Antibiotic Resistance: No Longer an Apocalyptic Fantasy

Well, we have finally done it. Our overuse of antibiotics is selecting for “super bugs” of bacteria that are resistant to antibiotic therapy that threatens world health. As patients, pet owners, and doctors, we are all too quick to treat symptoms with antibiotics rather spend the time and money to work-up cases to find if bacterial infection is really the problem. As consumers and food producers we have been too eager to ensure a cheap supply of animal protein by the use of antibiotics. It appears we are now paying the price for our choices.

Dr. Keiji Fukuda, MD of the World Health Organization (WHO), warns that “common infections and minor injuries can kill” due to antibiotic resistance.

Dr. Fukuda’s Report on Antibiotic Resistance
In 2014 Dr. Fukuda issued a report to the World Health Organization titled “Antimicrobial resistance: global report on surveillance 2014.” This report shared data on the present state of antimicrobial drug resistance and called for more shared data to identify the extent of the problem. His own data surveyed information from 114 countries. The results are alarming. Fifty percent of isolated bacteria in many countries are resistant to antibiotics commonly used to treat these infections. Life threatening bacteria like E. coli, Staphylococcus and Klebsiella are now resistant to the last drug of resort to combat these bacterial infections. One-in-five countries report bacterial resistance to the most common treatment for E. coli bacteria.

The report cites two major causes for this problem: the accelerated use of antibiotic use in humans and animals, and the lack of new antibiotics to replace ineffective ones. The report emphasizes that the use of the same drugs for human disease as animal disease, particularly animals raised for food, contributes to the cross species drug resistance problem. Because we may share the same bacteria with food producing species, genetic resistance to antibiotics in food animals can be transferred to us and our pets. But the problem is not isolated to antibiotic use in livestock. The report states:

“In many countries, the total amount of antibiotics use in animals (both food-producing and companion animals), measured as gross weight, exceeds the quantity used in the treatment of disease in humans.”

Dr. Fukuda calls for “global recognition of the need to avoid inappropriate antimicrobial uses and to reduce the administration of those drugs in animal husbandry and aquaculture as well as reducing their use in humans.

What is Being Done About Antibiotic Resistance?
The FDA has asked pharmaceutical companies to withdraw drug approval for the administration of antibiotic drugs in livestock that promote growth or increased feed efficiency in livestock. They have threatened regulatory action against non-compliance. More than 24 drug companies have agreed to comply.

What Can You and Your Veterinarian Do?
When your veterinarian recommends an antibiotic for a disease symptom ask for a rationale. He/she should be able to tell you the probability of bacterial infection as the cause and the justification for antibiotic use. If the rationale is equivocal and requires further diagnostics, inquire into the cost and relevance of potential findings and the importance of antibiotics for those treatments.

Antibiotics have revolutionized human health worldwide. We have a responsibility to not abuse them. Let the body do what it does best: heal.