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Biosecurity requires drug reform. (Editorial).

Before those anthrax-laced letters hit the U.S. postal system last October, most people had probably never heard of Ciprofloxacin, the anthrax-killing drug more commonly known as Cipro. Even fewer were likely to have heard of its cousin, Baytril. Both drugs are fluoroquinolones, a relatively new and potent class of antibiotics. Cipro, like most powerful new antibiotics, was used initially as a medical last resort--as a drug for treating bacterial infections that nothing else seemed to control. But Baytril never did duty on that front. Baytril is really an agrochemical: it's mixed into the feed of billions of chickens raised in U.S. factory farms every year. This "sub-therapeutic" dosage is intended to suppress pathogens that would otherwise thrive in the extremely crowded conditions of such farms. The use of antibiotics in this way--particularly when they are as powerful as Baytril--may be just as important a biosecurity issue as "weaponized" anthrax.

When those letters killed two Washington, D.C. postal workers, a Florida journalist, and a New York City healthcare worker, the U.S. public health system responded by putting thousands of people on Cipro. The response was a preventative measure; those people might also have been exposed to anthrax. At the time, mass-prescription of a potent antibiotic was an understandable reaction, given the novelty of the threat. But as a policy for bioterror--and it's now sadly apparent that the United States will need such a policy--the cure could conceivably be worse than the disease.

Widespread and often unnecessary antibiotic use is already breeding "super pathogens"--strains of drug-resistant bacteria. Doctors in industrialized countries frequently appease patients with unnecessary prescriptions; pharmacists in developing countries frequently dispense drugs with no prescription at all. Our germ-fighting arsenal is weakening, and overprescription as a matter of policy could leave us even more vulnerable, not just to other episodes of bioterror, but to routine infections as well.

What has any of this got to do with Baytril? About the same time that the Cipro was being doled out, the New England Journal of Medicine published three studies confirming that the routine use of antibiotics in agriculture also encourages the growth of drug-resistant bacteria. That's not just a farm problem, because the bacteria can spread to people when animal products are consumed. You don't want to swallow Baytril-resistant bacteria, because they could well be resistant to human medicines as well. Nor is this problem limited to Baytril--or even to agriculture. Antimicrobial soaps, lotions, and other household products are likely causing drug resistance as well.

Antibiotics are too precious to waste. Pumping livestock full of drugs so they will survive miserable factory farm conditions is not conducive to public health. Nor is the use of antibiotics as a marketing ploy in hand soaps. There are better ways to farm and better ways to wash your hands. If there's anything good to be said about the anthrax episode, maybe it's this: it's an open invitation to think systematically about what public health really means.

Danielle Nierenberg, Staff Researcher
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Title Annotation:overuse of antibiotics
Publication:World Watch
Article Type:Brief Article
Geographic Code:1USA
Date:Jan 1, 2002
Words:501
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