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When Alexander Fleming accepted his Nobel Prize in 1945 for penicillin, the first widely used antibiotic, he laid out this hypothetical:
Mr. X. has a sore throat. He buys some penicillin and gives himself not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his wife. Mrs. X gets pneumonia and is treated with penicillin. As the streptococci are now resistant to penicillin, the treatment fails. Mrs. X dies. Who is primarily responsible for Mrs. X’s death? Why Mr. X, whose negligent use of penicillin changed the nature of the microbe.
Flash forward to present day.
A new strain of resistant E. Coli bacteria was found on a Chinese pig farm last November. The superbug carries a gene, mcr-1, which allows it to resist even a last resort antibiotic, colistin, which is normally reserved for after all other options to treat an infection have failed. Scientists worldwide immediately went to work testing old samples, and discovered the superbug in multiple countries, in both farm animals and humans. Last week, the U.S. joined that list.
Authors of the study detailing this discovery said that it "heralds the emergence of a truly pan-drug resistant bacteria."
That means that we may be on the verge of the post-antibiotic era, in which common infections can once again kill. In such a time, major surgery would be much more dangerous (if not impossible), childbirth would pose serious risks, and chemotherapy would likely be unviable.
So, what is primarily responsible for losing this foundation of modern medicine?
The overuse and misuse of these life-saving drugs contributes to the rapid spread of antibiotic-resistant bacteria, the very microbes Fleming forewarned over seven decades ago. Despite knowing of this risk since the beginning, antibiotics remain widely misused.
One of the most negligent uses of antibiotics doesn’t happen in doctors’ offices, but on farms. Roughly 70 percent of medically-important antibiotics sold in the U.S. are for use on livestock and poultry. Many farms administer these drugs to animals that aren’t sick in order to make them grow faster, or to prevent disease brought on by often-unsanitary conditions. As a result, large-scale farms have become hotbeds of antibiotic-resistant bacteria. These superbugs can travel off the farm via between animals and humans, contaminated meat, soil, water, or even the air.
Public health experts are concerned and, as they’re sounding the alarm, consumers are increasingly looking to purchase meat raised without routine antibiotics. Some marketplace players are moving quickly to meet this demand. In less than two years, we’ve seen major announcements from McDonald's, Subway, and Noodles & Co. They joined industry leaders Chipotle and Chick-fil-A in making commitments to stop the overuse of antibiotics on livestock and poultry. Most recently, two of the three Yum! Brands restaurants, Taco Bell and Pizza Hut, took steps in that same direction.
Meat producers are also beginning to change. Tyson Foods, a major U.S. meat producer and supplier to McDonald's, has plans to stop using human antibiotics in its chicken production, as well as some of its pork, “because it’s the right thing to do.” Perdue, the third largest U.S. chicken producer, continues to lead the flock, with two thirds of its chickens now being raised without antibiotics.
These marketplace actions are critical -- we can't evade the post-antibiotic era without them -- but there is a major actor missing. The Food and Drug Administration -- the government agency charged with protecting public health -- continues to fail to stop the overuse of antibiotics in food animals for good.
So far, the FDA's voluntary guidelines have not reduced the use of antibiotics in the meat industry. In fact, antibiotics sales to livestock and poultry operations continue to increase, according to the most recent estimates.
In 1945, Mr. X may have had the excuse of ignorance, but as superbugs rise and research continues to link this public health crisis to antibiotics overuse, that defense is weakening. The FDA should eliminate the routine use of antibiotics on food animals that are not sick.
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