asiv

e?

Who

se re

spon

sibl

ity is

it to

redu

ce a

ntib

iotic

use

and

resi

stan

ce?

You

may

als

o w

ant t

o re

cap

wha

t ant

ibio

tics

can

be u

sed

to

treat

, and

wha

t ant

ibio

tic re

sist

ance

is. T

his

can

be a

use

ful

way

of c

heck

ing

wha

t the

y ha

ve le

arne

d.

Bac

kgro

und

note

s A

ntib

iotic

s ar

e dr

ugs

that

affe

ct b

acte

rial c

ells

, but

not

our

was

pen

icilli

n, d

isco

vere

d by

Ale

xand

er F

lem

ing

in 1

928.

Al

thou

gh s

ome

natu

rally

occ

urrin

g an

tibio

tics

had

been

use

d

in tr

aditi

onal

med

icin

e fo

r at l

east

2,0

00 y

ears

. The

anc

ient

G

reek

s an

d Eg

yptia

ns u

sed

extra

cts

of m

ould

s an

d pl

ants

to

treat

infe

ctio

ns.

by p

lant

s or

fung

i. It’

s ob

viou

sly

usef

ul to

pla

nts

or fu

ngi t

o

prod

uce

chem

ical

s th

at s

top

bact

eria

bei

ng a

ble

to a

ttack

them

. M

any

com

mer

cial

ly p

rodu

ced

antib

iotic

s ha

ve u

sed

thes

e

natu

rally

occ

urrin

g su

bsta

nces

and

we

have

pig

gy-b

acke

d on

th

e w

ork

that

evo

lutio

n ha

s do

ne fo

r pla

nts

and

fung

i ove

r

new

ant

ibio

tics.

Ant

ibio

tic re

sist

ance

is w

hen

a ta

rget

bac

teriu

m b

ecom

es

resi

stan

t to

a pa

rticu

lar a

ntib

iotic

. Som

e an

tibio

tics

are

‘eas

y’

very

exa

ctly

to a

par

t of a

pro

tein

in th

e ba

cter

ial c

ell a

nd s

top

it w

orki

ng. I

t may

onl

y ta

ke a

cha

nge

of o

ne b

ase-

pair

of D

NA

to

chan

ge th

at p

art o

f the

pro

tein

so

that

the

drug

can

’t bi

nd a

ny

shap

e of

the

targ

et p

rote

in a

nd th

eref

ore

mor

e th

an o

ne

mut

atio

n to

thro

w th

em o

ff.

(a ‘g

ener

atio

n’ fo

r bac

teria

can

be

as li

ttle

as 2

0 m

inut

es),

and

also

, the

y sw

ap D

NA

with

eac

h ot

her.

Man

y ba

cter

ia c

an s

wap

D

NA

with

tota

lly u

nrel

ated

bac

teria

. And

som

e ba

cter

ia e

ven

just

thei

r gen

omes

. Thi

s m

eans

onc

e on

e ba

cter

ium

evo

lves

resi

st-

For e

xam

ple,

cep

halo

spor

ins

are

a cl

ass

of a

ntib

iotic

s us

ually

us

ed b

y do

ctor

s as

a s

econ

d lin

e of

trea

tmen

t (i.e

. whe

re th

e m

ore

com

mon

ly u

sed

antib

iotic

s ca

n’t b

e us

ed a

s so

meo

ne h

as

a ba

cter

ium

whi

ch is

resi

stan

t to

them

). Ba

cter

ia re

sist

ant t

o

year

s, c

epha

losp

orin

resi

stan

ce w

as b

eing

foun

d ar

ound

th

e w

orld

, in

load

s of

unr

elat

ed b

acte

ria.

6pp

A6

Inst

ruct

ions

She

ets

(Ant

i Res

) (Fi

nal 1

5th

oct).

indd

2

15/1

0/20

14

20:0

3

This

wor

k is

lice

nsed

und

er th

e C

reat

ive

Com

mon

s A

ttrib

utio

n-N

onC

omm

erci

al-S

hare

Alik

e4.

0 In

tern

atio

nal L

icen

se. T

o vi

ew a

cop

y of

this

lice

nse,

visi

t http

://cr

eativ

ecom

mon

s.or

g/lic

ense

s/by

-nc-

sa/4

.0/.

Que

stio

n: S

houl

d th

e N

HS

tell

GPs

to

give

bac

k-up

pre

script

ions

inst

ead

of

imm

edia

te a

ntib

iotic

s w

here

ver po

ssib

le?

Teac

her N

otes

Less

on p

lan

The

diffe

rent

‘rou

nds’

of t

he d

ebat

e he

lp s

tude

nts

thin

k th

roug

h th

e is

sues

and

reco

nsid

er th

eir o

pini

ons.

The

st

ruct

ure

also

sho

ws

them

how

to b

uild

a d

iscu

ssio

n

and

back

up

thei

r opi

nion

s w

ith fa

cts.

Star

ter:

5 m

inut

es.

Has

any

one

in th

e cl

ass

ever

take

n an

tibio

tics?

Wha

t did

th

ey ta

ke th

em fo

r? C

an th

ey s

ay w

hat a

ntib

iotic

s ar

e?

Wha

t illn

esse

s ca

n th

ey b

e us

ed to

trea

t? (Y

ou m

ay w

ant t

o re

cap

the

diffe

renc

e be

twee

n vi

ruse

s an

d ba

cter

ia h

ere)

. A

re th

ere

any

disa

dvan

tage

s of

taki

ng a

ntib

iotic

s?

Do

stud

ents

alre

ady

have

an

opin

ion

on w

heth

er th

e N

HS

sh

ould

tell

GP

s to

giv

e ba

ck-u

p pr

escr

iptio

ns?

Ask

thei

r on

line

surv

ey

(deb

ate.

imas

cien

tist.o

rg.u

k/an

tibio

tic-r

esis

tanc

e-re

sour

ces)

Mai

n A

ctiv

ity: 3

5 m

inut

es.

1) S

plit

stud

ents

into

as

man

y gr

oups

as

char

acte

rs y

ou

wan

t to

cove

r.

Des

igne

d fo

r 11-

18 y

ears

Bac

k-up

pre

scrip

tions

A ba

ck-u

p pr

escr

iptio

n (s

omet

imes

als

o ca

lled

a de

laye

d

pres

crip

tion)

is w

hen

the

GP

advi

ses

the

patie

nt th

at th

ey

will

pro

babl

y ge

t bet

ter w

ithin

a fe

w d

ays

anyw

ay, e

xpla

ins

th

e pr

oble

ms

with

ant

ibio

tic u

se, g

ives

them

som

e ad

vice

on

ta

king

car

e of

them

selv

es in

the

mea

ntim

e, B

UT

give

s th

em

a pr

escr

iptio

n fo

r ant

ibio

tics

whi

ch th

ey c

an u

se if

they

don

’t ge

t bet

ter s

oon,

or t

hey

feel

wor

se, a

nd th

ey th

ink

they

nee

d

it. T

his

save

s th

e pa

tient

hav

ing

to m

ake

a se

cond

vis

it to

th

eir G

P su

rger

y or

out

of h

ours

ser

vice

, put

s bo

th th

e

doct

or’s

and

pat

ient

’s m

inds

at r

est,

and

allo

ws

the

patie

nt to

st

art t

reat

men

t im

med

iate

ly if

they

get

a lo

t wor

se (s

o

prev

entin

g co

mpl

icat

ions

).

Com

mon

mis

conc

eptio

nsA

ntib

iotic

s ca

n be

use

d to

trea

t a c

old

– an

tibio

tics

can’

t hel

p w

ith v

iral i

llnes

ses,

onl

y ba

cter

ial o

nes.

Viru

ses

have

a d

iffer

ent

stru

ctur

e to

bac

teria

l cel

ls a

nd s

o an

tibio

tics

do n

ot a

ffect

them

.

As

they

got

bet

ter l

ast t

ime

with

ant

ibio

tics

they

nee

d th

em th

is ti

me

– ho

wev

er m

ost r

espi

rato

ry tr

act i

nfec

tions

bette

r on

thei

r ow

n w

ithou

t the

nee

d fo

r ant

ibio

tics,

ev

en m

any

of th

e on

es c

ause

d by

bac

teria

.

It’s

the

pers

on w

ho b

ecom

es re

sist

ant –

rese

arch

has

sho

wn

that

man

y of

the

publ

ic h

ave

a ve

ry h

azy

unde

rsta

ndin

g of

w

hat a

ntib

iotic

resi

stan

ce m

eans

. Som

e th

ink

that

the

pe

rson

bec

omes

resi

stan

t to

the

antib

iotic

, so

they

can

’t ta

ke it

an

ymor

e. In

fact

it is

the

bact

eriu

m w

hich

bec

omes

resi

stan

t.

cour

se, s

ome

of th

e ba

cter

ia in

fect

ing

you

and

also

som

e of

th

e ‘fr

iend

ly’ b

acte

ria th

at w

e ca

rry h

arm

less

ly in

our

gut

, will

be

resi

stan

t to

the

antib

iotic

. So

anyo

ne w

ho’s

take

n an

tibio

tics

in

the

last

yea

r will

prob

ably

hav

e a

few

resi

stan

t bac

teria

livi

ng

on th

eir b

odie

s. T

his

isn’

t usu

ally

a p

robl

em fo

r the

m, a

s

mos

t of t

he b

acte

ria th

ey w

ere

infe

cted

with

hav

e be

en

kille

d, a

nd th

eir i

mm

une

syst

em is

abl

e to

dea

l with

the

rest

of

them

. The

se re

sist

ant b

acte

ria c

an h

owev

er b

e a

prob

lem

fo

r pre

gnan

t wom

en, a

nd th

ose

with

repe

ated

infe

ctio

ns o

r ot

her c

hron

ic il

lnes

ses.

Ant

ibio

tics

are

pain

kille

rs –

Ant

ibio

tics

only

kill

bact

eria

and

Taki

ng a

ntib

iotic

s m

eans

you

can

’t dr

ink

alco

hol –

m

ost a

ntib

iotic

s ar

e sa

fe to

com

bine

with

alc

ohol

. Onl

y

met

roni

dazo

le th

at is

use

d fo

r par

ticul

ar g

ut o

r too

th in

fect

ions

ca

uses

a p

robl

em w

ith a

lcoh

ol.

Sup

porte

d by

:

All

fact

s in

this

kit

have

bee

n re

sear

ched

. Ref

eren

ces

can

be

foun

d on

line

at: d

ebat

e.im

asci

entis

t.org

.uk/

antib

iotic

-res

ist-

ance

-res

ourc

es

Spe

cial

than

ks to

Dr M

icha

el M

oore

, fro

m U

nive

rsity

of

Sou

tham

pton

; Ste

ve E

ldrid

ge, f

rom

Vet

erin

ary

Med

icin

es

Dire

ctor

ate;

Dr M

ark

Web

ber,

from

Uni

vers

ity o

f Birm

ingh

am;

Rut

h D

ale,

from

NH

S D

evon

; Dr A

lun

With

ey, f

rom

Uni

vers

ity

of E

xete

r; an

d D

r Vic

ki Y

oung

and

Dr C

liodn

a M

cNul

ty, l

eade

rs

of th

e e-

Bug

team

.

The

kit h

as b

een

prod

uced

by

the

awar

d-w

inni

ng I’

m a

S

cien

tist t

eam

and

fund

ed b

y e-

Bug

, a p

roje

ct o

pera

ted

by

Pub

lic H

ealth

Eng

land

.

Kit N

o 7

6pp

A6

Inst

ruct

ions

She

ets

(Ant

i Res

) (Fi

nal 1

5th

oct).

indd

1

15/1

0/20

14

20:0

3

We

spok

e to

an

expe

rt in

ant

ibio

tic p

resc

ribin

g, h

e sa

id, “

Peop

le

talk

abo

ut th

e po

st-a

ntib

iotic

era

, but

for s

ome

bact

eria

, in

som

e pl

aces

, it’s

alre

ady

here

.” Th

ere

are

patie

nts

toda

y in

UK

ho

spita

ls w

ho h

ave

infe

ctio

ns th

at n

one

of o

ur a

ntib

iotic

s ca

n tre

at. A

ll do

ctor

s ca

n do

is k

eep

them

com

forta

ble

and

hope

that

th

eir i

mm

une

syst

em k

icks

in. T

he s

ituat

ion

is fa

r wor

se in

par

ts

of th

e de

velo

ping

wor

ld a

nd in

Chi

na; w

here

ant

ibio

tic-re

sist

ant

bact

eria

are

mor

e co

mm

on. P

atie

nts

ther

e ar

e al

so u

nlik

ely

to

be a

ble

to a

fford

the

spec

ialis

ed s

econ

d an

d th

ird li

ne a

ntib

iotic

s w

e m

ight

take

her

e.

The

econ

omic

s of

new

ant

ibio

tics

Ant

ibio

tic re

sist

ance

is g

ener

ally

rega

rded

as

a gr

ave

thre

at

to h

uman

ity, (

in fa

ct, i

t was

vot

ed b

y th

e pu

blic

as

the

long

itude

priz

e.or

g), h

owev

er, m

ost d

rug

com

pani

es a

re n

ot

be

caus

e th

e ec

onom

ics

of it

don

’t st

ack

up fo

r the

m. I

f so

meb

ody

disc

over

ed a

new

ant

ibio

tic, w

hich

cou

ld b

e us

ed

to tr

eat i

nfec

tions

resi

stan

t to

our e

xist

ing

drug

s, th

en w

e

wou

ld h

ave

to u

se it

ver

y sp

arin

gly

– to

pre

vent

resi

stan

ce

spre

adin

g. S

o th

e dr

ug c

ompa

ny w

ould

n’t m

ake

muc

h m

oney

fro

m it

. It c

osts

hal

f a b

illio

n po

unds

to g

et a

new

dru

g to

in b

acte

ria h

ave

alre

ady

been

exp

loite

d. It

’s h

ard

to k

now

2) G

ive

them

thei

r cha

ract

er c

ards

– o

ne p

er g

roup

, and

gi

ve th

em a

few

min

utes

to re

ad th

em o

ver.

3) G

et o

ne s

tude

nt in

eac

h gr

oup

to re

ad o

ut th

eir

se

ctio

n to

the

rest

of t

he c

lass

. Wha

t are

the

clas

s’s

initi

al

thou

ghts

? Is

ther

e on

e po

sitio

n th

ey id

entif

y w

ith o

r rej

ect?

4) T

ake

it in

turn

s to

read

out

thei

r fac

t. D

oes

it ch

ange

the

way

on

line

surv

ey.

5) R

ead

the

issu

e. A

ny d

iffer

ent f

eelin

gs?

6) E

ach

team

ask

s th

eir q

uest

ion

to th

e ch

arac

ter o

f th

eir c

hoic

e.

Plen

ary:

10

min

utes

Vote

for w

hich

pos

ition

they

agr

ee w

ith m

ost (

if th

ere

is o

ne).

onlin

e su

rvey

.W

hy?

Whi

ch a

rgum

ents

wer

e th

e m

ost p

ersu

asiv

e?

Who

se re

spon

sibl

ity is

it to

redu

ce a

ntib

iotic

use

and

resi

stan

ce?

You

may

als

o w

ant t

o re

cap

wha

t ant

ibio

tics

can

be u

sed

to

treat

, and

wha

t ant

ibio

tic re

sist

ance

is. T

his

can

be a

use

ful

way

of c

heck

ing

wha

t the

y ha

ve le

arne

d.

Bac

kgro

und

note

s A

ntib

iotic

s ar

e dr

ugs

that

affe

ct b

acte

rial c

ells

, but

not

our

was

pen

icilli

n, d

isco

vere

d by

Ale

xand

er F

lem

ing

in 1

928.

Al

thou

gh s

ome

natu

rally

occ

urrin

g an

tibio

tics

had

been

use

d

in tr

aditi

onal

med

icin

e fo

r at l

east

2,0

00 y

ears

. The

anc

ient

G

reek

s an

d Eg

yptia

ns u

sed

extra

cts

of m

ould

s an

d pl

ants

to

treat

infe

ctio

ns.

by p

lant

s or

fung

i. It’

s ob

viou

sly

usef

ul to

pla

nts

or fu

ngi t

o

prod

uce

chem

ical

s th

at s

top

bact

eria

bei

ng a

ble

to a

ttack

them

. M

any

com

mer

cial

ly p

rodu

ced

antib

iotic

s ha

ve u

sed

thes

e

natu

rally

occ

urrin

g su

bsta

nces

and

we

have

pig

gy-b

acke

d on

th

e w

ork

that

evo

lutio

n ha

s do

ne fo

r pla

nts

and

fung

i ove

r

new

ant

ibio

tics.

Ant

ibio

tic re

sist

ance

is w

hen

a ta

rget

bac

teriu

m b

ecom

es

resi

stan

t to

a pa

rticu

lar a

ntib

iotic

. Som

e an

tibio

tics

are

‘eas

y’

very

exa

ctly

to a

par

t of a

pro

tein

in th

e ba

cter

ial c

ell a

nd s

top

it w

orki

ng. I

t may

onl

y ta

ke a

cha

nge

of o

ne b

ase-

pair

of D

NA

to

chan

ge th

at p

art o

f the

pro

tein

so

that

the

drug

can

’t bi

nd a

ny

shap

e of

the

targ

et p

rote

in a

nd th

eref

ore

mor

e th

an o

ne

mut

atio

n to

thro

w th

em o

ff.

(a ‘g

ener

atio

n’ fo

r bac

teria

can

be

as li

ttle

as 2

0 m

inut

es),

and

also

, the

y sw

ap D

NA

with

eac

h ot

her.

Man

y ba

cter

ia c

an s

wap

D

NA

with

tota

lly u

nrel

ated

bac

teria

. And

som

e ba

cter

ia e

ven

just

thei

r gen

omes

. Thi

s m

eans

onc

e on

e ba

cter

ium

evo

lves

resi

st-

For e

xam

ple,

cep

halo

spor

ins

are

a cl

ass

of a

ntib

iotic

s us

ually

us

ed b

y do

ctor

s as

a s

econ

d lin

e of

trea

tmen

t (i.e

. whe

re th

e m

ore

com

mon

ly u

sed

antib

iotic

s ca

n’t b

e us

ed a

s so

meo

ne h

as

a ba

cter

ium

whi

ch is

resi

stan

t to

them

). Ba

cter

ia re

sist

ant t

o

year

s, c

epha

losp

orin

resi

stan

ce w

as b

eing

foun

d ar

ound

th

e w

orld

, in

load

s of

unr

elat

ed b

acte

ria.

6pp

A6

Inst

ruct

ions

She

ets

(Ant

i Res

) (Fi

nal 1

5th

oct).

indd

2

15/1

0/20

14

20:0

3

We

spok

e to

an

expe

rt in

ant

ibio

tic p

resc

ribin

g, h

e sa

id, “

Peop

le

talk

abo

ut th

e po

st-a

ntib

iotic

era

, but

for s

ome

bact

eria

, in

som

e pl

aces

, it’s

alre

ady

here

.” Th

ere

are

patie

nts

toda

y in

UK

ho

spita

ls w

ho h

ave

infe

ctio

ns th

at n

one

of o

ur a

ntib

iotic

s ca

n tre

at. A

ll do

ctor

s ca

n do

is k

eep

them

com

forta

ble

and

hope

that

th

eir i

mm

une

syst

em k

icks

in. T

he s

ituat

ion

is fa

r wor

se in

par

ts

of th

e de

velo

ping

wor

ld a

nd in

Chi

na; w

here

ant

ibio

tic-re

sist

ant

bact

eria

are

mor

e co

mm

on. P

atie

nts

ther

e ar

e al

so u

nlik

ely

to

be a

ble

to a

fford

the

spec

ialis

ed s

econ

d an

d th

ird li

ne a

ntib

iotic

s w

e m

ight

take

her

e.

The

econ

omic

s of

new

ant

ibio

tics

Ant

ibio

tic re

sist

ance

is g

ener

ally

rega

rded

as

a gr

ave

thre

at

to h

uman

ity, (

in fa

ct, i

t was

vot

ed b

y th

e pu

blic

as

the

long

itude

priz

e.or

g), h

owev

er, m

ost d

rug

com

pani

es a

re n

ot

be

caus

e th

e ec

onom

ics

of it

don

’t st

ack

up fo

r the

m. I

f so

meb

ody

disc

over

ed a

new

ant

ibio

tic, w

hich

cou

ld b

e us

ed

to tr

eat i

nfec

tions

resi

stan

t to

our e

xist

ing

drug

s, th

en w

e

wou

ld h

ave

to u

se it

ver

y sp

arin

gly

– to

pre

vent

resi

stan

ce

spre

adin

g. S

o th

e dr

ug c

ompa

ny w

ould

n’t m

ake

muc

h m

oney

fro

m it

. It c

osts

hal

f a b

illio

n po

unds

to g

et a

new

dru

g to

in b

acte

ria h

ave

alre

ady

been

exp

loite

d. It

’s h

ard

to k

now

2) G

ive

them

thei

r cha

ract

er c

ards

– o

ne p

er g

roup

, and

gi

ve th

em a

few

min

utes

to re

ad th

em o

ver.

3) G

et o

ne s

tude

nt in

eac

h gr

oup

to re

ad o

ut th

eir

se

ctio

n to

the

rest

of t

he c

lass

. Wha

t are

the

clas

s’s

initi

al

thou

ghts

? Is

ther

e on

e po

sitio

n th

ey id

entif

y w

ith o

r rej

ect?

4) T

ake

it in

turn

s to

read

out

thei

r fac

t. D

oes

it ch

ange

the

way

on

line

surv

ey.

5) R

ead

the

issu

e. A

ny d

iffer

ent f

eelin

gs?

6) E

ach

team

ask

s th

eir q

uest

ion

to th

e ch

arac

ter o

f th

eir c

hoic

e.

Plen

ary:

10

min

utes

Vote

for w

hich

pos

ition

they

agr

ee w

ith m

ost (

if th

ere

is o

ne).

onlin

e su

rvey

.W

hy?

Whi

ch a

rgum

ents

wer

e th

e m

ost p

ersu

asiv

e?

Who

se re

spon

sibl

ity is

it to

redu

ce a

ntib

iotic

use

and

resi

stan

ce?

You

may

als

o w

ant t

o re

cap

wha

t ant

ibio

tics

can

be u

sed

to

treat

, and

wha

t ant

ibio

tic re

sist

ance

is. T

his

can

be a

use

ful

way

of c

heck

ing

wha

t the

y ha

ve le

arne

d.

Bac

kgro

und

note

s A

ntib

iotic

s ar

e dr

ugs

that

affe

ct b

acte

rial c

ells

, but

not

our

was

pen

icilli

n, d

isco

vere

d by

Ale

xand

er F

lem

ing

in 1

928.

Al

thou

gh s

ome

natu

rally

occ

urrin

g an

tibio

tics

had

been

use

d

in tr

aditi

onal

med

icin

e fo

r at l

east

2,0

00 y

ears

. The

anc

ient

G

reek

s an

d Eg

yptia

ns u

sed

extra

cts

of m

ould

s an

d pl

ants

to

treat

infe

ctio

ns.

by p

lant

s or

fung

i. It’

s ob

viou

sly

usef

ul to

pla

nts

or fu

ngi t

o

prod

uce

chem

ical

s th

at s

top

bact

eria

bei

ng a

ble

to a

ttack

them

. M

any

com

mer

cial

ly p

rodu

ced

antib

iotic

s ha

ve u

sed

thes

e

natu

rally

occ

urrin

g su

bsta

nces

and

we

have

pig

gy-b

acke

d on

th

e w

ork

that

evo

lutio

n ha

s do

ne fo

r pla

nts

and

fung

i ove

r

new

ant

ibio

tics.

Ant

ibio

tic re

sist

ance

is w

hen

a ta

rget

bac

teriu

m b

ecom

es

resi

stan

t to

a pa

rticu

lar a

ntib

iotic

. Som

e an

tibio

tics

are

‘eas

y’

very

exa

ctly

to a

par

t of a

pro

tein

in th

e ba

cter

ial c

ell a

nd s

top

it w

orki

ng. I

t may

onl

y ta

ke a

cha

nge

of o

ne b

ase-

pair

of D

NA

to

chan

ge th

at p

art o

f the

pro

tein

so

that

the

drug

can

’t bi

nd a

ny

shap

e of

the

targ

et p

rote

in a

nd th

eref

ore

mor

e th

an o

ne

mut

atio

n to

thro

w th

em o

ff.

(a ‘g

ener

atio

n’ fo

r bac

teria

can

be

as li

ttle

as 2

0 m

inut

es),

and

also

, the

y sw

ap D

NA

with

eac

h ot

her.

Man

y ba

cter

ia c

an s

wap

D

NA

with

tota

lly u

nrel

ated

bac

teria

. And

som

e ba

cter

ia e

ven

just

thei

r gen

omes

. Thi

s m

eans

onc

e on

e ba

cter

ium

evo

lves

resi

st-

For e

xam

ple,

cep

halo

spor

ins

are

a cl

ass

of a

ntib

iotic

s us

ually

us

ed b

y do

ctor

s as

a s

econ

d lin

e of

trea

tmen

t (i.e

. whe

re th

e m

ore

com

mon

ly u

sed

antib

iotic

s ca

n’t b

e us

ed a

s so

meo

ne h

as

a ba

cter

ium

whi

ch is

resi

stan

t to

them

). Ba

cter

ia re

sist

ant t

o

year

s, c

epha

losp

orin

resi

stan

ce w

as b

eing

foun

d ar

ound

th

e w

orld

, in

load

s of

unr

elat

ed b

acte

ria.

6pp

A6

Inst

ruct

ions

She

ets

(Ant

i Res

) (Fi

nal 1

5th

oct).

indd

2

15/1

0/20

14

20:0

3

This

wor

k is

lice

nsed

und

er th

e C

reat

ive

Com

mon

s A

ttrib

utio

n-N

onC

omm

erci

al-S

hare

Alik

e4.

0 In

tern

atio

nal L

icen

se. T

o vi

ew a

cop

y of

this

lice

nse,

visi

t http

://cr

eativ

ecom

mon

s.or

g/lic

ense

s/by

-nc-

sa/4

.0/.

Que

stio

n: S

houl

d th

e N

HS

tell

GPs

to

give

bac

k-up

pre

script

ions

inst

ead

of

imm

edia

te a

ntib

iotic

s w

here

ver po

ssib

le?

Teac

her N

otes

Less

on p

lan

The

diffe

rent

‘rou

nds’

of t

he d

ebat

e he

lp s

tude

nts

thin

k th

roug

h th

e is

sues

and

reco

nsid

er th

eir o

pini

ons.

The

st

ruct

ure

also

sho

ws

them

how

to b

uild

a d

iscu

ssio

n

and

back

up

thei

r opi

nion

s w

ith fa

cts.

Star

ter:

5 m

inut

es.

Has

any

one

in th

e cl

ass

ever

take

n an

tibio

tics?

Wha

t did

th

ey ta

ke th

em fo

r? C

an th

ey s

ay w

hat a

ntib

iotic

s ar

e?

Wha

t illn

esse

s ca

n th

ey b

e us

ed to

trea

t? (Y

ou m

ay w

ant t

o re

cap

the

diffe

renc

e be

twee

n vi

ruse

s an

d ba

cter

ia h

ere)

. A

re th

ere

any

disa

dvan

tage

s of

taki

ng a

ntib

iotic

s?

Do

stud

ents

alre

ady

have

an

opin

ion

on w

heth

er th

e N

HS

sh

ould

tell

GP

s to

giv

e ba

ck-u

p pr

escr

iptio

ns?

Ask

thei

r on

line

surv

ey

(deb

ate.

imas

cien

tist.o

rg.u

k/an

tibio

tic-r

esis

tanc

e-re

sour

ces)

Mai

n A

ctiv

ity: 3

5 m

inut

es.

1) S

plit

stud

ents

into

as

man

y gr

oups

as

char

acte

rs y

ou

wan

t to

cove

r.

Des

igne

d fo

r 11-

18 y

ears

Bac

k-up

pre

scrip

tions

A ba

ck-u

p pr

escr

iptio

n (s

omet

imes

als

o ca

lled

a de

laye

d

pres

crip

tion)

is w

hen

the

GP

advi

ses

the

patie

nt th

at th

ey

will

pro

babl

y ge

t bet

ter w

ithin

a fe

w d

ays

anyw

ay, e

xpla

ins

th

e pr

oble

ms

with

ant

ibio

tic u

se, g

ives

them

som

e ad

vice

on

ta

king

car

e of

them

selv

es in

the

mea

ntim

e, B

UT

give

s th

em

a pr

escr

iptio

n fo

r ant

ibio

tics

whi

ch th

ey c

an u

se if

they

don

’t ge

t bet

ter s

oon,

or t

hey

feel

wor

se, a

nd th

ey th

ink

they

nee

d

it. T

his

save

s th

e pa

tient

hav

ing

to m

ake

a se

cond

vis

it to

th

eir G

P su

rger

y or

out

of h

ours

ser

vice

, put

s bo

th th

e

doct

or’s

and

pat

ient

’s m

inds

at r

est,

and

allo

ws

the

patie

nt to

st

art t

reat

men

t im

med

iate

ly if

they

get

a lo

t wor

se (s

o

prev

entin

g co

mpl

icat

ions

).

Com

mon

mis

conc

eptio

nsA

ntib

iotic

s ca

n be

use

d to

trea

t a c

old

– an

tibio

tics

can’

t hel

p w

ith v

iral i

llnes

ses,

onl

y ba

cter

ial o

nes.

Viru

ses

have

a d

iffer

ent

stru

ctur

e to

bac

teria

l cel

ls a

nd s

o an

tibio

tics

do n

ot a

ffect

them

.

As

they

got

bet

ter l

ast t

ime

with

ant

ibio

tics

they

nee

d th

em th

is ti

me

– ho

wev

er m

ost r

espi

rato

ry tr

act i

nfec

tions

bette

r on

thei

r ow

n w

ithou

t the

nee

d fo

r ant

ibio

tics,

ev

en m

any

of th

e on

es c

ause

d by

bac

teria

.

It’s

the

pers

on w

ho b

ecom

es re

sist

ant –

rese

arch

has

sho

wn

that

man

y of

the

publ

ic h

ave

a ve

ry h

azy

unde

rsta

ndin

g of

w

hat a

ntib

iotic

resi

stan

ce m

eans

. Som

e th

ink

that

the

pe

rson

bec

omes

resi

stan

t to

the

antib

iotic

, so

they

can

’t ta

ke it

an

ymor

e. In

fact

it is

the

bact

eriu

m w

hich

bec

omes

resi

stan

t.

cour

se, s

ome

of th

e ba

cter

ia in

fect

ing

you

and

also

som

e of

th

e ‘fr

iend

ly’ b

acte

ria th

at w

e ca

rry h

arm

less

ly in

our

gut

, will

be

resi

stan

t to

the

antib

iotic

. So

anyo

ne w

ho’s

take

n an

tibio

tics

in

the

last

yea

r will

prob

ably

hav

e a

few

resi

stan

t bac

teria

livi

ng

on th

eir b

odie

s. T

his

isn’

t usu

ally

a p

robl

em fo

r the

m, a

s

mos

t of t

he b

acte

ria th

ey w

ere

infe

cted

with

hav

e be

en

kille

d, a

nd th

eir i

mm

une

syst

em is

abl

e to

dea

l with

the

rest

of

them

. The

se re

sist

ant b

acte

ria c

an h

owev

er b

e a

prob

lem

fo

r pre

gnan

t wom

en, a

nd th

ose

with

repe

ated

infe

ctio

ns o

r ot

her c

hron

ic il

lnes

ses.

Ant

ibio

tics

are

pain

kille

rs –

Ant

ibio

tics

only

kill

bact

eria

and

Taki

ng a

ntib

iotic

s m

eans

you

can

’t dr

ink

alco

hol –

m

ost a

ntib

iotic

s ar

e sa

fe to

com

bine

with

alc

ohol

. Onl

y

met

roni

dazo

le th

at is

use

d fo

r par

ticul

ar g

ut o

r too

th in

fect

ions

ca

uses

a p

robl

em w

ith a

lcoh

ol.

Sup

porte

d by

:

All

fact

s in

this

kit

have

bee

n re

sear

ched

. Ref

eren

ces

can

be

foun

d on

line

at: d

ebat

e.im

asci

entis

t.org

.uk/

antib

iotic

-res

ist-

ance

-res

ourc

es

Spe

cial

than

ks to

Dr M

icha

el M

oore

, fro

m U

nive

rsity

of

Sou

tham

pton

; Ste

ve E

ldrid

ge, f

rom

Vet

erin

ary

Med

icin

es

Dire

ctor

ate;

Dr M

ark

Web

ber,

from

Uni

vers

ity o

f Birm

ingh

am;

Rut

h D

ale,

from

NH

S D

evon

; Dr A

lun

With

ey, f

rom

Uni

vers

ity

of E

xete

r; an

d D

r Vic

ki Y

oung

and

Dr C

liodn

a M

cNul

ty, l

eade

rs

of th

e e-

Bug

team

.

The

kit h

as b

een

prod

uced

by

the

awar

d-w

inni

ng I’

m a

S

cien

tist t

eam

and

fund

ed b

y e-

Bug

, a p

roje

ct o

pera

ted

by

Pub

lic H

ealth

Eng

land

.

Kit N

o 7

6pp

A6

Inst

ruct

ions

She

ets

(Ant

i Res

) (Fi

nal 1

5th

oct).

indd

1

15/1

0/20

14

20:0

3

Created by Gallomanor, 7-9 North Parade Buildings, Bath, BA1 1NS. Registered in England & Wales, No. 03980700.. Licensed under a Creative Commons Attribution 2.0 UK licence.

Suggested homeworks:Seasonal foods – make a poster promoting seasonal foods grown in the UK. You may need to explain that seasonal food means fruit or vegetables that are harvested at particular times of year – in a survey, one respondent, asked to name a seasonal food, said Easter eggs.

Local seasonal food – research what food grows locally and design a balanced meal using local ingredients.

Carbon footprint – research and compare the factors that make up the carbon footprints of some foods grown in the UK and abroad.

All facts in this kit have been researched. References can be found online at: debate.imascientist.org.uk/foodsecurity

This debate kit was commissioned and funded by the Global Food Security programme with support from the University of Nottingham, and was independently produced by the I’m a Scientist team at Gallomanor.

The Global Food Security programme brings together the UK’s main public funders of food-related research that are working together to meet the challenge of providing the world’s growing population with a sustainable, secure supply of nutritious food from less land and using fewer inputs. For further information visit

Food Security 6pp Teacher Notes FINAL AW..indd 2

Background notes for teachersThis kit has been commissioned by the UK’s Global Food Security programme. This programme brings together the work of all government departments and agencies that fund research related to food. What is global food security?In essence, global food security means providing everyone in the world with enough to eat. Not just enough calories, but the right nutrients to live a healthy life. The challenge is doing this with a growing population and sustainably, given that in the future there will likely be less land available and climate change will mean we need to use the Earth’s

The present situationAt the moment 925 million people in the world experience hungermacronutrients (carbohydrates, fats and protein).

Perhaps another billion are thought to suffer from ‘hunger’, in which important micronutrients (such as vitamins and minerals) are missing from their diet, with consequent risks of physical and mental impairment.

In contrast, a billion people are substantially spawning a new public health epidemic involving chronic conditions such as type 2 diabetes and cardiovascular disease.

5) Read the issue. Any different feelings?6) Each team asks their question to the character of their

choice.

Support: To help students you can put the following prompt sentences up on the board: “I think our school should/shouldn’t only buy food from the UK because………………….”

“I think ……………… is the most important point to think about.”

Plenary: 10 minutesVote for which position they agree with most (if there is one).Why? Which arguments were the most persuasive?

Note – Pupils can stay in roles all the way through debate, or

give them a chance to express their own opinion at the end and in the plenary.

might help to have them start by discussing the question and/or their character’s position in pairs, and then compare notes in fours. They’ve then had chance to rehearse some of what they want to say before having to do it in front of the whole class.

Food Security 6pp Teacher Notes FINAL AW..indd 3

Page 3: e-Bug is operated by Public Health England Debate Kit ... · of the e-Bug team. The kit has been produced by the award-winning I’m a Scientist team and funded by e-Bug, a project

Angie Smolenska Antibiotic ResearcherI work trying to discover new drugs that we can use to fight bacteria that are making us ill. It is really hard! They need to kill the bacteria cells, but not our cells. All the ‘easy’ drugs have already been found, and I don’t know if we will find any more antibiotics in my lifetime. This proposal doesn’t go far enough. Back-up prescriptions will still mean we use a lot of antibiotics. We need to use a LOT less.

Fact: A recent study shows that 60%-70% of people given a back-up prescription will take the antibiotics.

Issue: Much of modern medicine would be impossible without antibiotics – including deep surgery, or chemotherapy for cancer. Once there are bacteria resistant to all our drugs, we are really in trouble.

Question: Why can’t we tell the public, “You can’t have antibiotics unless you are really ill”?

C

M

Y

CM

MY

CY

CMY

K

IAS Anti Res Debate Cards (Angie) FINAL.pdf 1 15/10/2014 20:05

Barry AshdownBusiness OwnerI run my own business as a window cleaner. If I can’t work, I can’t earn a living. I don’t want to let my regular customers down, they might start going elsewhere. If I’m ill and antibiotics could help me, I want them right away, so I can be back at work as soon as possible. I don’t accept that without antibiotics we’ll return to the dark ages anyway. Better hygiene, and vaccinations, have also made a difference to how long we live these days.

Fact: While only 1 in 4,000 cases of tonsilitis leads to an abscess, taking antibiotics, even if you don’t have a complication, can speed up the recovery process by a day.

Issue: My time is important to me, and I have a family to support.

Question: Why should my business – and my family – suffer,just because of something that might happen.

C

M

Y

CM

MY

CY

CMY

K

IAS Anti Res Debate Cards (Barry) FINAL .pdf 1 14/10/2014 16:11

Rekha Prasad GranddaughterI was really close to my Granny, she was the kindest woman. Last year she had a hip operation. She got an antibiotic resistant infection. You think modern medicine can fix everything, but there was nothing doctors could do for her and she died. I miss her every day.

Fact: People who have taken antibiotics will still have some resistant bacteria living in their gut and on their bodies up to a year later.

Issue: A few resistant bacteria probably won’t harm you if you are otherwise healthy. But they could be a death sentence for someone like my Gran if you pass them on.

Question: Do people realise that you can pass resistant bacteria on to others even when you have no symptoms, just by using the same door handle?

C

M

Y

CM

MY

CY

CMY

K

IAS Anti Res Debate Cards (Rekha) FINAL.pdf 1 14/10/2014 16:11

Sarah Manse Retired GPI loved being a GP and working in the NHS. But it seemed like every year there were more forms to fill in. In the end I took early retirement because I couldn’t take it any more. Of course we should be careful with antibiotics - sometimes patients wanted them for viral infections, and that really made me cross! But GPs know medicine and should be allowed to make their own decisions, not told what to prescribe by managers far away.

Fact: It takes more than ten years of study to become a GP. Five years at medical school, and then at least another six years of on-the-job training.

Issue: Every patient and every situation is different. GPs are trained to consider all these things up and decide what to prescribe.

Question: Do you want your treatment to be decided by policy, or by a trained GP?

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Y

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MY

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IAS Anti ResDebate Cards (Sarah) FINAL.pdf 1 14/10/2014 16:11

Page 4: e-Bug is operated by Public Health England Debate Kit ... · of the e-Bug team. The kit has been produced by the award-winning I’m a Scientist team and funded by e-Bug, a project

Martin Upton Computer ProgrammerScience is great. Look at all the fab things it’s invented – cars, X-Boxes, cookie-dough ice cream... I think back-up prescriptions are really defeatist. Rationing out our antibiotics like a mean person with his money. We should be optimistic and find new antibiotics. We just need scientists to focus on this issue, and governments to put money into it.

Fact: Most drug companies have abandoned their research into new antibiotics, because it costs so much to develop new drugs and they wouldn’t make enough profit as antibiotics are only used for about 7 days and new developed ones are saved for patients in hospital.

Issue: I think science can do anything if we make it a priority and invest in it.

Question: Why aren’t governments putting loads of money into the search for new antibiotics, instead of making us suffer?

C

M

Y

CM

MY

CY

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IAS Anti Res Debate Cards (Martin) FINAL.pdf 1 14/10/2014 16:10

Glen Rosewell Medical HistorianI study 19th Century medicine, a time before antibiotics were discovered. Because of that I know about what a world without antibiotics would be like and it scares me. Before antibiotics, people could get an infection from something as simple as a scratch, which could turn into blood poisoning and kill them. I don’t want my children living in that world, so I think we should try everything we can.

Fact: In the 1890s, 1 in 7 children in Britain would die before their first birthday, mostly of infectious diseases we could easily cure today.

Issue: The more we use antibiotics, the more antibiotic resistant bacteria emerge and spread.

Question: Isn’t it worth putting up with minor illnesses a bit more, if it means antibiotics still work, and we can save people’s lives when they get a serious illness?

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IAS Anti Res Debate Cards (Glen) FINAL.pdf 1 14/10/2014 16:11

Rowena Brown GPI am worried about antibiotic resistance. And I know GPs over-prescribing antibiotics is part of what causes it. But I also feel pressure from patients to give them something to help them. A back-up prescription means I can give the patient something, but also explain why they should wait a bit first, to see if they get better without it. And also give them advice on looking after themselves.

Fact: 80% of patients’ prescriptions for antibiotics are from GPs. The remaining 20% are mainly in hospitals, often for seriously ill patients.

Issue: If I can say it’s NHS policy, that makes it easier for me. I don’t feel like the bad guy!

Question: Should it be down to individual GPs to reduce antibiotic use, or should the NHS overall have a clearer policy? Whose responsibility is it to make sure our drugs keep working?

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IAS Anti Res Debate Cards (Rowena) FINAL.pdf 1 14/10/2014 16:10

Jeremy Smart FarmerSome people blame farmers for antibiotic resistance, but it’s not our fault. Some farmers used to put antibiotics in feed, to make the animals grow bigger, but that was banned in the EU in 2006. Now we can only give antibiotics to ill animals with a prescription from a vet. It’s humans over-using antibiotics that causes the problems.

Fact: In Europe, when the Netherlands had the highest rate of antibiotic use in animals, they still had very low rates of antibiotic resistant bacteria in humans. Probably because people in the Netherlands have almost the lowest use of antibiotics in humans across Europe.

Issue: People need to take responsibility for the problems they’ve created, not blame it on farm animals.

Question: Do you think about the threat of antibiotic resistance, when you demand antibiotics for a sore throat?

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IAS Anti Res Debate Cards (Jeremy) FINAL.pdf 1 14/10/2014 16:10