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Zachary Doubak was your typical 12 year old boy from New Brunswick, New Jersey, who was active in sports.  After a baseball game one afternoon, he complained of knee pain that worsened overnight.  He was admitted by his mother, Dr. Marnie Doubak, a family physician to the local hospital.  When the initial drug regimin failed to control the infection that quickly spread all over his body, he was placed into a medically induced coma.  He was prescribed the powerful antibiotic drug Vancomycin for the dangerous infection called MRSA (Methicillin-Resistant Staphylococcus Aureus).  MRSA infects 2 million people per year and results in over 20,000 deaths.  Luckily, he survived after six surgeries to remove infected tissue (debridement) but he still walks with a limp one year later.  "We may never know how he got infected, "said Dr. Doubak.  "But we know that the antibiotic that should have helped him didn't work."  Jeffrey was one of the fortunate ones, but the consequences of antibiotic resistance can be fatal. 

 
Scientists, researchers, doctors, public health officials, and other disease experts have been warning us for years of the impending antibiotic resistance to our strongest antibiotics and health care providers haven't listened.  Over two million Americans are infected by antibiotic-resistant bacteria every year, causing 23,000 deaths.  2.25 million Americans get sick from misuse of antibiotics resulting in 37,000 deaths.  These numbers are growing. 
 
The World Health Organization and the European Union stated that the rise of resistant bacteria is one of the world's most serious health crises, pushing us to a "post-antibiotic" world. That means a world without effective antibiotics.    
 
There are a couple of reasons why this has happened.  Many strains of bacteria have become resistant to some of our strongest drugs because they have evolved much faster than expected due to the over-prescription of antibiotics for the last 50 years (such as giving antibiotics for a viral infection).  Dr. Arjun Srinivasan, associate director for the CDC, stated that as much as half of all antibiotics prescribed in this country "are either unneeded or patients are getting the wrong drugs to treat their infections."  Clostridium Difficile, a condition in which antibiotics wipe out your good bacteria and replace it with bad bacteria accounts for 250,000 hospital visits per year and 14,000 deaths.  It is not just prescription use that is over saturating our bodies.  Agricultural use accounts for 80% of antibiotic use in the United States so we are consuming even more than you realize.  That is 25 million pounds of antibiotics passed on to us each year through livestock and dairy products.  Adding antibiotics to feed livestock to make them grow bigger faster has been banned in Europe for years after studies concluded it wasn't safe for the public. 
 
"The more you use an antibiotic, the more you expose a bacteria to an antibiotic, the greater likelihood that resistance to that antibiotic is going to develop," said Dr. Srinivasan.  "So the more antibiotics we put into people, we put into the environment, we put into livestock, the more opportunities we create for these bacteria to become resistant. 
 
According to the Centers for Disease Control, 22% of all antibiotic resistant illnesses in humans are related to food.  48 million Americans contract foodborne illnesses each year which is approximately one in six.  For example, there are over 80 different antibiotics used in cow's milk.  Of the 12 antibiotic resistant diseases that pose a serious health risk to the public, according to the CDC four of them are found in food-
 
  1. Campylobacter (310,000 infections per year)
  2. Salmonella (100,00)
  3. E. Coli (265,000)
  4. Shigella (500,000)
 
A federal agency called the National Antimicrobial Resistance Monitoring System (NARMS) found antibiotic-resistant bacteria in 81% of ground turkey, 69% of pork chops, 55% of ground beef, and 39% of raw chicken.  A leading researcher for the agency, Dawn Undurraga, issued the following warning:
 
"Consumers should be very concerned that antibiotic-resistant bacteria are now common in the meat aisles of most American supermarkets.  These organisms can cause foodborne illnesses and other infections.  Worse, they spread antibiotic-resistance, which threatens to bring on a post-antibiotic era where important medicines critical to treating people could become ineffective."
 
So who is to blame?  The Food and Drug Administration (FDA) is responsible for keeping individuals safe from toxic food and pharmaceuticals.  Why hasn't the FDA taken action?  According to a report from the Natural Resources Defense Council (NRDC), the FDA has known that using antibiotics in factory farms is harmful to humans for over 12 years.  The only step they have taken is to ask the drug companies to "voluntarily" restrict the use of antibiotics in livestock.  If you guessed greed as a factor as to why it continues, my opinion is that you are correct.  There are billions of dollars at stake when it comes to these drugs.  A report by the NRDC found that 26 of the 30 drugs used in agriculture and livestock reviewed by the FDA did NOT meet safety guidelines...in 1973!  Today, all 30 drugs would not meet the guidelines.  The NRDC also found that all feed additives containing penicillin and tetracycline antibiotics pose a "high risk" to human health and should not be permitted. 
 
Doctors and patients may also share the blame.  Doctors are fully aware that antibiotics are ineffective against a viral infection.  A recent study, however suggested that some physicians are more likely to prescribe antibiotics for a viral infection toward the end of their work day.  This means they are giving the patient what they are asking for and not necessarily what they need.  More education for doctors has proven to reverse this trend.  When doctors were given just a one hour seminar on the guidelines and protocols of treating upper respiratory infections, antibiotic use was cut by 50%. 
 
Patients are also pressuring their doctor to "just give me something."  A recent Consumer Reports poll of 1,000 adults found that 20% of them received an antibiotic from their doctor simply because they asked for one.  "I often have patients who ask for antibiotics," explains Dr. Doubek.  "So I understand the pressure to just say OK.  But now, especially with Zachary's experience, no way."
 
Consumer Reports comprehensive report on this subject recommended three main things that need to change to reduce antibiotic overexposure in society;
 
  1. Doctors to stop overprescribing
  2. Hospitals to clean up their act
  3. Farmers to stop using needless antibiotics
 
What can you do?  Be vigilant about protecting and promoting your immune system.  Email me at drk14@verizon.net for healthy and safe ways to do this.
 

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