Antibiotic Resistance - Dangerous to Our Health

WEEKLY SENATE UPDATE
By U.S. Senator Olympia J. Snowe

August 6, for the week of August 8 through August 14, 2004

Antibiotic Resistance - Dangerous to Our Health

Since their introduction in the early 1940's, antibiotics have revolutionized human and veterinary medicine making curable many diseases which were once considered deadly. While designed to kill bacteria that cause infections, antibiotics are rarely able to eliminate these infections entirely since its genetic material (i.e., DNA) adapts to evade treatment. Bacteria becomes increasingly resistant to antibiotics and pass along this genetic evolution to future generations. The consequence is a deadly one - for too many patients, they can no longer be treated with those antibiotics that were once were highly effective in combating disease.

But the problem is not just "smart" bacteria. The rampant growth in antibiotic resistance has been severely exacerbated by the chronic over-prescription and use of these drugs. Physicians and patients alike came to know antibiotics as the cure-all for infection and illness. Doses were doled out sometimes for something as simple as the common cold - not against bacteria, but against viruses that do not respond to antibiotics. However, the more one uses these drugs, the more bacteria become tolerant against them-leading to even greater usage as patients tried to compensate by taking even larger doses. For example, staphylococcus, only twenty years ago, less than 5 percent infections were antibiotic-resistant, while today the CDC reports that 20-40 percent of Staphylococcal infections are impervious to treatment with one or more antibiotics. Streptococcus pneumoniae, the bacterial agent responsible for most cases of pneumoniae, and many cases of meningitis, a painful and deadly disease, is increasingly difficult to treat.

But like many problems, antibiotic resistance has multiple causes, and will require multiple solutions. While physicians are being educated on the healthcare front, we have yet to confront and change practices in the area where the greatest use of antibiotics occur - agriculture. As you'd expect, many of the drugs used to treat infections in humans are also used in livestock. It is estimated that 70 percent of the antibiotics and related drugs used in the United States - nearly 25 million pounds each year - are fed to livestock and poultry to promote faster growth and compensate for stressful and crowded conditions at many animal-producing facilities. What is disturbing is that more than half of those antibiotics are within classes of drugs used in treating humans.

It is only logical that if our livestock - a part of our food chain - are given these medications that it will affect humans. Moreover, soil, well water, and water runoff contaminated by waste material from animals can spread antibiotics to fruits, vegetables, and fish products. An April 1999 study by the General Accounting Office (GAO) concluded that resistant strains of 3 microorganisms that cause food-borne illness or disease in humans - Salmonella, Campylobacter, and E. coli - are linked to the use of antibiotics in animals. At my request, GAO has recently updated this report with explicit instructions for federal agencies to better address the risks to humans posed by antibiotic use in animals.

While we must confront the overuse of antibiotics, we need to do so in a balanced and reasonable manner. There is no question that our agricultural sector needs antibiotics for treating sick animals just as we do in human medicine. That is why I authored S.1460, the Preservation of Antibiotics for Medical Treatment Act of 2003, with Senator Ted Kennedy (D-MA) to promote the judicious use of antibiotics by providing a phased elimination of nontherapeutic use of those drugs used by humans to treat or prevent disease or infection in food-producing animals.

This legislation, endorsed by the American Medical Association and more than 300 other organizations nationwide, would help defray the cost of reducing such drugs' use, with priority given to family-owned or small farms and ranches-and provide grants for university research and demonstration programs for the phase out of the nontherapeutic use of critical antimicrobial animal drugs in livestock or poultry. This is a step - a critical step - to moving the ball forward in finding solutions to a problem that is bordering on a crisis where there may indeed be no cure.

Antibiotics remain one of the most effective tools in our healthcare arsenal in combating disease. Therefore, we must endeavor to find solutions by reducing the overall use and intake - whether by humans or animals - of antibiotics, and S. 1460 is a concrete, common sense step we can implement now.