We all have roles to play to avert a ‘post-antibiotic era’

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Recently the World Health Organization (WHO) published, for the first time ever, an extensive list of superbugs, aka bacteria that are resistant to multiple antibiotics, against which our modern antibiotics are quickly losing their effectiveness. The list warns that these superbugs now “pose the greatest threat to human health.”

The list emerges at a grim time when increasingly more and more people in the U.S. and around the world are dying from superbug infections at an unprecedented rate. The Centers for Disease Control and Prevention (CDC) estimate that at least 23,000 people die every year in the U.S. from drug resistant bacteria. Globally, this number jumps to 700,000 people dying each year.

The overuse of antibiotics can happen in many different ways, including inappropriately using them to treat a flu or the common cold, which antibiotics can’t cure. What’s even more concerning is the routine dosing of poultry and livestock with antibiotics even when they are not sick to promote weight gain and to prevent disease common in the often unsanitary, crowded conditions that exist on factory farms. The latter issue underlines a major contributor to the spread of superbugs—approximately up to 70 percent of the medically important antibiotics sold in the U.S. are for use on livestock and poultry.

In a detailed graphic from the CDC, various examples of how antibiotic resistance spreads highlight how dangerous the overuse of antibiotics is, especially when abused by the agriculture industry. Antibiotics are routinely mixed in with animal feed or water, leading animals to develop superbugs in their gut. Fertilizer and/or water containing superbug-contaminated animal feces are then used to raise food crops that are eaten by consumers, transferring the dangerous bacteria from the farm to our table.

“Antibiotic resistance is growing,” says Dr. Marie-Paule Kieny, WHO’s Assistant Director-General for Health, “and we are fast running out of treatment options.”

Dr. Kieny’s warning isn’t hypothetical, and it comes at a time when our reliance on antibiotics is now essential. It was only 75 years ago that the first American life was saved by penicillin at Yale-New Haven Hospital right here in Connecticut. Since then, we’ve made incredible advances in medicine with the use of antibiotics — unfortunately, it seems that our overuse of antibiotics is starting to set us back.

For example, a 70-year-old woman living in Reno, Nevada recently died from an infection that was resistant to all 26 antibiotics available in the entire U.S., even standing ground against antibiotics that were desperately created as a last-ditch effort to fight against the bacteria.

“Before, we could reliably squash the bugs,” says Dr. James Johnson, a Professor of Infectious Diseases Medicine at the University of Minnesota. “This case broke down even our last great gun.”

In the past years, this superbug issue has been garnering attention —and rightfully so— from a number of offices, even from the U.S. federal government. Former President Obama issued an executive order in 2014 that aimed to address the dangers of antibiotic resistance by devoting funding to and creating a national action plan for combating resistance.

Although parts of the action plan were beneficial, including efforts to institute better prescribing of antibiotics in healthcare, the plan fell short of what was needed to address antibiotic use on farms. Rather than banning all routine use of antibiotics on otherwise healthy animals, the guidelines from the Food and Drug Administration instated a voluntary ban on growth promotion uses.

Despite obstacles towards addressing the problem of superbugs on a federal level, consumer advocacy groups such as the U.S. Public Interest Research Group (for which there is a Connecticut state affiliate, Connecticut PIRG) are launching campaigns to raise awareness about antibiotic resistance and urge major restaurant chains to no longer serve meat raised with the routine use of antibiotics. As consumers, we have the power to make a change, and we can start by compelling major restaurants to stop buying from farms that raise animals on routine antibiotics.

U.S. PIRG has already helped convince McDonald’s and Tyson Foods (a major chicken producer and McDonald’s supplier) to phase out routine antibiotic use from their meat supply chains, and as just announced recently, has persuaded KFC to only purchase chicken raised without antibiotics important to human medicine by end of 2018. Even Subway, the popular restaurant franchise founded in Connecticut, listened to the voices of their local and nationwide consumers and phased out using antibiotics in its meat back in 2015.

It’s clear that given what’s at stake, we need to do everything we can to protect antibiotics for the future. That includes better antibiotic stewardship in healthcare, agriculture, and in our food system overall. With a rise in informative panels about antibiotic resistance such as the one held at Yale University last year that included notable speakers such as Dr. Nicholas Bennett from Connecticut Children’s Medical Center, it’s clear that more and more people are eager to tackle the topic of antibiotic resistance. Whether it’s fast food companies, farmers, doctors, or consumers, we all have a role to play to prevent the onset of a “post-antibiotic era.”

Nealie Ngo is a student at the Yale School of Public Health.

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