Antibiotics will prove to be either the greatest blessing or the greatest curse of modern medicine, depending on how they are used over the next decade. As powerful medicines that combat harmful bacteria, modern antibiotics have saved many lives since their discovery in the 1930s.
The concept of using chemicals to fight bacterial infections was recognized long before the invention of penicillin. The bark of the cinchona tree, for instance, was regularly used to treat malaria (an infection of a protist of the genus Plasmodium) and heavy metals like mercury and bismuth were long used to treat syphillis, an infection of the spirochete bacterium Treponema pallidum.
The first “modern” antibiotics were sulphur-containing drugs, such as Prontosil, and they were put into use as early as 1935. Though the effects of pencillin, a substance exuded by the fungus Penicillim rubens were observed in 1928 by Nobel laureate Alexander Fleming, it was not purified and put into commercial use until 1940.
Over the next 40 years, from 1940 to 1980, antibiotics would go on to save millions of lives and would be known for several generations as a miracle drug. Over the next 30 years, however, doctors began to prescribe antibiotics in an extraordinarily casual manner. This wouldn’t have been a problem if it were not for the remarkable plasticity of the microbes they target.
Bacteria, both good and bad, have been around for a very long time, likely because of their impressive ability to adapt to a changing environment. When confronted with an aggressive attacker like penicillin, bacteria had to adapt or perish. So, adapt they did.
In March of this year, Dr. Margaret Chan, director-general of the World Health Organization (WHO) warned that some bacteria were growing so resistant to modern antibiotics that it could bring about “the end of modern medicine as we know it.” As a result, every antibiotic ever developed is presently at risk of becoming useless, making routine operations impossible and common infections potentially fatal, just as they were a century ago.
If antibiotic resistance from overuse in the human market is the elephant in the room, then the use of antibiotics in animals raised for food is the 800 pound gorilla in the closet. According to a New York Times article released earlier this week:
Eighty percent of the antibiotics sold in the United States goes to chicken, pigs, cows and other animals that people eat, yet producers of meat and poultry are not required to report how they use the drugs — which ones, on what types of animal, and in what quantities.
So, copious amounts of tetracyclines (a class of broad-spectrum antibiotics) are added to animal feed as “growth promoters,” to help perfectly healthy animals grow faster. And since meat and poultry producers are not required to report the use, there is no data for scientists to study when things go wrong. What concerns me most about this is that the medical establishment is panicking about the misuse of the 20%, but almost no one is raising the alarm about the wave of the other 80% which is about to crash on the linchpin of modern pharmaceutics.
“There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” – Sir Alexander Fleming, December 11, 1945
Gregory Hake 
I work with a large number of livestock producers. While your comments of over use of antibiotics was true 20 years ago it is NOT the case today. Farmers will treat an animal if it shows signs of illness but your facts about preventive, growth promotion and super farms are emotional vs. factual. Antibiotics are expensive so farmers are only going to use them if and when they are absolutely needed. Farmers that I work with provide the highest known care and comfortable living arrangements for their animals according to modern science. I’ve personally witnessed farmers going without what many consider basic necessities in order to ensure their animals have what they need first, including breakfast.
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Thank you for your comment, David. It’s good to hear from an expert in the field! I’m a little confused, though, as everything I’ve found on the topic points to the facts used and support the level of urgency used in my post.
I understand that the FDA recently published an industry guidance “to promote the judicious use in food producing animals of antibiotics that are important in treating animals”, so the issue is clearly on their radar. From your perspective is this a reaction to a problem the industry faced 20 years ago that has since been solved?
While I am not one to trust the facts presented in news reports, I refer to a New York Times article in April of this year entitled “U.S. Tightens Rules on Antibiotics Use for Livestock” and another in June from the Wall Street Journal “FDA Ordered to Rethink Petitions on Farm Antibiotics” for more details on the current situation. Given that you are in the industry and that your view of what is happening here is so diametrically opposed to both liberal and conservative media outlets, I would love to hear the other side of this story.
Regarding your point on the cost of antibiotics, I understand that antibiotics are used in food animal production to promote weight gain (which is what the FDA is targeting in the above-mentioned voluntary program) as well as to prevent disease. Though I imagine these OTC drugs are expensive I also imagine that they yield a sufficient return on investment to warrant their regular use. Figures I’ve seen put that ROI at 300%.
My concern as a father of two young boys is to make sure that we use these miracle drugs wisely so that they serve us well into the future. If my impassioned treatment of the topic eclipsed the facts of the matter I shall surely stand corrected.
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In my opinion it is more related to activities from 20 years ago. Yes there is a cost benefit that you pointed out but the demands from the marketplace are dictating less and less antibiotic use. Plus if antibiotic residues are found in the animal at slaughter the entire carcass is destroyed and the farmer receives $0 for the their product. No one wants to risk not getting paid for their product, just like no one would work for nothing indefinitely. Furthermore the U.S. has the highest quality most stringent food safety rule in place anywhere in the world. I have no concerns feeding my young daughters meat, milk or any other products produced in the U.S. The next question is what will happen as more and more food production is imported?
I don’t think you have treated the topic lightly (as it does need to be discussed) and I also feel that there are and have seen changes occurring that have already addressed this issue. I’ve attacked too additional articles for your reading.
http://nationalhogfarmer.com/health/debunking-myths-about-antibiotic-resistance-pigs
http://www.foodsafetynews.com/2012/09/the-other-side-of-antimicrobial-resistance/#.UGSHOVE8q5I
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Thank you again for your thoughtful comments. The articles were interesting, particularly this point from Food Safety News:
Drug-resistant infections take a staggering toll in the United States and across the globe. Just one organism, methicillin-resistant Staphylococcus aureus (MRSA), kills more Americans every year than emphysema, HIV/AIDS, Parkinson’s disease and homicide combined. Nearly 2 million Americans per year develop hospital-acquired infections (HAIs), resulting in 99,000 deaths – the vast majority of which are due to antibacterial-resistant pathogens. Two common HAIs alone (sepsis and pneumonia) killed nearly 50,000 Americans and cost the U.S. health care system more than $8 billion in 2006.
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It is amazing how many things there are that are like this. They are obviously a problem, but because the subject is difficult or sensitive we don’t ever even begin to address it! Of course, with our system of super-farms, the antibiotics are needed because of the deplorable conditions the animals are kept in. Prophylactic use of antibiotics is absurd as a long term strategy, but it would be prohibitively expensive now to change the system all at once. So the preventative antibiotics are kept because it is the easiest solution, but it is merely causing a greater problem down the road.
We need some honesty in our system, along with an educational system that creates citizens who care enough to demand it. Hopefully we can make these changes quickly enough, because doing nothing is a decision as well, and I think that it will have a much more negative consequence.
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Wow, this is a tragic situation, where motive is certainly not in the best interest of the public and may have devastating long term effects. Working in the healthcare industry, I will be certainly looking at ways to help this situation in whatever way I can!
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Over use of antibiotics is one example of too much of a good thing. Be good to review other areas of our world where this can be applied and tempered.
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Great summary of a troublesome problem! Antibiotics can be beneficial as a more or less drastic and occasional intervention, but their application always has significant impact on the bacterial balance in ways that area just beginning to be understood. These are also probably the most commonly misprescribed and over-prescribed medications.
It emphasizes to me the care and respect that must be exercised in any intervention, lest the cure be more harmful than the initial problem! Also, there are many naturally occurring agents that provide excellent alternatives to antibiotics in the majority of cases where intervention is required.
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This is so worth educating ourselves about. Great post!
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I’m appalled that there hasn’t been more outcry by the public. If there was a group of people trying to restrict the use of antibiots according to some measure like affluence or religion there would be violent reaction. But here is a segment of industry that is in the act of obliterating it for generations and we haven’t heard but a peep! I find our special interest politics in this country often obfuscates the real platforms we should be taking into consideration when we elect our leaders.
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There have already been some serious concerns raised in regard to the enormous applications of antibiotics in livestock. Researchers at McGill University recently reported that persistent urinary tract infections in women are largely due to antibiotic resistant bacteria found in poultry.
This is a simple case of biological adaptation, where natural selection conditions a species to produce offspring most likely to survive various changes in the environment. It’s what is happening now to a new generation of pesticide resistant weeds and bugs that threaten to get out of control and destroy crops, all from an overuse of pesticides.
It would appear that we really are going to have to learn the lesson the hard way, that there is no way of dominating nature without drastic repercussions. We are being forced to learn to work with nature as in the examples above, within the laws of biology, to understand with greater wisdom the proper role of all life on our planet and thus create technologies that are truly sustainable. Our vision must always extend itself to the future to reflect whether or not the policies we adopt are going to serve us well. I think we are smart enough to do that, plus we have accumulated enough valuable experience to bring further perspective. The problem I see is the intersection between science and technology, where truth meets application, which then boils down to motive. How much we value ethics now becomes the real question to answer.
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