Real life and antibiotic resistance

On January 10, the WSJ online told its readers that America’s hog farmers were overusing antibiotics in their hogs’ feed—and that could lead to more antibiotic resistance in humans. Food editors eagerly pounced on the scare story. The U.S. Department of Agriculture, however, issued a correction statement on March 18, saying that the WSJ had “wrongly interpreted” a statement by one if its research administrators at a congressional hearing. Antibiotic resistance is a big deal. Until we got antibiotics, people used to die of “blood poisoning” all the time. Pneumonia carried off huge numbers of the young and old—until we got antibiotics. Tuberculosis was virtually incurable without the antibiotic “wonder drugs.” Unfortunately, Mother Nature herself creates resistance to antibiotics. Bacteria vary in their susceptibility to the drugs. Some aren’t killed, and they proliferate after the susceptible bugs are gone. We find the same thing in breeding resistance to viral diseases into crop varieties; eventually the resistance breaks down and we have to rebreed. The only way we’ve found to combat antibiotic resistance is by continuing to find new antibiotics. In recent years, however, the cost of developing and registering a new antibiotic has skyrocketed. Regulators still warily remember those thousands of deformed “thalidomide babies” of 50 years ago. We’ve registered only a few new antibiotics in recent decades, while antibiotic resistance keeps building. Scientific American followed the WSJ’s lead the next week with an editorial noting that the American Medical Association, the Infectious Disease Society of America, the American Public Health Association, a previous FDA commissioner, and many others have advised the U.S. to ban the low-level feeding of antibiotics. A similar roster of professional health associations had already led a ban-the-feed-antibiotics movement in Europe 25 years ago. Both Sweden and Denmark banned them. Unfortunately, their real-world experience has shown no beneficial result for humans, and quite possibly may have made the antibiotic resistance problem even worse. Results:

1. They’ve seen no difference in the buildup of antibiotic resistance in humans.
2. Farmers use lots less of the low-level feed antibiotics—but those were mostly not important in treating humans.
3. The lack of the “preventive” antibiotics has meant more sick animals and birds.

Ironically, this results in increased farm use of the more potent antibiotics that are important in treating humans as well as the now-really-sick animals and birds. For decades now, health professional have tried to blame farmers for the embarrassing antibiotic resistance problem. However, they know full well that half of the prescriptions written for antibiotics are for viral ailments that the antibiotics can’t cure—such as colds and influenza. I used to successfully plead for antibiotics myself some years ago to treat what turned out to be an allergy. I assume my doctor knew they wouldn’t do any good, but wanted to pacify me; and at that time saw no harm in doing so. Now, more doctors are correctly sending sniffling patients home without an RX and with a recommendation for bed rest. The second big human problem is that we stop taking our medication when we “feel better”—and the toughest bugs still haven’t been killed. Scientific American concedes these problems: “Careless use of the drugs in people also contributes to the problem. But agricultural use is still a major contributing factor.” The European experience has shown that a ban would mainly mean more sick hogs and chickens.