Being Good Stewards at "End of the Road" for Antibiotics

Antibiotic resistance may be the scariest, most critical health issue of our day. Read more here, and here. Even CDC Director Tom Frieden, MD, responding to recent news that transmissible resistance to the “last resort” drug, colistin, had spread to the U.S. pigs and patients, admitted that “the end of the road isn’t very far away for antibiotics”. 

Each of us will have to do whatever he or she can to turn the tide against this catastrophe-in-the-making, this future where antibiotics may no longer work. But health professionals have a special role, even when it comes to antibiotics used on farms. It is we who must speak for the mostly invisible victims of superbug infections. We must speak for children, and for others who don’t yet know they will become future victims.

We know that using and overusing antibiotics—wherever they are used—is what drives bacteria to become resistant to them. The sad fact is that at least 70 percent of all the antibiotics important to human medicine are sold in the U.S. for use in livestock, not people. Conventional producers in the U.S. often give antibiotics on a routine basis to animals that aren’t sick to make them grow faster, and to ward off disease brought on by unsanitary or stressful conditions. This use keeps going up, increasing 22 % from 2009 through 2014, despite the decades of warning from legislators, regulators and yes, doctors, that this enormous farm use of antibiotics is a bad idea. Both Congress and federal authorities have appeared fairly impotent, or too disinterested, to stop it. 

It doesn’t have to be this way. Much, if not most, of this farm use is avoidable. In some other major meat-producing countries antibiotic use has been more than halved, with no significant impacts on profits or animal health. And a growing number of U.S. producers, including organic producers, are making the same changes.

In contrast to the snail's pace of reform in public policy, the marketplace seems to evolve almost weekly. And no wonder, the mighty consumer has spoken. She's saying she wants to serve her family chicken or meat raised without any human antibiotics. It’s one of the fastest growing segments in the poultry industry. Arguably, the best exhibit for antibiotic stewardship today may be in the grocery aisle. 

Health professionals are the perfect and appropriate folks to cry fowl about how drugs of human importance are still being squandered on farms. We're the ones who know their importance to human life. We're the ones who will watch patients die when those medicines no longer work.

So, whether you're a nurse or doctor, dietitian or pharmacist, think about broadening your concept of antibiotic stewardship. Tell your patients, friends or family to take action, starting at the supermarket to buy products raised without routine antibiotics. And consider two additional steps you might take, to send the marketplace an even stronger stewardship message:

First, add your voice to the chorus calling on KFC, the largest and most iconic fast chicken chain the world, to commit to purchasing only chicken grown without the routine use of medically important antibiotics.

Second, sign a second, more general letter launched today from health professionals to other major restaurant chains. The letter, organized by U.S. PIRG, asks those chains to also stop serving meat raised with routine antibiotics.


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