Time is running out for action on reckless misuse of antibiotics
Gwynne Dyer says current practices for both humans and animals are increasing bacterial resistance, raising the spectre of an era when common infections will again prove deadly
At the UN recently, all member countries signed a declaration that recognises the rise in antibiotic resistance as a threat to the entire enterprise of modern medicine. It’s a start, but time is running out.
“The emergence of bacterial resistance is outpacing the world’s capacity for antibiotic discovery,” World Health Organisation director-general Margaret Chan warned the meeting. “The world is heading toward a post-antibiotic era in which common infections will once again kill.”
The declaration urges countries to cut back on the use of antibiotics to preserve their effectiveness, to make better use of vaccines instead, and to spend more money on developing new antibiotics. It doesn’t put any actual money on the table, however, and it doesn’t even make it illegal to pump “sub-therapeutic” doses of antibiotics into farm animals. (National governments have to do that.)
The reckless misuse of antibiotics is rapidly destroying their effectiveness. The problem of bacterial resistance has been understood for a long time. If the antibiotic kills all the harmful bacteria it targets in the person or animal it is given to, then no resistance develops. But if it only kills off the weaker ones because it was a very low dosage, or because the course of drugs was not finished, then the surviving bacteria will be the most resistant.
They will pass their resistance on to all their descendants, who will undergo similar episodes of winnowing out the less-resistant ones many more times, and gradually the resistance grows. The only way to keep antibiotics effective, therefore, is to use them as rarely as possible, and to make sure that they kill off all the target bacteria when they are used.
We are not doing this. Doctors overprescribe antibiotics. And nobody makes sure patients complete the course of treatment.
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Much worse is the widespread practice of giving regular low doses of antibiotics to cattle, pigs and chickens, partly to control the spread of disease in their cramped and insanitary living conditions, but mostly because it makes them put on weight more quickly.
This insanely greedy and reckless practice is now banned in the European Union, but is still common in China and the US.
This has to stop. So does overprescribing by doctors in developed countries, and the over-the-counter sale without prescriptions that is so normal in many developing countries.
We also need a whole new generation of antibiotics to replace the ones hopelessly compromised, which requires persuading large pharmaceutical companies to change their research priorities.
It all has to be done, and it has to start now.
Gwynne Dyer is an independent journalist