"Antibiotics"

"I don't know really, I shouldn't have bothered you; I just feel awful, listless, shivery, nausea and of course just a touch of diarrhoea. I've been like this for a couple of days now and I really need to get back to work, I can't afford any more time off."

"Don't worry, I've seen a lot of this recently, there's been a queue of people every morning recently with it - it's just something going around, I'll prescribe you a course of antibiotics and that will do the trick, in a few days you'll be as right as rain again."

"Thanks doctor."

Antibiotics, the miracle drug, a cure for all our ills, but is this really the case?

So many times over the last few years and more recently in the last few months we have heard the horror stories of how our hospitals are breeding grounds for Methicillin Resistant Staphylococcus Aureus (MRSA) bacteria. The threat from this super bug is now said to be almost 50% greater than was previously feared with Britain holding the shocking title of the 'MRSA capital of Europe'. Figures released by the Public Health Laboratory Service towards the end of last year show that over 3,500 NHS patients suffered MRSA infection in the first six months of 2002 compared with a little over 4,000 during the whole of 2001.

When Alexander Fleming first observed that penicillin mould killed off bacteria he opened the door to a new age in medicine, antibiotics when they were first introduced were hailed as the most effective way of dealing with 'bugs' that we were ever likely to see. They were wonder drugs, able to combat almost everything. Antibiotics became great lifesavers; no more epidemics of polio, diphtheria and TB. But since we started to use these lifesaving antibiotics, with what can only be described as gay abandon, what tragedies have we been bringing down on our heads? More or less as soon as penicillin was introduced fears about resistance to it caused concern, by the early 1950's the problem of resistance was acknowledged in medical, veterinarian and pharmaceutical press.

Yet many now believe they are becoming almost totally ineffective thanks partly to our own over reliance on them to cure all ills and the speed with which all bacteria seem to become resistant, too many times as in the example above we rush off to our doctors with a sore throat or similar looking for a magic cure. Over prescribing in the United States produced the curious effect that those with repeated infections are more likely to come from rich neighbourhoods than poor ones. This is because medicine in America is expensive and therefore not so readily available to the poorer households and as a bizarre turnaround they benefit from the lack of use of these miracle cure antibiotics far more than those taking them.

However the main reason for their ineffectiveness has to be the way they are now used as growth promoters. Yes! Incredible isn't it? It was discovered that certain antibiotics act as growth promoters or, as intensive rearers would call them, 'dietary enhancers'. They are what makes it possible for a chicken to grow to its killing weight in only 41 days after pecking its way out of its egg, from egg to table in six short weeks, why cows are producing up to three times more milk now than they did 20 years ago. Back in May 1998 it was reported that a number of organisations; including the World Heath Organisation and the European Commission wanted the practice of feeding our animals and spraying our crops with antibiotics stopped, fearing that the over-use of them could lead to the emergence of new drug-resistant 'superbugs'.

Even as recently as last year the farming and pharmaceutical lobbies continued to disagree saying that the risks were over stated. They argued that antibiotics 'are incorporated into animal feed to create favourable conditions in the animals intestine for the digestion of food', 'mainly being used for improving feed conversion capabilities and hence the growth rates of animals without laying down excessive amounts of fat'. (as one that has always argued the advantages of fat in meat give me the fat any day!)

The argument continues with: low doses of antibiotics not only help to keep the animals disease free but also that less food is required (if for example the approximately 115 million pigs in Europe were fed with antibiotics or dietary enhancers they would require some 1.3 million tonnes less feed during fattening) thereby requiring less land to produce it, that healthier animal intestines produce less waste gases into the air (in France, Germany and the UK it is thought that the animals given these dietary enhancers are thought to excrete 1,246 million cubic meters less methane per day into the air) and that they also, by requiring less food, produce less manure. Then to cap it all the same article from which these extracts are taken goes on to say 'consumers benefit from the availability of good, wholesome food, tailored to their demands, at a reasonable price'. In the 1940's about 95% of staphylococcus aureus (this is the bacteria that is a frequent cause of infections in hospitals, bacteria that are highly contagious, can cause pneumonia and can even kill) were sensitive to penicillin. By the 1990's 95% had become resistant to penicillin!

These staph. can fight off humble penicillin and now shrug aside the ever more powerful drugs that have followed: erythromycin, streptomycin to name but two. They now cause havoc in the running of many hospitals as already mentioned with the Portsmouth NHS Trust being forced to close down in 2000, it had become impossible to sterilise equipment for operations because of them. And now we have MRSA to contend with. Statistics from 1999 showed that there were at least as many antibiotics used on the farms and in the broiler sheds of Britain than were used by family doctors and hospitals put together, at the time farm animals consumed 35% of all the antibiotics administered in the EU and of these 6% were given directly as growth promoters.

Thankfully this amount has started to decrease rapidly over the intervening years and many of the antibiotics in use then have now been banned with more bans on the way but can we be sure that this is the same in every country? It was just last summer that an Irish farmer was accused of using banned growth promoters (a substance that had been banned since 1999) on his pigs. The EU have recently reached a political agreement to ban four widely used antibiotics in feed: monensin sodium, salinomycin sodium, avilamycin, and flavophospholipol and are committed to trying to phase all growth promoters out by 2006 and the EFAH are looking for alternatives to them to be available by 2005 which they feel is not an unrealistic timeframe.

The question still remains though, should we have been using them in the first place? Why should we be dosing our pigs on penicillin to make them grow bigger and quicker, surely it would be better for all, especially the pig, if we gave it good food instead! Yes of course it would put the price of meat up - good farming practices always do but how much safer would it be? A report to the government in 1999 by the advisory committee on the microbial safety of food said the growth of superbugs could be blamed directly on the use of antibiotics on farmed animals. As recently as September 2002 the Soil Association reported on how chickens reared for meat and carrying the Little Red Tractor logo of the farm assurance scheme can now receive daily doses of antibiotic growth promoters, which were previously not allowed under the scheme.

Their allegation is that with almost 85% of all chickens sold in the UK being reared under the Assured Chicken Production Scheme, its claim, to prohibit the use of all antibiotic growth promoters, has been reversed. In June of last year standards that banned the use of these antibiotics following evidence that the misuse of them was leading to resistance to important medical drugs were quietly changed and that now some promoters are allowed on the 'specific recommendation of the responsible veterinarian'. The drugs in question - avilamycin and flavomycin are both on the list of drugs to be banned by the EU.

Thankfully it seems that our government is now moving in the right direction and seeing sense, over the last 50 years concerns have been constantly expressed over the safety of using antibiotics in animal feed - especially those also used by humans. In 1969 the Swann Report (Report, Joint Committee on the use of Antibiotics in Animal Husbandry and Veterinary Medicine) made extensive recommendations that if they had been implemented as recommended instead of being manipulated and watered down the way they were we may not have been in the mess we now find ourselves. At the time they were fought, quite understandably, even in their weakened state, tooth and nail by the pharmaceutical industry - did the public not realise that the measures proposed in the report would add as much as three pence to the price of a pound of bacon!

What the report wanted was to ban certain antibiotics from being sold without prescription, they wanted them to be stopped being used as growth promoters and a permanent committee set up to oversee both medical and veterinary use of antibiotics. This was the minimum of what the report called for yet under fierce lobbying from industry and despite Swann's opposition to using growth promoting antibiotics for adult and breeding cattle the green light was given for their use in 1976!

Some obviously think that problems antibiotics bring with them are a price worth paying for cheaper food- do you?

Recipe: 'Breast of Chicken with Balsamic Roast Vegetables'....

Sources of Information:
EU Food Law News Commission press release 16th December 2002
Soil Association Press release 30th September 2002
Antimicrobials as growth promoters: resistance to common sense Lars-Erik Edqvist and Knud Borge Pedersen
European Federation of Animal Health (EFAH)
The Daily Telegraph September 2002
Daily Mail October 2002
BBC News
www.pighealth.com
The Great Food Gamble, John Humphrys