About seven years ago, I had a procedure in the hospital to look into some recurrent infections. The procedure showed that everything was fine and normal, and soon after my recurrent infections stopped. But while in the hospital, I picked up Clostridium difficile, a drug-resistant strain of bacteria. Since I had recently taken antibiotics for the infections, my body was primed to be taken over by c-diff (as doctors call it). It struck about a week later, while I was on vacation, and left me needing to assess the locations of all the bathrooms in every museum, restaurant, friend's home, and store that we visited. The plane ride home was also super fun. When I got home, lab results confirmed what the advice nurse and my doctor had suspected.
My doctor prescribed a powerful and rarely utilized antibiotic. She explained to me that there were then only two antibiotics that could get rid of c-diff, and doctors were only allowed to prescribe them for the c-diff infection, lest the bacteria become resistant to these drugs as well (note that some people get a c-diff strain that is resistant to all antibiotics). I was on the first antibiotic for almost a month. I was lucky that it did clear up my infection and that I have not had a recurrence (which is common). But the drug made my mouth taste sour and metallic and I could only stomach eating rice and bland chicken the entire time I was on it and for some time afterwards.
More significantly, for a long time after I was done with the antibiotic, I would have about 90 seconds to get to the bathroom when I realized to needed to go. Highly inconvenient for an elementary school teacher. Every ounce of flora I had developed over the last two and a half decades of my life was gone. It was about a year before I was back to reasonably normal. But my gut never completely recovered, and I now have gas and other unpleasant reactions to foods that never gave me problems before. Needless to say, it is not an experience I have forgotten.
Sadly, these types of infections are becoming more and more common. In fact, the CDC reports that "antibiotic resistance has been called one of the world’s most pressing public health problems."
Facts about antibiotic use and antibiotic resistance (from CDC and WHO):
- The number of bacteria resistant to antibiotics has increased in the last decade. Many bacterial infections are becoming resistant to the most commonly prescribed antibiotic treatments.
- Misuse of antibiotics jeopardizes the usefulness of essential drugs. Decreasing inappropriate antibiotic use is the best way to control resistance.
- A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA).
- Children are of particular concern because they have the highest rates of antibiotic use.
- Parent pressure makes a difference. For pediatric care, a study showed that doctors prescribe antibiotics 62% of the time if they perceive parents expect them and 7% of the time if they feel parents do not expect them.
In my opinion, the most unnecessary and ridiculous use of antibiotics is the practice of giving feedlot animals antibiotics daily in their feed. The Union of Concerned Scientists has estimated that 70 percent or more of antibiotics used in the United States is given to healthy chickens, pigs and cattle to encourage their growth or to prevent illnesses. Not surprisingly, "livestock producers insist that antibiotic use in animals has not been definitively linked to antibiotic-resistant bacteria that can harm people" (source).
Come on. Isn't this the definition of overuse? Does it really take a rocket scientist to figure out that this practice will lead to antibiotic resistance? Does it seem like a good idea to douse animals with medication that is potentially life-saving for humans, but only if it is not overused? And here's a thought: if the conditions under which animals are being raised are such that the animals need antibiotics daily to remain healthy or grow quickly enough, maybe the conditions and/or growth expectations need to be changed. But that common sense seems to be absent from the world of industrial agriculture. Instead, we dump 24.6 million pounds of antibiotics into livestock annually to get the results we want under the conditions we want.
What you can do to reduce antibiotic resistance:
- Don't ask your doctor for antibiotics for you or your child. If you need them, your doctor will prescribe them. Even if your doctor suggests antibiotic use, ask if you can wait a few days to see if the problem resolves on its own, or consider getting a second opinion. For example, my doctor wanted to prescribe antibiotics for my child's ear infection. After consulting with a relative who is an ER pediatrician (and aware of the latest research on ear infections and antibiotics), I decided against it, at least for several more days. I did discuss that decision with my doctor, who did not oppose it. For more on children's ear infections and antibiotic use, click here.
- If you need to take an antibiotic, follow your doctor's instructions and finish the entire round. Make sure you consume probiotics during and after your antibiotic treatment. Throw away any remaining antibiotic in the trash (a very few communities have unused prescription drug take-back programs). Never take antibiotics that were not prescribed for you for your current condition.
- Stop using antibacterial soaps. There is no evidence that they kill any more germs than simple soap and water, but there is concern that they are accelerating antibacterial resistance. They also contain toxic chemicals. I would also recommend that you stop using antibacterial wipes and hand sanitizer, unless they are non-toxic and natural.
- Eat fewer conventional animal products. Feed lot animals (pigs, cows, chickens, etc.) are the #1 consumers of antibiotics in the United States. If you decrease or eliminate your consumption, you are helping reduce your own consumption of antibiotics (via your food), as well as the overall amount of antibiotics dumped into livestock. Routine antibiotic use is not allowed in the production of organic food.
Antibiotic / Antimicrobial Resistance (CDC)
Antibiotic Resistance Questions & Answers (CDC)
Task Force Issues Antibiotic Resistance Report (Food Safety News)
Administration Seeks to Restrict Antibiotics in Livestock (NY Times)
Photo credit: Stephen Cummings