There have been several stories involving antibiotics and antibiotic resistance lately.
This story was news to me. Like many consumers of organic produce, I wasn't aware that antibiotics were ever allowed in organic agriculture. As Urvashi Rangan, the director of consumer safety and sustainability at Consumer Reports put it, "This isn't what consumers expect out of organics" (source). Exactly! I have been looking askance at my apples for weeks. Happily, the National Organics Standards Board has rejected a petition to extend the exemption that allowed the use of antibiotics on organic produce. However, I wonder just how much antibiotic I have ingested over these past few years eating organic apples and pears. (Note that not all organic apples and pears are treated: the article reports that up to 16 percent of all apple acreage and up to 40 percent of all pear acreage get sprayed with antibiotics each year.)
In March I heard this NPR interview discussing a press conference by Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, in which he announced the need to "sound an alarm" on the advance of CRE, a highly drug-resistant bacteria. I learned in this interview that the antibiotics prescribed to treat many patients with superbugs have not been used for decades. That's because the antibiotics have such undesirable side effects as kidney failure. Facing death from an infection caused by a superbacteria, however, the patients are left with no other choice but to take a drug that may cause them serious harm.
And just today I read this story about a report that found that surprisingly few new antibiotics are being developed for the treatment of infections caused by an especially nasty class of superbugs, such as CRE.
I always pay special attention when antibiotics are in the news, because I once had a drug-resistant bacteria. Needless to say, it was not a pleasant experience, and definitely one I will never forget. Antibiotics are one of the great accomplishments of Western medicine, and it is a tragedy that we are squandering this precious resource through our own misuse. Here are some ways that humans are contributing to the creation of bacterial superbugs that cannot be treated with regular antibiotics.
4 Ways to Create Bacterial Super Bugs
1. Practice hyper-cleanliness.
In our quest for hyper-cleanliness, antibacterials are added to all kinds of personal products and cleaning products where they are completely unnecessary. Hot water and soap has been shown to be just as effective in killing germs as antibacterial soaps, for example. Select carefully and use very judiciously any product labeled as a disinfectant or an antibacterial.
During the NPR interview listed above, one listener emailed in: Does the use of antibacterial soap increase the likelihood that my body won't respond properly to standard antibiotics? Guest Carl Zimmer, a science writer and blogger, responded:
Well, by doing anything that exposes bacteria, even good bacteria, to antibiotics, you're creating the opportunity for the evolution of resistance. Any genes that provide resistance are going to become more common, and mutations to those genes are going to be favored by natural selection. And the real tricky thing about bacteria is that once they've got these highly evolved resistance genes to different drugs, they trade them. They swap them around. And actually you'll have some bacteria like the bacteria we're talking about today, which have accumulated lots and lots of genes for lots of different antibiotics.
2. Use consumer products containing antibacterial pesticides.
Perhaps you have noticed the proliferation of school supplies and other products (such as crib mattresses and even underwear) containing antimicrobials or antibacterials such as Microban. What exactly is Microban? The Smart Mama explains in her post "Back to School with Microban":
Microban is a broad range of antimicrobial technologies that are designed to protect products from microbes. Microban technologies do not protect the user of the product from disease causing microorganisms (if Microban International was making such claims, it would be subject to certain regulatory requirements and would have to have proof to support the claims).
Imagine my annoyance when I discovered that the extra-fat pencils my son uses in his Kindergarten class contained Microban. Really? Do we really need to sanitize a pencil? And in what universe would this help at all with the spread of germs among 5-year-olds? I also recently ordered some Timberland sandals for my 1.5 year old. When they arrived, they sported a Microban tag. I sent them back. I kind of understand wanting to avoid odor-causing bacteria in a teenager's shoes, but in a 1-year-olds? I plan to call Timberland and ask about this gratuitous use of antimicrobials in their products, because I expect more environmental responsibility from an outdoors company. Remember, any unnecessary use of antibiotics gives bacteria the opportunity to mutate and adapt. I refuse to purchase any consumer product labeled as antimicrobial or antibacterial.
3. Purchase conventional meat and animal products.
I've read different estimates, but usually the figure is around 70% to 80% of all antibiotics in the U.S. are used on livestock. 30 million pounds of antibiotics are given to livestock annually. Antibiotics are used to prevent animal illness (conventional feedlot practices involve unnatural diets and conditions which promote illness) and just plain old fatten up those animals more quickly. According to a report published by the FDA's National Antimicrobial Resistance Monitoring System, "store-bought meat tested in 2011 contained antibiotic-resistant bacteria in 81 percent of raw ground turkey, 69 percent of raw pork chops, 55 percent of raw ground beef and 39 percent of raw chicken parts" (source). I once asked a doctor relative (who is often skeptical of my green concerns) what he thought of the use of antibiotics on livestock. He immediately replied, "completely and totally irresponsible." This misuse of antibiotics is one of the top reasons I do my best to avoid and never purchase conventional meat and dairy. Read more about superbugs in supermarket meat in EWG's Meat Eater's Guide: "Superbugs Invade American Supermarkets" as well as "Tips to Help you Avoid Superbugs in Meat."
4. Ask your doctor for antibiotics for you or your child.If you need antibiotics, 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. Neither my 2nd or 3rd child has ever taken antibiotics despite several ear infections (about 80 percent of all ear infections clear up on their own). I treat ear infections with pain killers, observe, and consult with my doctor. The AAP recently issued new guidelines for the treatment of ear infections. One change is that observation without antibiotics is given as an option for children over 6 months of age. I push back hard when any doctor suggests antibiotic use for me or my children. It's not that I don't believe in them, it's that I want them to work when they are really needed.
I have no doubt that we will one day reach the "post-antibiotic" world that so many public health experts are warning about. I just hope we can delay it long enough to come up with alternate means of dealing with bacterial infections before we get there.
I Survived a Drug-Resistant Bacterial Infection
Green Cleaning Series
What are you doing to prevent the overuse and misuse of antibiotics?