Millions of people died during World War II, but many soldiers survived thanks to an advance that had nothing to do with bombs and bullets. Penicillin emerged as the state-of-the-art remedy for all manner of infections, from burns to gunshot wounds to syphilis. It was termed a “miracle drug.”
It’s hard for modern Americans to grasp how dangerous bacteria could be a century ago, before this revolutionary innovation. But we’re getting an unwelcome glimpse. New “superbugs” have emerged that are resistant to most antibiotics. They now sicken 2 million Americans — and kill 23,000 — a year. Left unchecked, they’re a major threat to public health.
So it’s good to see action to combat the danger. Two priorities: Reducing the unnecessary use of antibiotics and stimulating the development of new ones. Those steps would slow the emergence of resistant bugs and provide new weapons against those that already exist.
Recently the White House unveiled its “National Action Plan for Combating Antibiotic-Resistant Bacteria,” which includes a range of measures. Among them are more money for drug research, better diagnostic tools and new rules to promote “antibiotic stewardship” — defined as using “the right antibiotic at the right time at the right dose for the right duration.”
Boston University law professor Kevin Outterson told The Wall Street Journal, “It is the boldest move against antibiotic resistance by any U.S. administration ever.”
The stewardship provision is supposed to curb overuse and misuse of these drugs — advancements that would speed the evolution of bacteria to outwit them. The U.S. uses antibiotics at twice the rate of Germany or the Netherlands. Some doctors are to blame for still prescribing them on the mere chance of a bacterial infection. But two-thirds of the antibiotics used here go to food animals.
The administration wants the Food and Drug Administration to eliminate the use of medically important antibiotics to promote growth and prevent disease in livestock raised for food. McDonald’s recently said it would require its chicken suppliers to end the practice, and Perdue announced last year it would no longer employ antibiotics at its hatcheries.
Given time, other livestock producers should be able to adapt as well. Some hog operations have already gone antibiotic-free — like Johnson-Pate Pork in DeKalb, which markets 25,000 hogs a year to Whole Foods and other buyers. One way the company reduces its need for antibiotics is to rely more on vaccines to prevent pigs from getting sick.
Relying less on antibiotics is bound to raise food costs, but there will be savings in human illnesses avoided and lives saved. Pumping food animals with antibiotics is not really inexpensive — it just looks that way because the cost to health doesn’t show up on your grocery bill.
It’s not enough to reduce the use of antibiotics. New ones are needed as well.
But pharmaceutical companies have only modest interest in finding them, because these drugs are typically less profitable than medications that have to be taken for years to combat chronic, serious ailments. Since 2008, reports Brad Spellberg of the David Geffen School of Medicine at UCLA, there have been only two new “systemic antibacterial agents” — compared to 16 from 1983 through 1987.
So the administration blueprint calls for more federal funding of research and development of the next generation of antibiotics. The FDA has promised to ease regulations on clinical trials, which Spellberg says are far more burdensome than those mandated in Europe.
More funds and streamlined regulations will make it easier to create new antibiotics. It’s a crucial part of a broader strategy to save the miracle drugs that have saved so many lives. We need to act quickly, because the superbugs aren’t waiting.
