Six More Questions to Help #2

2. Why does human medicine’s contribution to the problem get a pass?

Methicillin-resistant Staph. aureus, or MRSA, blanketed the news three years ago when the CDC announced it was killing more people than AIDS. Farm antibiotics took an undue share of blame. Now, that news event has turned into the news non-event of this year. With little to no media attention, MRSA infection is now on the decline — effected not by changes in farm antibiotic use, but by wholesale changes in how hospitals and clinics (where CDC shows 85 percent of cases occur) test for it, disinfect against it, and otherwise manage it. It’s another example that leaves farmers and veterinarians wondering why the rightful responsibility for an estimated 96 percent of all drug resistance isn’t laid in the lap it belongs in: human, not veterinary, medicine.

Yes, using veterinary antibiotics does select for resistance in some important organisms, writes German microbiologist Trudi Wassenaar, DVM, PhD. But placing blame on food for drug resistance that affects hospital patients is like blaming the fly on the grill of the truck that ran you over. Here’s why, according to Dr. Wassenaar:
• Most resistant pathogens posing a serious risk to human health result from human use of antibiotics.
• She points to numerous examples of human pathogens that started susceptible but were then rendered resistant during the course of treatment.
• “Prudent use in human medicine is not common practice everywhere,” she notes, and too many human prescribing practices still are not evidence-based.
• Not all “resistant” bacteria, even foodborne ones, are untreatable.
• Not all resistant bacterial infections have therapeutic consequences.
• Countries with low use of veterinary antibiotics don’t report fewer human treatment failures.

Source: Critical Reviews in Microbiology, 31:155–169, 2005

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