The use of antibiotics in food-producing animals has led to a greater risk of life-threatening infections in young children — and dramatically reduced medicine’s ability to treat those infections.
That danger is the subject of a report published today in Pediatrics, the journal of the American Academy of Pediatrics (AAP).
Dr. Jerome A. Paulson, FAAP, the lead author and the AAP’s immediate past chair of the executive committee of the Council on Environmental Health, wrote in the introduction: “Antimicrobial resistance is one of the most serious threats to public health globally, and threatens our ability to treat infectious diseases.”
The report debuts on the same day the World Health Organization (WHO) issued a statement saying there are misunderstandings worldwide about antibiotic resistance.
Among other things, WHO officials said 64 percent of people surveyed in 12 countries said antibiotic resistance is an important issue. However, 66 percent said people are not at risk of a drug-resistant infection if they take their antibiotics as prescribed. Another 44 percent said antibiotic resistance is only a problem for people who take these prescriptions regularly.
The reports were part of World Antibiotic Awareness Week, which began today.
How Serious Is the Threat?
More than 2 million people in the United States become ill with antimicrobial-resistant infections each year, resulting in more than 23,000 deaths, Paulson told Healthline.
In 2013, there were more than 19,000 infections involving young children, according to the Foodborne Diseases Active Surveillance Network, a system operated by the U.S. Centers for Disease Control and Prevention that covers 15 percent of the U.S. population. Those infections caused 4,200 hospitalizations and 80 deaths.
The highest incidence rate in this group was for children younger than 5, Paulson told Healthline.
“Life-threatening infections are extremely unusual in otherwise healthy children,” he said. “Most life-threatening infections occur in children with other medical problems. That said, healthy children can get pneumonia, from the pneumococcal bacteria, which may be life-threatening. And they can get infections with E. coli 0157, which they may get from contaminated meat, and that can be life-threatening.”
Overall, antimicrobial-resistant infections add significant costs to the U.S. healthcare system — an estimated $21 billion to $34 billion annually, resulting in 8 million additional hospital days, Paulson noted.
Approximately 80 percent of the overall tonnage of antimicrobial agents sold in the United States in 2012 was for animal use, the AAP report stated.
A particular farming method is one of the primary causes of antimicrobial resistance.
Farmers add low doses of antimicrobial agents to the feed of healthy animals over prolonged periods to promote growth, increase feed efficiency, and prevent disease.
“These non-therapeutic uses contribute to resistance and create new health dangers for people, and often render antibiotics ineffective when doctors need them to treat infections in humans,” said Paulson, who is also a professor emeritus of pediatrics and of environmental and occupational health at George Washington University’s School of Medicine.
Children, in particular, are at risk.
"Children can be exposed to multiple-drug resistant bacteria, which are extremely difficult to treat if they cause an infection, through contact with animals given antibiotics and through consuming the meat of those animals," Paulson said.
"Like humans, farm animals should receive appropriate antibiotics for bacterial infections,” he added. “However, the indiscriminate use of antibiotics without a prescription or the input of a veterinarian puts the health of children at risk.”
What Parents Need to Know
Paulson offered two immediate steps parents can take.
“They can work with others to demand the end of antimicrobial use in farm animals except to treat disease,” he said. “They can also purchase meat and poultry that has not been raised using antimicrobial agents.”
This threat to human health has been developing over decades and has been discussed for many years in veterinary, medical, and agriculture circles, Paulson said.
“Deaths related to multiple-resistant organisms have been occurring for years and have been increasing slowly over time,” he said. “While it is obvious when someone is infected with one of these organisms, it is rarely possible to link the infection in a specific individual to bacteria that became multiple-resistant as the result of antimicrobial use in agriculture.”
Both medicine and agriculture need to be more selective in the use of antibiotics, Paulson said.
“Physicians need to be prudent in their use of antibiotics in humans,” he said. “Antibiotics should never be prescribed for colds, for upper-respiratory tract infections unless they are known to be bacterial in nature, or for other ill-defined purposes. Veterinarians should control the use of antimicrobial agents in animals, and such agents should not be added to feed or water to promote growth.”
The report authors note that many antimicrobial agents used in food animals are the same as or similar to those used in human medicine.
“Unlike in human medicine,” they wrote, “antibiotic agents in food animals may often be used without a prescription or any veterinary oversight.”
“This issue is a danger to adults and children,” Paulson said. “The American Academy of Pediatrics, of course, only has the expertise to weigh in on the situation as it relates to children. The AAP has published this technical report to bring attention to the problem.”
In a press release, the authors expressed concern that a voluntary Food and Drug Administration initiative and measures proposed by members of Congress to reduce the drugs’ non-therapeutic use have met with opposition from the agriculture and farming industry.