Our Opinion: A microscopic apocalypse


In its first ever global report on antibiotic resistance, the World Health Organization warns "superbugs" are a serious threat to human health.

"It is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country," notes the WHO.

More than 23,000 Americans die every year from infections that can't be cured, according to the Centers for Disease Control and Prevention.

Dr. Keiji Fukuda, WHO's Assistant Director-General for Health Security, said effective antibiotics have been one of the pillars allowing humans to live longer, live healthier, and benefit from modern medicine, but the overuse of antibiotics has led to strains of resistant bacteria that are now a major threat to public health.

"Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill," said Fukuda. "Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating."

The WHO report notes that while resistance is occurring across many different infectious agents, it focuses on seven different bacteria responsible for sepsis, diarrhoea, pneumonia, urinary tract infections and gonorrhoea.

"The results are cause for high concern, documenting resistance to antibiotics, especially ‘last resort' antibiotics, in all regions of the world."

One of the bacteria, K. pneumoniae, is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.

In the 1980s, notes the report, urinary tract infections caused by E. coli were treated to almost 100 percent effectiveness by fluoroquinolones, but today, there are countries in many parts of the world where this treatment is now ineffective in more than half of patients.

And with more than one million people infected with gonorrhoea around the world every day, treatment by third-generation antibiotics has failed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom.

The WHO is leading an effort to develop tools and standards that will improve collaboration around the world to track drug resistance, measure its health and economic impacts, and design targeted solutions, but the most effective way to reduce antibiotic resistance is to not need them at all by preventing infections from happening through better hygiene, access to clean water, infection control in health-care facilities, and vaccinations.

The WHO advises that people who have been prescribed antibiotics by a doctor complete the full prescription, even when feeling better, and never share antibiotics or use leftover prescriptions. Health professionals are being urged to enhance infection prevention and control; only prescribe and dispense antibiotics when they are truly needed; and only use the right antibiotics to treat an illness. The WHO also calls upon policymakers to strengthen resistance tracking and laboratory capacity; regulate and promote the appropriate use of medicines; foster innovation, research and development of new tools; and promote cooperation and information sharing.

"The problem is so serious that it threatens the achievemnts of modern medicine," notes the report. "A post-antibiotic era -- in which common infections and minor injuries can kill -- far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century."

"Overuse of antibiotics contributes to the problem, but the medical and science communities say that if farmers and ranchers don't change their practices, it will get worse," wrote Stacy Finz for SFGate.

James Hamblin, writing for The Atlantic, points out that most antibiotics are not used on humans, but on food animals so that producers can get them to grow faster and in tighter proximity to each other.

"The world population is exploding, and it demands cheap meat," wrote Hamblin. "By 2050 there will be 10 times more humans on Earth than there were in 1800. Factoring in the costs of widespread antibiotic use and resistance to the health of said humans -- healthcare spending, lost productivity, unsettling collateral damage to our own natural microbiomes ... it's not at all cheap."

According to Physicians for Social Responsibility, 73 percent of the antibiotics in the United States are used on food animals.

"We know that giving antibiotics to young chickens, cows and pigs means bigger fatter animals brought to market," wrote Abigail Zuger, a doctor of infectious diseases, for the New York Times."But we are doing pretty much the same thing to our own young, repeatedly dosing them up aginst all infectioins of childhood (many of which do not require antibiotics to resolve)."

In California, legislators are considering banning the sale of meat and poultry fed non-therapeutic antibiotics.

"If we used the same warped logic on our day care and nursery school attendees as those who add antibiotics to animal feed, we would be sprinklin antibiotics into children's PB&J sandwiches and milk to prevent infections and ensure better weight gain," Dr. John Bolton told SFGate.

Zuger wrote that doctors like her "operate in a state of permanent near panic as common infections demand increasingly powerful drugs to control." She also notes that humans suffer the consequences not just because of antibiotic resistance, but because "the gazillions of benevolent, hardworking bacteria colonizing our skin and the inner lining of our gastrointestinal tracts" are being destroyed.

"Antibiotics have cowed many of our old bacterial enemies into submission: We aimed to blast them off the planet, and we dosed them accordingly," wrote Zuger. "Now we are beginning to reap the consequences. It turns out that not all germs are bad -- and even some bad germs are not all bad."

While the intent of antibiotic use was good, as is often the case, humanity takes preventative measures to the extreme, much to our own detriment. And the use of antibiotics on farm animals, like much of the things wrong with our factory-farming industry, is simply inexcusable. We need to ratchet down the level of fear that has promoted the overuse of antibiotics and the "merchandising of sterility" (hand sanitizer anyone?). The ramifications of inaction are horrendous to contemplate, and each and every one of us can do our own little bit to head the problem off at the pass.

As noted above, don't overuse antibiotics and when they are prescribed, use them until they're finished. And just as importantly, stop buying meat produced with the unneccessary use of antibiotics. If you must eat meat, there are plenty of good, local farmers who raise farm animals thoughtfully and organically without drugs. Not only would you be doing yourself, your children and the world a favor, you would also be doing a favor for the hard-working farmers who break their backs to compete against the consolidated animal farming operations.


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