Dame Sally Davies, Chief Medical Officer for England, has been beating the drum over the threat of antibiotic resistance. It is, she claims, a “ticking time-bomb not only for the UK but also for the world”. Indeed, doctors in Canada, academics in Australia and politicians in America have been wringing their hands over this phenomenon. One problem, it seems, is that the development of new antibiotics has been slow. Correspondents of the British Medical Journal, however, offer what they call “an important and alarming caveat”…
…new antibiotics alone are not enough to eliminate the threat of drug-resistant bacteria. Indeed, given their rapid turnover and high mutation rate, it is inevitable that bacteria will develop resistance to any newly developed drug regardless of the pharmacological mechanism of action. Thus interventions to tackle antibiotic resistance must focus on targeting misuse and over-prescription.
Antibiotics are often prescribed for such complaints as sore throats, middle ear infections and coughs that they do little to ease and that do not justify their use. Doctors, though, presented with distressed patients or the demanding parents of ailing children, are liable to offer them.
In Britain, doctors have said that there is “clear scope for reductions in antibiotic prescribing”. In America, millions of cases of antibiotic prescription have been found to be unnecessary and over a hundred thousand people, most of them young children, have been admitted to hospital after suffering adverse effects from their treatment. The most frightening case, though, is China, where powerful monetary incentives for prescribing has led to the extraordinary rates that Qiang Sun and his colleagues described in Health Affairs…
In Henan, China’s most populous province with nearly 100 million residents, antibiotics constituted fully 70 percent of prescriptions in village clinics and township health centers. Another study found that 98 percent of outpatients with a common cold were prescribed antibiotics. One study has estimated that approximately half of antibiotic prescriptions in China were medically unnecessary and implicated in more than one million children’s becoming deaf or suffering neurological disorders.
The Chinese government began to fight back against overprescription last year, after it was estimated that its citizens use an average of 138 grams of antibiotics per year – ten times that of Americans. If you consuming far more of a product than the average American, and it isn’t green and vegetably, that is more often that not a cause for concern.
The other problem, as I have discussed before, is the use of antibiotics in the raising of animals for their flesh, milk and eggs. In the EU, drugs are at least banned as a means of growth promotion but they are still used in vast quantities, largely in factory farms, where crowding, stress and aggressive, unsuitable diets seem likely to provoke illness.
In America, where almost four times as many antibiotics are sold for meat and poultry production as to treat ailing people, they are still used like steroids to bulk up miserable creatures. So it seems to have been in China, where a recent study into contaminants in swine farms found…
Diverse, abundant, and potentially mobile [antibiotic resistant genes] in farm samples [that] suggest that unmonitored use of antibiotics and metals is causing the emergence and release of ARGs to the environment.
Education programs that discourage seeking antibiotics to treat minor and unsuitable illnesses have proved successful in the past, and education programs, formal or otherwise, on the distressing conditions of factory farms may help to curb appetites for their products. I am sure drug regulations could be tightened for such places but a more effective solution would be to end the demand for the goods that inspire these practices. (This is, of course, one of many reasons for not encouraging the abuse of animals.)
As Professor Matthew Cooper of the Australian Infectious Diseases Research Centre says, though: “Animals get transported between countries, as do people. Infectious disease is no longer a national issue, it’s a global issue.” The idle distribution of antibiotics across China and also India and South-East Asia has contributed to the formation of such dangerous conditions that experts are warning that tourists are shuttling infections back with them. There should be a concerted international effort to address this problem, as it would be a tragedy of vomitous proportions if our aversion to discomfort and appetite for cheap sausages was a cause of devastation.