Antibiotic Resistance: A Worldwide Scourge
Part One of Three
In your wildest conspiratorial imaginings, did you ever think antibiotic-resistant bacteria would be called a national security issue before Congress? If not, keep reading!
In June 2010, Brad Spellberg, MD, FIDSA (Fellow of the Infectious Diseases Society of America), spoke before the House Committee on Energy and Commerce Subcommittee on Health. Dr. Spellberg, an infectious diseases specialist and Associate Professor of Medicine at the Geffen School of Medicine at the University of California, Los Angeles (UCLA), stated:
“Antibiotic resistance is a serious public health, patient care and safety, and national security issue. Antibiotic-resistant infections are extremely difficult to treat and frequently recur. These infections result in tremendous pain, suffering, and disfigurement in adults, children, and infants, and have caused millions of deaths worldwide. Hospital-acquired antibiotic-resistant infections currently kill nearly one hundred thousand Americans each year (this does not include infections acquired outside of hospitals) and have been estimated to cost the U.S. health care system between $21 billion and $34 billion annually.”1 [Emphasis added.]
Antibiotic-resistant infections cause pain, suffering, disfigurement, and death. The cost to America’s health care system ranges from $21 to $34 billion. Indeed, we have a problem. We first need to understand why this problem is so out of control.
Why Do Bacteria Become Resistant to Antibiotics?
One quick answer to that question is overuse! Some sources2 say that nearly half of all medical prescriptions for antibiotics in the U.S. are unnecessary, prescribed after pressure from patients who have a virus (antibiotics do not kill viruses) and after pressure from patients because of direct-to-consumer marketing from pharmaceutical companies.
It has also been counterproductive to throw antibacterial agents in hand soaps, household cleaning products, and now even lotions. Regular soap and water kill germs just as well as those pumped with antibacterials. One example, the overuse of the antibacterial agent triclosan, has resulted in many triclosan-resistant bacteria, including triclosan-resistant MRSA (Methicillin resistant Staphylococcus aureus).3,4
Patients themselves add to the problem when they start to feel better after a few days on an antibiotic and stop taking it. Robert W. Steele, a board-certified pediatrician, explained that “The best way to cause bacteria to become resistant to antibiotics is to undertreat them.” 5
Exposing the bacteria to an antibiotic for just a short time allows the bacteria to develop resistance. Now if reading this makes you feel guilty as you have perhaps not taken a full course of antibiotics in the past, let that guilt go. You are not the problem! The two entities most responsible for our galloping problem of antibiotic resistance are pharmaceutical companies and concentrated animal feedlot operations (CAFOs).
Antibiotic bottles on a pig farm Photo: Animal Equality http://www.animalequality.net/
Livestock antibiotics comprise 80 percent of the total antibiotics sold in the U.S.—30 million pounds worth annually! In contrast, antibiotics used for men, women, and children in the U.S. amount to 6 million pounds. Worse than that comparison is the fact that low doses of antibiotics are given to the animals for a short period of time to speed up animal growth and to help them endure the crowded, unsanitary conditions of concentrated animal feedlot operations (CAFOs). Why do doctors tell you to take the full course of antibiotics? Because stopping before you take the full dose is like taking a low dose. Feeding animals (or people) low doses of antibiotics allows pathogens to survive, adapt, and eventually, thrive. A microbiologist reported that “the kind of routine, low-dose use of antibiotics that is the norm in the livestock industry—not to treat sick animals but to substitute for better management practices—is exactly what scientists use to foster antibiotic resistant bacteria in a lab for experimental purposes.” 6
So What Do We Do?
We should expect that our government health agencies will protect us. Right? Well, one of them is giving terrific lip service to the problem. The U.S. Centers for Disease Control joined with 25 national health organizations, such as the American Academy of Pediatricians, Consumers Union, Infectious Diseases Society of America, the National Association of Directors of Nursing Administration in Long Term Care, and the Pew Charitable Trusts, in issuing a list of 12 actions to take to address the antibiotic resistance problem. The last two principles “to both conserve and replenish our antibiotic resources” are:
11. To work with regulatory, veterinary and industry partners to promote the judicious use of antibiotics in food animals
12. To reinforce the judicious use of antibiotics in agriculture by limiting the use of medically important human antibiotics in food animals; supporting the use of such antibiotics in animals only for those uses that are considered necessary for assuring animal health; and having veterinary oversight for such antibiotics used in animals7
This action is well and good, except that the CDC has no regulatory authority; and Dr. Arjun Srinivasan, associate director for healthcare-associated infection prevention, was quoted in a Reuters story November 13, 2012, as saying that the problem cannot be addressed by curbing antibiotic use in animals. “This is a joint problem,” he said.8 Srinivasan also said, “How we use and protect these precious drugs must fundamentally change,” but apparently only by following a 12-point joint plan and not attacking the misuse of 80 percent of antibiotic use in concentrated animal feedlot operations.
It appears that the CDC is backing industries, both the pharmaceutical and the concentrated animal feedlot operation industries, at the expense of the consumer. That also seems to be how the FDA approaches the problem. The agency has asked food producers to voluntarily limit their use of certain antibiotics. On December 22, 2011, a notice was posted in the Federal Register that the FDA would no longer pursue its plan to reduce the use of antibiotics in agricultural animal feed, a plan in the works for 34 years. In other words, the only regulatory agency with authority is not using it. The FDA’s voluntary request to limit antibiotic use seems excessively polite and easily ignored.9
The European Union banned the use of antibiotics as growth promoters in animal feeds in January 2006.The World Health Organization (WHO), the Food and Agriculture Organization, and the World Organization for Animal Health recommend such a ban, and other countries are expected to phase out these substances.10
One thing that should change now is the fact that food producers do not need to consult a veterinarian to use antibiotics in animals raised for food. If the unsanitary, crowded conditions in CAFOs were improved, antibiotics would not be necessary.
Next week — Part Two: Natural Antimicrobials for Food Safety
- Brenwald NP, Fraise AP. “Triclosan resistance in methicillin-resistant Staphylococcus aureus (MRSA),” J Hosp Infect. 2003 Oct;55(2):141-4.
- Ciusa ML, et al. “A novel resistance mechanism to triclosan that suggests horizontal gene transfer and demonstrates a potential selective pressure for reduced biocide susceptibility in clinical strains of Staphylococcus aureus,” Int J Antimicrob Agents. Sep;40(3):210-20.
- Castanon JI. “History of the use of antibiotic as growth promoters in European poultry feeds,” Poult Sci. 2007 Nov;86(11):2466-71.