Glenn Reynolds criticizes a ridiculous web site that Rebecca Blood links to, which reminded me of something I wrote late last month but never posted about Blood’s extremely credulous post about antibiotic resistance to staph infection. Blood wrote,
And the genie is out of the bottle:
‘The U.S. Centers for Disease Control has announced the first confirmed case of vancomycin-resistant staph aureus–known in the medical world as VRSA–found last month in a Michigan man.’ (via fmh)
For years I’ve wondered if history would look back on my lifetime as a Golden Age–when a few tablets could kill infections. What fools we are to have squandered it on factory farming and fear of household germs. [NY Times: rebeccas_pocket, password: pocket]
According to the Humane Society, ‘more than 70% of the antibiotics used in the United States is given to farm animals, largely to fatten them and to make them grow.’
Now tell me: in the light of this, doesn’t it seem like a matter of public health to outlaw the routine use of antibiotics in factory farming? If the farmers need to revamp their entire operations, so be it. They’re going to be selling less meat one way or another.
[ 07/19/02 ]
Since she’s been wondering for years about antibiotic resistance, it’s a shame she never bothered to do any actual research.
First, it would have been nice if Blood had bothered to point out that the vancomycin-resistant staph aureus does, in fact, respond to other antibiotics. The Michigan man who contracted the resistant strain was successfully treated with linezolid and quinupristin/dalfopristin. Both of those are much more expensive than vancomycin, but so far there is no strain of staph auereus that is resistant to every antibiotic treatment available.
Second, the only fool here is Blood who seems to think that resistance to staph aureus is driven by antibiotics given to farm animals. Give me a break.
The real threat has always been another common bacteria found in hospitals enterococcus. Once a vancomycin-resistant enterococcus was found — which happened in 1987 — it was just a matter of time before vancomycin-resistance found its way into staph auerus. Researchers knew from lab tests that the two bugs could share genes for antibiotic resistance.
Look, right now you are probably covered in staph aureus. It lives in significant numbers on human skin, where it does not cause a problem. But when a person goes into surgery, there is a significant chance that the bacteria will enter into the body of the patient. For this reason, almost everyone who goes into surgery is given antibiotics prophylactically.
That practice right there almost guarantees that staph aureus will rapidly develop resistance. In fact it took less than a year after linezolid was first widely for a resistant strain to appear (which is a real mystery if it is agricultural use of antibiotics that is leading to resistance).
The long-term solution for staph infection — which is already in development — is not antibiotics, which vaccination. In fact an anti-staph vaccine has already proven a success in small-scale human trials with immuno-compromised patients and should be widely available in a few years (see my post, Developing an impossible vaccine).
Finally, should we end routine use of antibiotics in animal agriculture? Absolutely not.
Lets be blunt — the single best thing that could be done to end antibiotic resistance would be to stop overprescription of antibiotics in human beings. In the United States, for example, some studies estimate that as many as half of children who go to the doctor with viral infections are prescribed antibiotics which do nothing at all to treat the virus.
At least farmers who use antibiotics gain an economic benefit from doing so. Estimates of how much costs would increase if antibiotics were banned from use in animals vary, but some studies suggest that it would cost an additional $300 million per year just in the cost of producing broiler chickens. The use of antibiotics in animals also helps drug companies recover development costs of drugs.
Which does not mean there shouldn’t be tighter monitoring of antibiotic use in animal agriculture. At the moment the biggest problem in both humans and animals is we don’t really have good solid data on the extent of antibiotic resistance.
But banning them completely or presenting chicken little stories of an end to antibiotics is absurd.