More on resistance to antibiotics

I don't usually write two blog entries in one day, but when I saw today's JHBSPH news feed, I just couldn't resist (no pun intended given what I am writing about).  Today, I will refer readers to another article in the Washington Post (although since it is an Associated Press article you could probably find it other places).  Another reason to write about this article is that one of my JHBSPH colleagues, Ellen Silbergeld, is quoted.

In any case, this article is about the use of antibiotics on the farm rather than the use of antibiotics in humans.  The article's byline is from Frankenstein, MO.  I can only assume that the author was aiming for some type of humor.  We are certainly not talking about engineering organisms that cause disease, but we are talking about the effects of our engineering of antibiotics when they are use in ways that do not necessarily promote long-term public health.

In the article, one farmer is quote as saying that all the public cares about is safe foods at cheap prices.  Maybe.  There are any number of consumers these days who purchase eggs, milk, or meats raised with no antibiotics.  Some insist on only this type of product. Some do it as long as they can afford.  Some mix and match whether they look specifically for labels indicating no antibiotics depending on prices and other issues that affect their purchasing decisions.

The issue is this.  Antibiotics are given to some healthy animals.  They promote growth and keep the animals from getting diseases against which the antibiotics are effective.  One key issue is, as was pointed out in the article, that we would not "sprinkle antibiotics on healthy kids' cereal".  Giving antibiotics as a matter of course allows for the development of drug resistant disease causing organisms.  Notably, a member of the Union of Concerned scientists was quoted as pointing out that the drug resistant organisms that are found in the gut of a pig on a farm in Iowa (and it could have been any state) don't stay there.  

So what does this mean?  If using antibiotics keeps the price down now but threatens our health later what is the correct tradeoff?  Should everyone be forced to pay higher prices for meats and other products raised without antibiotics or should be leave it to the private market so that people who want to pay more can and those who do not can continue to buy products produced with antibiotics in the feed?  The ultimate answer will be made by our society as it struggles with the issues outlined in the article.  This may be another situation, however, in which only the coordination and regulation hat a government can bring will solve the problem.  Having a relatively small fraction of the population paying for antibiotic free produce because they are willing to is unlikely to solve the problem.