The Overuse of Antibiotics
Reading a recent issue of Public Citizen’s excellent Health Letter titled "Know When Antibiotics Work," I recalled the recent tragic loss of a healthy history professor who was rushed to a fine urban hospital, with a leading infectious disease specialist by his side. No antibiotics could treat his mysterious "superbug." He died in 36 hours.
Wrongful or overuse of antibiotics has a perverse effect—causing the kinds of bacteria that these drugs can no longer destroy. The World Health Organization has cited antibiotic resistance as one of the three most serious public health threats of the 21st century.
The Centers for Disease Control and Prevention (CDC) notes that just in hospitals, where between 5 and 10 percent of all patients develop an infection, about 90,000 of these patients die each year as a result of their infection. This toll is up from 13,300 patient deaths in 1992. Some percentage of these people have problems because of antibiotic resistance.
No matter how many national and global public health organizations warn about this silent, deadly epidemic, no matter how many official recognitions and definition of the problems and demands for local and international action, the fatality toll and the economic costs keep growing.
As Dr. Sidney Wolfe, editor of the Health Letter says: "We’ve known about this problem for and the needed solutions for well over 30 years but almost nothing is being done about it!" The drug companies keep pushing these drugs while investing too little in truly new antibiotics that can overtake resistant bacteria. Too many doctors still prescribe antibiotics for viral infections that should not be treated with antibiotics. They don’t work on viruses. These include, says Dr. Wolfe, "colds, flu—in the absence of bacterial complications, most coughs and bronchitis, sore throats (except those resulting from strep throat) and some ear infections.
Doctors say that patients demand antibiotics—its part of the culture. But doctors should be there to inform patients in those instances when antibiotics are inappropriate.
The CDC states that "many infectious diseases are increasingly difficult to treat because of antimicrobial-resistant organisms, including HIV infection, staphylococcal infection, tuberculosis, influenza, gonorrhea, candida infection and malaria."
Dr. Wolfe writes that "drug resistant infections also spread in the community at large. Examples include drug-resistant pneumonias, sexually transmitted diseases (STDs) and skin and soft tissue infections."
Let us pause for a puzzling question. How many elected representatives, whose chore they say is America’s safety, spend any time on this devastating taking of lives because of preventable antibiotic resistant infections, compared to the daily focus on terrorism and the trillions of dollars spent on arms, surveillance, searching of tens of millions of Americans (at airports, for example) and sending soldiers all over the world to kill and be killed?
"Smart use of antibiotics," says Dr. Wolfe, "is the key to controlling the spread of resistance. Too many types of bacteria have become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic resistant bacteria can quickly spread to family members, schoolmates and co-workers—threatening the community with a new strain of infectious diseases that is more difficult to cure and more expensive to treat."
The veterinary medical community as well is showing a growing concern of too many antibiotics in domesticated animals which enter the human food supply.
"Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria," says the Public Citizen Health Letter, adding that bacteria that survive an antibiotic change so as to "neutralize or escape the effect of the antibiotic" then multiply rapidly.
There are lots to be done by many participants in the production, prescription, sale and use of these drugs. You can start by questioning your doctor and not buying soaps, handwipes and cleaning agents whose vendors lure you with the label "antibacterial."
For more about what you can do, visit citizen.org/hrg.
RALPH NADER is the author of Only the Super-Rich Can Save Us!, a novel.