The White House is about to release a “comprehensive plan” to deal with the challenge of antibiotic resistance over the next five years.
And anytime you encounter that phrase, it’s virtually guaranteed you can dismiss three-quarters of the window dressing padding the plan, before you get to the substantive new regulations government wants to impose.
According to Reuters, the 60-page report, which was compiled by a task force that included the administration’s officials in health and agriculture, will call for “significant investments and policy changes” from federal health agencies.
The goals of the $1.2 billion proposal include drastically reducing the rates of the deadliest “super infections” within five years, investing in new diagnostic tools and new classes of antibiotics and improving antibiotic usage, surveillance and prescribing practices in hospitals and on farms.
Which makes sense: The ubiquitous use of antibiotics in medicine, in animal agriculture — heck, in every household in America; yes, that pump-action container of hand sanitizer sitting on your kitchen counter is part of the problem — has contributed to a situation that is potentially as serious as it gets.
We’re not there now, but if we were ever to arrive a point in the future where even the most powerful antibiotics couldn’t control pathogens, the entire profession of medicine would be tuned upside down.
Even now, the Centers for Disease Control and Prevention have estimated that 2 million people are infected with resistant bacteria every year, which results in about 23,000 deaths. Some authorities claim those are conservative estimates; personally, I would point out that the majority of those 23,000 deaths occur among elderly, immune-compromised or seriously ill patients recovering from major surgery.
That doesn’t dismiss the seriousness of emergent antibiotic-resistant pathogens, but like cancer death rates, resistant antibiotic mortality statistics are inflated by the extended life spans that we modern citizens enjoy.
The real controversy
Under the proposed plan, doctors who are reimbursed by Medicare and Medicaid health plans will have to report their antibiotic prescribing patterns, “particularly when used to treat non-bacterial infections, such as common colds,” Reuters reported.
The CDC will focus on controlling the most serious infections: reducing Clostridium difficile infections by 50%, reducing carbapenem-resistant enterobacteriaceae infections by 60% and reducing methicillin-resistant Staphylococcus aureus infections by 50%.
How would such dramatic improvements happen? For starters, hospitals would be required to implement infection control programs, including increased handwashing, sanitizing of surfaces and equipment and oh, yeah — one other initiative: reducing the use of antibiotics.
Shouldn’t that last measure be at the top of the list? Yes, better sanitation and more aggressive handwashing would help control the spread of resistant infections, but those actions actually increase the cycle of resistance.
Even Lysol, which we’re encouraged to spray on any and every surface a human could touch, admits to only killing 99.9% of bacteria. That surviving 0.1%? There’s your antibiotic-resistant microbial soldiers ready to march into battle spreading super infections everywhere they can.
The one key variable in this new plan, one that will need to be thoroughly vetted, is how the use of low-level, sub-therapeutic antibiotics will be regulated in livestock production. No one with a shred of scientific savvy — not to mention basic humanity — would argue against the administration of veterinary antibiotic to treat sick animals.
That’s the not the issue.
The issue is how USDA and the Food and Drug Administration will address the use of medically useful antibiotics used for health maintenance and growth promotion. That protocol is a critical component of modern livestock production, yet is undeniably linked — at least tangentially — to the larger problem of antibiotic-resistant infections.
According to Reuters, the new plan recommends that FDA and USDA “take further steps to curtail the use of medically important classes of antibiotics for growth promotion in [food] animals,” but did not set a specific goal.
Unless and until that happens, all the rest is just political posturing.
Dan Murphy is a food-industry journalist and commentator