The 2000s were go-go years for the microbe sector.
E. coli, Campylobacter, Salmonella and Listeria flourished in the food supply; S. aureus, S. pneumoniae and C. difficile gained footholds in hospitals and the community and Acinetobacter got all the way to Iraq where it threatened our troops.
But when the late Sen. Edward Kennedy introduced legislation to discourage the overuse of antibiotics (AB) responsible for life-threatening antibiotic resistance (AR) in humans 2007, it gained no traction.
"It seems scarcely believable that these precious medications could be fed by the ton to chickens and pigs," said the bill's background text. "These precious drugs aren't even used to treat sick animals. They are used to fatten pigs and speed the growth of chickens. The result of this rampant overuse is clear: meat contaminated with drug-resistant bacteria sits on supermarket shelves all over America."
Worse, when the FDA issued a directive in 2008 to ban non-therapeutic use of cephalosporin ABs in livestock--drugs also used in humans--to curtail resistance, irate lobbyists stormed Capitol Hill and the Bush administration backed down.
But now, with a new administration and Congress seated, Kennedy's bill has a House version, support from 300 organizations including the American Medical Association, American Public Health Association, American Academy of Pediatrics and American College of Preventive Medicine--and a good chance of passage.
The Preservation of Antibiotics for Medical Treatment Act (PAMTA) sponsored in the House by Rep. Louise M. Slaughter (D-NY)--who has degrees in both microbiology and public health--would phase out non-therapeutic use of "medically important antibiotics" in livestock and strengthen standards for approval of new livestock ABs while still allowing their use in sick animals. Eighty-four percent of grower-finisher swine farms, 83 percent of cattle feedlots, and 84 percent of sheep farms currently use ABs non-therapeutically says the bill. Seventy percent of ABs are fed to livestock not people in the US.
Many people who've rented apartments in large complexes know the resistance problem first hand. Monthly visits from the exterminator don't mean you have no bugs--they mean you have bionic bugs--on top of pesticide exposure!
Nor is veterinary use the only resistance culprit. ABs are also abused by hospitals, clinics and doctors to prevent infection and to "treat" a virus when patients, especially parents of young children, want the psychological assurance of a pill. Even AB hand sanitizers and laundry detergents contribute to resistance, as do natural AB treatments like tea tree oil. In fact AR might be the ultimate biological demonstration of the principle, "That which doesn't kill you makes you stronger."
Europe banned human-use ABs in livestock in 1998 and all non-therapeutic ABs in 2006, making it a test kitchen for AR reduction--especially Denmark, the world's largest pork exporter. In Denmark, AB use is down 51 percent and bacteria and AR bacteria are also down, says the Pew Campaign on Human Health and Industrial Farming, with no increase in the cost of meat. Sweden, Norway and the Netherlands have also reported AR reductions as has Australia.
Reductions of AB use are also underway in European hospitals like Norway where testing and isolating patients with MRSA (methicillin resistant S. aureus) and prescribing fewer ABs has brought down the AR rate, according to an in-depth AP report. Similar successes with screening for S. aureus upon hospital admission were reported by the New England Journal of Medicine in January.
On the surface, a bill addressing AR infections which kill 70,000 in the US a year--19,000 from MRSA alone--and could return us to pre-AB medicine circa 1908-- once we use our "last bullet"--looks like a no brainer. That's why the Animal Health Institute (AHI) and newly merged Pfizer/Wyeth (Fort Dodge) and Merck/Schering-Plough (Intervet) animal drug giants are lobbying so hard against it. In fact PAMTA may be the only bill that pits veterinarians against doctors!