Tuesday, June 12, 2007

Magic Bullets

My 10 month old daughter was just diagnosed with bacterial pneumonia. Nothing like an intensely personal interest to make one appreciate the miracle of antibiotics. Which has made me think deeply about the case of Andrew Harley-Speaker and his globetrotting case of antibiotic resistant TB.

Most of the news coverage focused on the Homeland "Security" farce and gossips has a field day with Speaker's decision to go on his honeymoon despite his infection. That is too bad.

The real story is the growing threat of antibiotic resistance. When did we stop attaching the appellative "life saving" to antibiotics? When did they become so routine that we forgot how vital they are? We are mad to squander this precious resource!!! As soon as I finish this entry, I plan on writing my senators to urge their support for the Preservation of Antibiotics for Medical Use Act of 2007.

Concentrated Animal Feed Operations (CAFOs) routinely administer large doses of antibiotics to make livestock grow faster on less feed (and to compensate for crowded and unsanitary living conditions). More than 24 million pounds of antibiotics are added to animal feed every year. This massive overuse dwarfs the problems created by patients failing to finish antibiotic prescriptions and physicians overprescribing antibiotics (though those are real concerns that must also be addressed.)

The results are frightening. According to the FDA, 70% of bacteria that cause infections in hospitals are resistant to at least one form of antibiotic. This problem is only increasing.

In 2005, after five years of wrangling, FDA for the first time banned the use of an antibiotic in agriculture. Concerns that growing resistance to Baytril was reducing the effectiveness of CIPRO prompted the ban. Lets hope this decision is a precedent. But, five years is a long time in the evolution of antibiotic resistance.

Mr. Speaker's case presented a perfect opportunity to educate the public about the dangers of antibiotic resistance, but instead spent the ink and bandwidth on nonsense. If I were the editor in charge, the headlines would scream MAGIC BULLETS NOT WORKING!! (yeah, i know, stick with my day job . . .) But, we have seen a world without antibiotics--it's called 1900. TB in that pre-antibiotic day was the leading cause of death in the United States. In the prosperous West, there are few remaining survivors from the world before antibiotics. But my 97 year old grandfather sure can tell some horrible stories about illness and death in the days before antibiotics. Do we really want to risk returning to those days?

Pneumonia used to be a dread disease-- the "captain of the men of death." Today, thanks to life-saving antibiotics most pneumonia patients don't even need to be hospitalized. My daughter is going to be fine, but I have a new appreciation of the fragility of our grasp on health and life.


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