The Phantom, and Other Menaces
In the midst of warnings that the post-antibiotic era is quickly approaching, we see evidence that it has already arrived.
It is remarkable – and deeply troubling – that a post-antibiotic era is no longer hypothetical.
In the months since we launched our campaign to stop the overuse of antibiotics on factory farms, calls from health professionals, scientists, elected officials, and public health activists have grown. As a result, the marketplace is changing to adopt practices that better protect public health. But as support is growing, so too are the superbugs.
Now, in the midst of warnings that the post-antibiotic era is quickly approaching, we see evidence that it has already arrived. Carbapenem-resistant Enterobacteriaceae (CRE), dubbed the “phantom menace” superbug, is on the rise across the U.S. Just weeks ago, researchers discovered bacteria containing a gene resistant to colistin — a last last-resort antibiotic — in animals, meat and people in China. Last week, Denmark announced that the same resistance factor is present in their country.
It’s unlikely that China and Denmark are the only countries harboring this gene. After all, bacteria can spread rapidly across the world, hitching rides between countries like European vacationers.
In short: antibiotic resistant bacteria is on the rise. It’s spreading globally. And, increasingly, many of these resistant “superbugs” are resulting from irresponsible antibiotics use on livestock and poultry.
We’ve known about this danger for years. Scientists began warning about the connection between indiscriminate use in livestock and antibiotic resistance in the 1970’s. Back then, the FDA proposed policies to limit antibiotics use in agriculture, which were promptly opposed by a powerful coalition of pharmaceutical and agricultural interest groups. The FDA tabled the discussion.
It shouldn’t have. Superbugs are not a problem that can be buried in stacks of paper, and they don’t slow down for more research. Researchers worldwide are already offering solid evidence that administering antibiotics to animals that aren’t sick on a routine basis allows bacteria to become resistant. Yet this fall, the FDA opted to propose regulations to collect data on antibiotic use on farms rather than meaningful prohibitions on routine antibiotic use. That up to 70% of medically-important antibiotics are sold for use on farm animals that often aren’t sick to promote growth or prevent disease should be enough data to prompt swift action. What we lack is a comprehensive plan to address this rapidly-increasing public health threat.
Current FDA guidelines are not enough. Pharmaceutical companies can merely change drug labels to disallow use for growth promotion, but still permit routine use for disease prevention, and thus put no significant dent in antibiotic use in factory farms. Similar action taken by the Denmark in the 1990’s failed to reduce the amount of antibiotics fed to livestock, which is necessary to slow the development and spread of antibiotic-resistant bacteria.
There are no guarantees about how long antibiotics will remain effective. What’s certain is that every time we use antibiotics improperly, resistance grows. Yet, that is exactly what factory farms are doing by routinely using antibiotics on their animals. And there is little evidence that factory farms will stop until doing so is explicitly banned. As long as this remains the norm, we’re willingly sprinting towards the brink of the post-antibiotic era, in which now-minor infections can once again kill.
In the meantime, we’re seeing progress in the marketplace. Major restaurant chains like Chick-fil-A, McDonald’s have committed to serving chicken raised without antibiotics; others, like Chipotle and Subway, have committed to phase out routine antibiotics use from all their meats. These restaurants’ actions are forcing the industry to change.
It’s time for the FDA to catch up, and ban the routine use of antibiotics on factory farms to protect our life-saving medicines for future generations and protect the public from the growing threat of antibiotic resistant bacteria.