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Since their introduction in the early 1940’s,
antibiotics have revolutionized human and veterinary
medicine making curable many diseases which were
once considered deadly. While designed to kill
bacteria that cause infections, antibiotics are
rarely able to eliminate these infections entirely
since its genetic material (i.e., DNA) adapts to
evade treatment. Bacteria becomes increasingly
resistant to antibiotics and pass along this genetic
evolution to future generations. The consequence is
a deadly one – for too many patients, they can no
longer be treated with those antibiotics that were
once were highly effective in combating disease.
But the problem is not just "smart" bacteria. The
rampant growth in antibiotic resistance has been
severely exacerbated by the chronic
over-prescription and use of these drugs. Physicians
and patients alike came to know antibiotics as the
cure-all for infection and illness. Doses were doled
out sometimes for something as simple as the common
cold – not against bacteria, but against viruses
that do not respond to antibiotics. However, the
more one uses these drugs, the more bacteria become
tolerant against them -- leading to even greater
usage as patients tried to compensate by taking even
larger doses. For example, staphylococcus, only
twenty years ago, less than 5 percent infections
were antibiotic-resistant, while today the CDC
reports that 20-40 percent of Staphylococcal
infections are impervious to treatment with one
or more antibiotics. Streptococcus pneumoniae,
the bacterial agent responsible for most cases of
pneumoniae, and many cases of meningitis, a painful
and deadly disease, is increasingly difficult to
treat.
But like many problems, antibiotic resistance has
multiple causes, and will require multiple
solutions. While physicians are being educated on
the healthcare front, we have yet to confront and
change practices in the area where the greatest use
of antibiotics occur – agriculture. As you’d expect,
many of the drugs used to treat infections in humans
are also used in livestock. It is estimated that 70
percent of the antibiotics and related drugs used in
the United States – nearly 25 million pounds each
year – are fed to livestock and poultry to promote
faster growth and compensate for stressful and
crowded conditions at many animal-producing
facilities. What is disturbing is that more than
half of those antibiotics are within classes of
drugs used in treating humans.
It is only logical that if our livestock – a part
of our food chain – are given these medications that
it will affect humans. Moreover, soil, well water,
and water runoff contaminated by waste material from
animals can spread antibiotics to fruits,
vegetables, and fish products. An April 1999 study
by the General Accounting Office (GAO) concluded
that resistant strains of 3 microorganisms that
cause food-borne illness or disease in humans –
Salmonella, Campylobacter, and E. coli – are linked
to the use of antibiotics in animals. At my request,
GAO has recently updated this report with explicit
instructions for federal agencies to better address
the risks to humans posed by antibiotic use in
animals.
While we must confront the overuse of
antibiotics, we need to do so in a balanced and
reasonable manner. There is no question that our
agricultural sector needs antibiotics for treating
sick animals just as we do in human medicine. That
is why I authored S.1460, the Preservation of
Antibiotics for Medical Treatment Act of 2003, with
Senator Ted Kennedy (D-MA) to promote the judicious
use of antibiotics by providing a phased elimination
of nontherapeutic use of those drugs used by humans
to treat or prevent disease or infection in
food-producing animals.
This legislation, endorsed by the American
Medical Association and more than 300 other
organizations nationwide, would help
defray the cost of reducing such
drugs' use, with priority given to family-owned or
small farms and ranches -- and provide grants for
university research and demonstration programs for
the phase out of the nontherapeutic use of critical
antimicrobial animal drugs in livestock or poultry.
This is a step – a critical step – to moving the
ball forward in finding solutions to a problem that
is bordering on a crisis where there may indeed be
no cure.
Antibiotics remain one of the most effective
tools in our healthcare arsenal in combating
disease. Therefore, we must endeavor to find
solutions by reducing the overall use and intake –
whether by humans or animals – of antibiotics, and
S. 1460 is a concrete, common sense step we can
implement now. |
