Parker, Waichman, Alonso LLP

Home » Resources »

The Overuse, Misuse, and Frivolous Use of Antibiotics in People and Food Animals Have Created a Serious Health Risk from Drug-Resistant Bacteria

Jun 1, 2008 PARKER WAICHMAN ALONSO Newsletter – June 2008
The Overuse, Misuse, and Frivolous Use of Antibiotics in People and Food Animals Have Created a Serious Health Risk from Drug-Resistant Bacteria
In 1939, Tyrothricin was the first antibiotic used successfully in the treatment of human disease. Too toxic for general use, it is used in the external treatment of certain infections. Other antibiotics, also produced by soil bacteria, have proved more successful. Streptomycin, for example, discovered in 1944, was, at one time, the main treatment for tuberculosis.

Over the next several decades, antibiotics became accepted as “wonder drugs” that promised to control or end many types of infections and infectious diseases. They could be used topically or internally and often provided dramatic results.

Unfortunately, as the old adage goes, you can sometimes have “too much of a good thing” and that is precisely what has happened in the case of antibiotics and other antibacterial products.

Without even considering the fact that antibiotics can be very toxic and even deadly in their own right, the frivolous overuse and misuse of antibiotics and antibacterial products has opened the door to an even more serious problem.

Whenever an antibiotic or antibacterial is used, it will never kill all of the targeted bacteria. While some of the weaker bacteria may escape, it is the more resistant strains that pose the real threat. If ever “survival of the fittest” applied in a negative way, it is in the case of bacteria.

Even assuming an antibiotic or antibacterial eliminates 98% of the targeted bacteria, the surviving 2% are the problem. Bacteria reproduce quickly and the ones that are then mutating are the strongest ones, which have already demonstrated a degree of or complete resistance to the antibiotic or antibacterial used. These then multiply and create new strains of bacteria that do not respond to antibiotics that were previously effective. Emergence of resistance is enhanced when patients do not finish a full course of an antibiotic -- or when antibiotics are overused or misused.

In time, antibiotics and antibacterial products become less and less effective and that leads to the need for more powerful replacements. Eventually, there are only a few, if any, antibiotics to choose from when dealing with highly resistant bacteria. Those antibiotics, being the most powerful, are also the most toxic and dangerous to humans.

The number of drug-resistant and multidrug-resistant strains of bacteria is up sharply from just a few years ago. About 70% of the bacteria that cause infections in hospitals are now resistant to at least one common antibiotic.

The growing problem with the frivolous use and overuse of antibiotics in humans is only half the story, however. Antibiotic-resistant bacteria are also developing in animals and fish that are being treated with antibiotics and, according to the results of a recent study in Taiwan, those same antibiotic-resistant bacteria are able to spread to humans through the animals they eat.

For the most part, salmonellosis is a self-limiting infection. Sometimes, however, it leads to systemic infection and death.

Fluoroquinolones are antibiotics used to treat salmonella where it is resistant to other antibiotics. Now, however, a strain of this bacterium has developed a resistance to fluoroquinolones. As a result, people can be infected by this antibiotic-resistant strain by eating infected pork products.

The authors of this study evaluated salmonella resistance to fluoroquinolones, such as ciprofloxacin, and cases of fluoroquinolone-resistant salmonella in 2000 and 2001 in Taiwan.

Although there were no cases of antibiotic-resistant bacteria on the island in 1999, by 2001, 60% of the samples of salmonella taken at two Taiwanese hospitals were resistant to the antibiotic.

Although none of the patients with the fluoroquinolone-resistant salmonella had taken the drug, samples of the strain from the humans and agricultural swine showed the same genetic mutation thereby linking the infections with food as the source.

The study concluded that humans may be susceptible to infection from antibiotic-resistant salmonella in pork that they eat. The authors stated: "In view of the severe adverse consequences for human health of the use of fluoroquinolones in food animals, we suggest that such use should be prohibited."

U.S. scientists say antibiotic-resistant bacteria has been found in pigs, pork products and even some veterinarians who work with swine. In fact, the Wall Street Journal has reported that public-health doctors at the University of Iowa found drug-resistant bacteria in nearly half of pigs tested with nasal swabs.

Researchers at the University of Minnesota found the bacteria in 7% of swine tested and an Ontario Veterinary College researcher found the bacteria in 10% of ground pork and pork chops tested in parts of Canada.

Although not regarded as a significant source of disease at this time, there are grounds for concern since Canadian researchers have found antibiotic-resistant Staph bacteria in pork products purchased in various retail stores.

This raises questions as to how the contamination occurred, how frequently it occurs and whether it has implications for human health.

Slightly under 10% of the pork chops and ground pork bought in four provinces tested positive for methicillin-resistant Staphylococcus aureus or MRSA, according to lead researcher Dr. Scott Weese in a presentation to the International Conference on Emerging Infectious Diseases.

Since these bacteria would be destroyed by proper cooking, Staph food poisoning would not be a major concern. Dr. Weese, however, expressed concern that people handling meat with MRSA on its surface would end up inadvertently "colonizing" themselves.

People who carry the bacteria on their skin or in their nostrils are at greater risk of developing a Staph infection, which can range from a hard-to-heal boil to pneumonia to a potentially deadly bloodstream infection.

Although MRSA infections were once acquired mostly in hospitals, recently there have been increasing rates of infections in people who have not been in hospitals and have not been taking antibiotics. Such infections are referred to as community-acquired MRSA, and the unexpected rise in their occurrence in the U.S. (and now in parts of Canada) has scientists looking for possible explanations this changing pattern.

Dr. Weese believes that, at this point, all that is necessary is to take reasonable precautions such as washing your and paying attention to how you handle pork products.

This is the first confirmed report of MRSA in retail meat in North America and one of only a few such reported findings in the world. In 2007, Dutch researchers reported they had isolated MRSA from two pork samples in the Netherlands. In 2005, Japanese scientists reported they had found MRSA in two samples of raw chicken.

In July 2005, the FDA banned the antibiotic (Baytril) from use in poultry citing concerns over antibiotic-resistant infections in humans. Its decision to no longer allow distribution or use of the antimicrobial drug enrofloxacin for the purpose of treating bacterial infections in poultry did not affect other approved uses of the drug. This animal drug (a fluoroquinolone) is marketed under the name Baytril by Bayer Corporation. The drug is in the same “family” as Cipro, the widely used human antibiotic.

The FDA’s decision had been long-awaited by many infectious disease experts. The withdrawal was handled by the FDA’s Center for Veterinary Medicine (CVM).

The FDA acknowledged scientific data showed that the use of enrofloxacin in poultry caused resistance to emerge in Campylobacter, a bacterium that causes foodborne illness. Chickens and turkeys normally harbor Campylobacter in their digestive tracts without causing poultry to become ill.

Enrofloxacin does not completely eliminate Campylobacter from the birds' intestinal tracts, and those Campylobacter bacteria that survive are resistant to fluoroquinolone drugs. These resistant bacteria multiply in the digestive tracts of poultry and persist and spread through transportation and slaughter, and are found on chicken carcasses in slaughter plants and retail poultry meats.

Campylobacter bacteria are a significant cause of foodborne illness in the U.S. Antimicrobial treatment is recommended for people with severe illness as well as the very young, the elderly, and people with certain medical conditions.

Complications of such infections can include reactive arthritis and, more rarely, blood stream infections. Early treatment can mitigate symptoms and may decrease the risk of complications.

Fluoroquinolones used in humans are ineffective if used to treat Campylobacter infections that are resistant to them. This failure can significantly prolong the duration of the infections and may increase the risk of complications. The proportion of Campylobacter infections that are resistant to fluoroquinolones has increased significantly since the use of enrofloxacin in poultry was approved in the U.S.

Also in 2005, the state of Louisiana stopped the sale of some 700,000 pounds of fish from Vietnam pending an investigation into the use of the banned antibiotic. Nearly 350 tons of Vietnamese seafood was been taken off the market and quarantined until it could be analyzed.

Inspectors checked cold storage facilities, seafood markets, restaurants, grocery stores, and other retail establishments, looking for any basa catfish, crab meat, and any other seafood products from Vietnam. All sales of seafood from Vietnam were stopped after the FDA found the antibiotic fluoroquinolones in imported basa catfish. The catfish were bought in Louisiana under the LA Fish Co. label.

The antibiotics are sometimes added to seafood in other countries and are used to treat tuberculosis, pneumonia and other infections in people. The antibiotics will not cause illness but are not allowed in United States, Canadian, and European food because germs could become resistant to them.

Louisiana authorities conducted a search from location to location in an effort to find all shipments containing the antibiotic.

Thus, it should be very clear that antibiotics are not harmless medications. They can be highly toxic and even deadly, and should only be used only when absolutely necessary.

To summarize some of the potential adverse effects associated with the use of antibiotics, J. Kevin Shushtari, M.D., Rx.com's Chief Medical Officer, notes the following:

Allergic reactions – These may be extremely serious and can even cause death within a matter of a few days.

Alteration of normal bacterial flora – “Broad-spectrum antibiotics kill bacteria, which normally live in the intestines and in the vagina. Alteration of the flora in the gastrointestinal system during antibiotic administration can cause minor bouts of diarrhea. More-severe alteration of the flora can even lead to life-threatening colitis, a severe inflammation of the colon. I have seen young patients require surgery because of colitis, after which they required a colostomy bag. Along these same lines, antibiotics alter the normal vaginal flora and often bring about vaginal yeast (a type of fungus) infections. When you kill the ‘good’ bacteria with antibiotics, yeast -- which is part of the normal flora -- can take over because antibiotics do not kill it. Many women patients will tell their doctors that they need vaginal yeast medication before they will even take an antibiotic. Antibiotics can also bring about fungal skin infections for the same reasons.”

Creation of a superior strain of bacteria – “Bacteria often become resistant when they are repeatedly exposed to antibiotics -- the genetic makeup of the bacteria changes, making infections extremely difficult to treat. Many doctors consider first-line antibiotics, like penicillin and amoxicillin, to be no less dangerous than candy. But we know better, or at least we should. Most have heard of super-resistant staph infections; well, these infections have been brought about in large part by the repeated unnecessary use of antibiotics.”

Interference with other medications – “Antibiotics often alter the way other drugs are metabolized. I later learned that the nurse to whom I prescribed the erythromycin was also taking birth control pills. It is well documented that erythromycin can make birth control pills less effective. It is possible the nurse could have become pregnant due to the interference of the antibiotic.”

If you or a loved one has experienced an injury that may have been associated with the use of any antibiotic, please do not hesitate to contact Parker Waichman Alonso at www.yourlawyer.com for a free consultation and case evaluation from one of our attorneys.