We tend to think of antibiotics as the pills our doctors prescribe to clear up a sinus infection or a case of strep throat. But the vast majority of the antibiotics doled out in the United States are actually given to the farm animals that make up our food supply: Fully 80 percent of antibiotics in the United States are given to the fish, cows, chickens and other livestock we raise, reported a new paper in the New England Journal of Medicine. And according to its authors, that's a problem.
Farmers use antibiotics to prevent fatal illness among animals that are housed unnaturally close to one another and because many of these drugs promote growth, resulting in larger animals. Although this practice is seen as a money-saving measure, the paper argues that the boost in revenue is marginal and the risk, exponential. As bacteria is exposed to antibiotics, they mutate and evolve to survive the medicine, creating a problematic new strain that has fewer, or even no, remedies.
“Modern medicine relies on antibiotics to kill off bacterial infections,” wrote lead author Aidan Hollis, Ph.D., a professor of economics at the University of Calgary. “This is incredibly important. Without effective antibiotics, any surgery -- even minor ones -- will become extremely risky. Cancer therapies, similarly, are dependent on the availability of effective antimicrobials. Ordinary infections will kill otherwise healthy people.”
What's more, this resistant bacteria will thrive while more vulnerable microbes will be killed by the existing medicine. Super-bacteria will pose a global health threat, Hollis writes, because it evolves at a faster pace than does pharmaceutical research. And there is no simple solution, like avoiding meat from farms that use antibiotics.
"It's not just the food we eat," he says. "Bacteria is spread in the environment; it might wind up on a doorknob. You walk away with the bacteria on you and you share it with the next person you come into contact with. If you become infected with resistant bacteria, antibiotics won't provide any relief."
But it's not just a medical issue, it's a financial problem too: Even just a 1 percent reduction in the usefulness of current antibiotics could cost the U.S. $600 billion to $3 trillion in lost human health, the paper's researchers estimate.
Instead, Hollis and his co-author, Ziana Ahmed, a student at the University of Toronto, propose enacting a fee for use of antibiotics in agriculture or aquaculture. They argue a fee would be easiest and fastest to implement, would serve as a deterrent for non-essential use of the medicines and could be an important revenue source to help fund development of next-generation antibiotics and offset the high cost of caring for those with drug-resistant infections.
Recently, the U.S. Food and Drug Administration began a program to work with farmers to voluntarily put a limit on their use of antibiotics, which they believe will be faster than legislating limits. And the World Health Organization is working to address the problem of farm-borne antimicrobial resistance, calling for more comprehensive risk assessment and a global effort to reduce the use of human medicine in farm animals.
"The real value of antibiotics is saving people from dying. Everything else is trivial," Hollis concludes.