In this article put on line at...Common Dreams, note the assertion by
the Ag-industry that the principle misuse of ATB comes from within the
hospitals, and not from the misuse of ATB in agriculture. This is
probably correct, so what then lies behind this misuse of ATB within the
hospitals?
It has to do with a medical system driven by profit motives, that
latches on to giving "treatment" to patients that are already dying or
that have had their health significantly destroyed. A system that
delivers the majority of treatment that individuals receive in their
lifetime, all within the last year or two of life.
In order to keep these people alive (often against their own wishes),
doctors have to literally swim patients in a sea of antibiotics in the
Cancer wards, ICUs, and even within the general medical units.
It is not humanity that drives this setup, but rather a payment system
that has slowly been pieced together through the years, to favor the
big business operators in the health care industry.
The solution is to simply reverse the majority balance of the flow of
funding to the other end of life (children and young adults), and to
eliminate or restrict processes in society that cause early disease in
life. There is nothing wrong with a government that assumes its
responsibility to regulate away hazards, as much as possible, though
capitalist society will clamor that this is limiting individual
freedoms.
But the current problem is, that the evolution to resistent forms of
bacteria is almost as difficult a problem to reverse, as the extinction
of species is, or to reverse the the global warming that has occurred.
It is easier to destroy the environment than it is to repair it.
What works against any solution, is that the population is still in
general awe of the witchdoctors that push, and are wedded, to the "high
tech". That, and the lack of any real public health care policy
that could override Ag-business interests, in the name of public health
and national security.
Tony Abdo
_________________________________
Published on Friday, March 17, 2000 in the Washington Post
Worries Rise As Agribusiness Feeds Livestock Pro-Growth Antibiotics
by Marc Kaufman
A 66-year-old woman was recovering from a heart bypass in a hospital
near Detroit when she suddenly developed respiratory failure and a
serious infection. Doctors quickly gave her an antibiotic that usually
works. This time, however, it didn't. The bacteria causing the woman's
infection were resistant to the drug.
The woman's doctors immediately turned to a newly approved antibiotic, a
powerful one designed specifically to attack the kind of dangerous
antibiotic-resistant microbes that had infected her. But her physicians
were dismayed to find that drug didn't work either--the bacteria in her
body were resistant to it as well. The woman died soon after.
Cases like this around the country have caused rising alarm among
infectious disease doctors and public health experts. They are also at
the center of an increasingly acrimonious dispute now before the Food
and Drug Administration over how antibiotics are used in this
country--specifically, how farmers use them to promote the growth of
livestock.
Experts have long known that the overuse of antibiotics by doctors and
their patients has reduced the ability of those drugs to cure
infections. Now there is mounting evidence that the antibiotics widely
used on farm animals are also diminishing the power of important
antibiotics to help people.
Giving animals antibiotics in their feed can cause microbes in the
livestock to become resistant to the drugs. People can then become
infected with the resistant bacteria by eating or handling meat
contaminated with the pathogens.
"Many of us believe there is a tremendous overuse of antibiotics for
animals," said Marcus Zervos, an infectious disease specialist at
William Beaumont Hospital in Royal Oak, Mich., who was involved in the
Michigan case. "There is some very strong opposition to our view that
animal antibiotics are undermining antibiotics for people, but this
whole area has to be reconsidered."
Most of the antibiotics used on the farm are not administered to treat
sick animals. Instead, farmers feed livestock a low-level diet of
antibiotics to attack bacteria that might require the animal's body to
expend energy to kill off. This allows animals to grow more quickly and,
from a producer's point of view, more efficiently.
But this practice has increasingly become the focus of concern.
Researchers have already found evidence that the use of antibiotics on
farms has led to an increase in antibiotic-resistant cases of food
poisoning caused by campylobacter and salmonella bacteria in people.
Now, doctors and researchers point to the antibiotic the Michigan woman
received--Synercid, an important drug-of-last-resort in fighting
life-threatening infections--as a case study illustrating why they are
so concerned.
While Synercid was approved for human use only last fall, a closely
related drug called Virginiamycin has been used on livestock since 1974.
Researchers have found Virginiamycin-resistant bacteria in as much as 50
percent of supermarket chicken, turkey and pork. That alone causes
concern that the effectiveness of Synercid is already significantly
reduced in humans.
"It's clear that the use of Virginiamycin to promote the growth of food
animals is a hazard to human health," said Frederick J. Angulo of the
federal Centers for Disease Control and Prevention (CDC). "It's
difficult to track the chain of evidence we need to say for certain that
the Virginiamycin in animals results in resistance to Synercid in
humans. But we do believe the seeds for Synercid-resistant [bacteria]
were planted on the farm, and are likely to blossom in hospitals."
Defenders of animal antibiotics say the scientific evidence linking
Virginiamycin resistance in animals to Synercid resistance in humans
remains inconclusive, and that animal antibiotics in general pose no
immediate danger to people. Studies have found Synercid resistance in 1
percent to 4 percent of humans tested, they point out, and that is far
below the rate of Virginiamycin resistance found in animals.
"We're not at all convinced, based on the data, that Virginiamycin is
the cause of the Synercid resistance, however minimal, in the human
population," said Carl Johnson of Pfizer Inc., which developed
Virginiamycin and later sold the rights to Synercid to Aventis
Pharmaceuticals. "We believe it is coming from hospital use."
Others see a need for immediate action. In Europe, officials have
already banned the farm use of Virginiamycin and three other
growth-promoting antibiotics, following recommendations from the World
Health Organization. Legislation to impose a similar ban in the United
States was introduced in Congress last year by Rep. Sherrod Brown
(D-Ohio). And consumer and public health groups petitioned the FDA last
year to stop the use of any drugs used as animal growth promoters that
are also used to treat diseases in people.
In response, the FDA is trying to fully understand and quantify the risk
to humans posed by antibiotic use in animals, and will undertake a
formal risk assessment of Synercid and Virginiamycin this spring.
"Experts are saying they're seeing resistance to Synercid, and that it
must be coming from the animal use of Virginiamycin," said Sharon
Thompson of the FDA's Center of Veterinary Medicine.
"That is exactly the concern we are looking at. We're collecting
information now and there will be a thorough review."
More than a year ago, the FDA proposed new guidelines to limit the
spread of antibiotic resistance, and late last year claimed authority to
require drug companies to prove any new animal antibiotics won't
dangerously increase antibiotic resistance in humans. In the future, FDA
officials said, the agency will also review some animal antibiotics
already on the market, and will require new testing and new standards
for those closely related to vital human antibiotics.
The FDA's actions have left drugmakers and livestock producers worried
and angry. They say that animal antibiotics have been safe and very
useful for decades, and that farmers need them to keep their animals
healthy and growing as fast as they can. Without them, American meat and
poultry would not be as safe from disease-causing organisms, and prices
would rise as well, they say. And they complain that the FDA has already
imposed a "de facto moratorium" on new animal antibiotics while the
proposed guidelines are debated.
The FDA "is adding new requirements for resistance information never
asked for in the past, and almost impossible to actually gather now,"
said Richard Carnevale of the Animal Health Institute, which represents
pharmaceutical companies that supply farm drugs.
"In essence, we can't get products approved because we can't learn what
we have to prove," he said. "One company has been working for more than
a year on a protocol [to test antibiotic resistance], and the FDA is
never satisfied and just tells them to keep tweaking."
Carnevale asserted that the FDA slowdown in animal antibiotic approvals
has discouraged drug companies from investing in the costly development
of new antibiotics for humans, too.
Livestock growers also are fighting efforts to limit antibiotic use.
They consider the medications essential to their business, and are
rushing as well to protect the FDA from what they consider to be
nonscientific influences.
"Unlike Europe, we want to make sure decisions are based on science
alone here," said Gary M. Weber of the National Cattlemen's Beef
Association. "At this point, we don't see any evidence of an
identifiable problem regarding antibiotic resistance from animal feed.
And in the absence of good science showing that, we think it would be a
real blunder to ban or limit its use."
The European Union asserts that governments can take action when they
believe a health danger is present, even if it cannot be scientifically
proven at the time. But the U.S. Trade Representative has opposed the
ban--supporting the U.S. industry position that the risks of animal
antibiotics have not been scientifically assessed--and has threatened to
take its case to the World Trade Organization.
Researchers agree that many aspects of antibiotic resistance remain
unresolved. But they say that more precise methods of studying bacteria
on the molecular level have recently allowed them to demonstrate that
resistant forms of at least two common bacteria--campylobacter and
salmonella--are being passed from animals to humans. These organisms
have become increasingly resistant to antibiotics known as
fluoroquinolones--which include the most widely used antibiotic to treat
food-borne infections, Ciprofloxacin.
Researchers found that chicken treated with fluoroquinolones were being
colonized by campylobacter bacteria resistant to the drug, and that
those bacteria were being passed to humans. An FDA-commissioned risk
assessment concluded in December that at least 5,000 Americans will
suffer longer bouts of campylobacter food poisoning annually because of
fluoroquinolone resistance passing from chicken to people.
The threat from Synercid-resistant bacteria is potentially greater,
because the drug generally is used to control infections when a
patient's immune system is already severely compromised--during organ
transplants and chemotherapy, for instance. But the pathway from
Virginiamycin resistance in animals to Synercid resistance in humans is
more complex than with campylobacter or salmonella.
Virginiamycin in feed produces resistance in bacteria called
enterococci, which inhabit the intestines of humans and animals. They
generally do not cause disease, and so there is no inherent risk
involved with their development of antibiotic resistance. They can,
however, become very dangerous if their resistance transfers to other
enterococci that inhabit human wounds, catheter infections and other
hospital-acquired contagions.
Synercid was approved to attack a dangerous form of enterococci
resistant to the antibiotic that used to be doctors' last resort,
Vancomycin.
Researchers believe that animal
resistance to Virginiamycin is appearing as Synercid resistance in those
now very dangerous enterococci. But the scientific debate over this is
fierce, and the newest scientific methods have not conclusively traced
Synercid resistance in humans from Virginiamycin resistance in animals.
"The Synercid story is just starting to play out," said J. Glenn Morris
of the University of Maryland in Baltimore, a specialist in the field.
"We know we have a major problem on our hands in terms of antibiotic
resistance in our hospitals. The question about Synercid is whether
we'll act to protect it now, or just accept the risk that it and other
important antibiotics may become ineffective sooner because of this
animal use."
Drugs in the Food Chain
Farm animals treated with low levels of antibiotics are developing
drug-resistant forms of bacteria, posing potential health risks in
humans.
Resistant infections
Researchers are concerned that animals fed the antibiotic Virginiamycin
are passing along antibiotic-resistant forms of enterococci (shown) to
humans.
Possible health risks
Food poisoning
Bacteria from farm animals, such as salmonella and campylobacter, have
been causing antibiotic-resistant cases of food poisoning in people.
SOURCE: Centers for Disease Control and Prevention
© 2000 The Washington Post Company
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