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Antibiotic resistance: Rethinking healthcare norms

27th Jun 2014

The world is about to witness, perhaps the largest paradigm shift in healthcare in generations: bacterial resistance to antibiotics. These drugs have changed healthcare and basically eradicated the fear of certain infections once posed, such as syphilis and salmonella. Yet the overuse of these drugs has led to bacterial evolution that can resist them, most notably MRSA.

Sir Alexander Fleming was renowned for accidently discovering penicillin in 1928, commonly considered the first antibiotic, though mould treatments had been used since the 17th century. The realisation that humans may be moving to a so-called “post-biotic era,” as stated by the World Health Organisation’s Dr Margaret Chan, came about primarily because of MRSA, or methicillin-resisitant Staphyloccocus aureus, as outbreaks have become increasingly common near CAFOs or concentrated animal feeding operations.

Environment Antibiotic resistance Rethinking healthcare norms

Livestock are often given antibiotics prophylactically to boost weight (though the latter practice is outlawed in the EU). Farmers and producers administer antibiotics as prophylactics because the conditions the animals reside in are often filthy and cramped, and the drugs can be administered without much input from veterinarians. The OIE (World Organisation for Animal Health) recently condemned the overuse of antibiotics at their annual congress. According to the BBC, “It’s estimated that 80% of the antibiotics purchased in the US are used on farm animals.”

A study conducted in Iowa published in the journal Infection Control and Hospital Epidemiology found that, “The increasing populations of swine raised in densely populated CAFOs and exposed to antibiotics presents opportunities for drug-resistant pathogens to be transmitted among human populations. Our study indicates that residential proximity to large numbers of swine in CAFOs in Iowa is associated with increased risk of MRSA colonisation.”

Due to colonisation, MRSA takes up residence on the skin or nostrils before causing infection. Because of Iowa’s large number of CAFOs, approximately 7,000, the study came up with a relative risk of 2.76 for people living within one mile of one of the facilities. That means that people living close to CAFOs are almost three times more likely to contract MRSA than someone living further away.

Often, the manure excreted from pigs is spread over the surrounding fields, becomes aerosolised, and can then be found in surrounding human food or water sources. However, pigs are not the only farm animals treated with the drugs; cows often also receive doses in their feed.

One extremely controversial piece of the equation is the TTIP (Transatlantic Trade and Investment Partnership) aimed at removing trade barriers between the EU and US.

Antibiotics are a major area of contention and, though the EU claims it will not negotiate on such issues, the closed-door deals will likely loosen restrictions. North America and Europe tend to see the risks of antibiotic resistance differently, and have opposing regulations when it comes to how farm animals are housed. Many also fear what the TTIP will mean for organically labelled produce as the regulations differ greatly between the two regions.

In order for the problem of antibiotic resistance to be addressed in a realistic way, the farms that largely administer these drugs need to be re-imagined. To cram thousands of animals into small spaces for the duration of their lives, marinating in their own faeces, dealing with untreated sores and then being taken to the slaughterhouse so that the world can eat cheap meat, is not sustainable.

Will MRSA need to infect millions of people before these inhumane conditions are addressed? Sadly, CAFOs are a ‘business as usual’ practice and keep the price of meat down because of their massive scale.

As infections that were considered obsolete reappear, and surgery becomes a riskier endeavour because its current safety is largely due to the use of antibiotics, only then will the drugs be used more sparingly. Healthcare advancements have changed the standards of the world; and the fact that drugs that have only been around for 70 years can now be out-evolved displays how quickly the expectations of an industry can change, even with extensive research.

It has been estimated that we are at least ten years away from discovering new antibiotics; none have been discovered since the 1980s. Changing ingrained perspectives about evolving products may prove to be a challenging task but it is up to the leaders of the world, to compromise on gradually phasing out the overuse of antibiotics if we hope to continue seeing the benefits of their efficacy.
Sarah Sakeena Marshall, B.S. Environmental Policy

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