Saturday, August 24, 2013

How You Can Help Fight Superbugs

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“As soon as antibiotics were discovered and developed for medical use, bacteria began the Darwinian ‘arms race’ that has been fought ever since.”  So wrote Steve Heilig in the most recent Journal of the San Francisco Medical Society, where he is a director. Due to overuse of antibiotics, “antimicrobial resistance has reached a crisis stage in human medicine.”  You are doubtless aware that doctors should not prescribe antibiotics for viral infections (colds and flu) unless there is good evidence of an additional bacterial infection.  You may not know that 70 to 80 percent of all antibiotics produced by U.S. companies are used in farm animals.  These animals are often penned in crowded, dirty conditions; they are fed low doses of antibiotics to prevent infections and promote growth.  Bacteria are killed by the low doses used, but some develop mutations that make them immune to the drugs.  These bacteria are passed on to the farmers, their contacts, and the consumer.  Thorough cooking can destroy them, but beware of cutting boards, knives, your hands, and ‘rare’ burgers. 

In a 1976 study, small amounts of tetracycline were given to a flock of chickens by a researcher.  He found that the chickens began to carry bacteria resistant to tetracycline and other antibiotics.  So did the farmers who tended them.  Based on this kind of evidence, in 1977 the FDA announced plans to ban the feeding of low doses of antibiotics to livestock.  However, there was strong backpressure from legislators and agribusiness, and the FDA failed to act on its own recommendation.  The American Academy of Pediatrics, the Centers for Disease Control, the National Academy of Sciences, and the World Health Organization had identified subtherapeutic use of antibiotics as a human health issue.  More than 30 years later, in 2011, the FDA reacted when sued by the Natural Resources Defense Council and other groups.  It revoked its 1977 recommendation (never implemented) and said a ‘voluntary effort’ would be more effective.  There is no evidence that this has worked.  Currently there are over 90,000 deaths per year due to antibiotic resistance.  The Centers for Disease Control are alarmed.  We all should be.

You may have heard of a dreaded bacterium called MRSA – methicillin resistant Staphylococcus aureus, which is found in the community as well as in hospitals.  MRSA related deaths in the U.S. have risen to over 19,000 per year. from antibiotic resistant bacteria.  In Iowa, large pig farms where 2000 pigs are confined shoulder to shoulder, nearly half of these animals carry MRSA according to a 2009 study.  Almost half the workers there carry MRSA as well.

Here’s news close to home – an Iowa pig farmer who used routine antibiotics joined Niman Ranch’s pork collective; he stopped confining his animals and using antibiotics. He found he had the same results as Danish farmers who banned subtherapeutic antibiotics in 2000.  Pork production rose, and the incidence of resistant bacteria fell dramatically in people and animals. 

What can we do to protect ourselves, our children and the public?  There is a microbiologist in Congress, Louise Slaughter, a Democrat from New York.  Every year she introduces a bill called The Preservation of Antibiotics for Medical Treatment Act. We should make sure our congressman, Jared Huffman, supports this bill.  We should refuse to buy or eat meat, poultry, eggs or fish treated with antibiotics.  If it is labeled organic, this is a given. Otherwise, ask the butcher behind the counter. Trader Joe’s shoppers answered a poll by Consumer Union; 69% wanted the store to stop selling meat raised on antibiotics.  The store has hedged on this; although they do sell some antibiotic-free meats, they “do not presume to make choices” for their customers. Bring up this issue when you shop there. Whole Foods does not sell antibiotic-raised meats.  While these personal choices can make the meat you buy more expensive, eating less of it, and using it as a condiment/flavoring for vegetables is a wise move.  When you eat out, ask about the source of the meat, be sure it is not too rare, or go vegetarian.  There is no conclusive proof as yet that taking a daily probiotic pill, or eating yogurt with live cultures is helpful, but some studies point in that direction.  I think it’s a good idea. 
Sadja Greenwood, MD   back issues at sadjascolumns.blogspot.com

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