- In the campaign to educate people about the danger of
over-prescribing antibiotics, victories seem to be coming in small doses.
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- U.S. pediatricians are prescribing fewer antibiotics
for common childhood respiratory infections than they were just a decade
ago, a recent study says. This suggests that messages about drug-resistant
germs are working.
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- At the same time, there's growing concern among some
scientists and members of the medical community that people are ingesting
too many antibiotics on a regular basis because of their widespread use
in the food supply.
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- According to a recent report in the Journal of the American
Medical Association the number of antibiotic prescriptions for children
under the age of 15 fell from 46 million in 1989 to 30 million in 2000.
And the rate of prescriptions per 1,000 doctor visits dropped by nearly
30 percent during the same period.
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- Despite the drop, the rate is "still probably too
high," says Linda F. McCaig, a statistician at the National Center
for Health Statistics and lead author of the study.
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- For instance, the study found that many doctors continue
to prescribe antibiotics such as penicillin and erythromycin for the common
cold, a viral condition that doesn't respond to bacteria-killing drugs,
McCaig says.
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- And experts estimate that as many as half of all prescriptions
for childhood respiratory ailments are unnecessary.
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- OK, so you and your doctor agree that, from now on, no
more antibiotics for trivial ailments. You won't ask for them and she won't
prescribe them unless and until they're needed.
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- That should take care of your personal antibiotic resistance
concerns -- unless you plan to eat food.
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- The Union of Concerned Scientists estimates that 70 percent
of the antibiotics being used in the United States today are fed to healthy
pigs, cows and chickens to promote growth and prevent disease. Of the 19
classes of antibiotics approved for use in animals, seven are commonly
prescribed for human infections -- including Cipro, Bactrim and ampicillin.
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- As a result, there's a growing number of common food-borne
bacteria strains -- such as listeria and E. coli -- that are becoming resistant
to antibiotics.
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- "This is a blind risk," says Dr. Linda Tollefson,
deputy director of the Center for Veterinary Medicine, part of the U.S.
Food and Drug Administration. "People are getting resistant pathogens
through food, and they don't even know it's happening. They are not in
the hospital for some necessary treatment where they pick up a resistant
pathogen. The risk that we're talking about is a crapshoot. It comes from
eating food. And most people eat food."
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- Several types of drug-resistant bacteria are believed
responsible for recent reports of drug-resistant infection.
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- For instance, an E. coli strain resistant to Bactrim
led to an outbreak of urinary tract infections among women on college campuses
across the United States last year. Although urinary tract infections aren't
normally epidemic, the widespread incidence of the same bacteria led investigators
to believe the source was food-borne, Tollefson says.
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- Then there's the Campylobacter bug, the most common bacterial
cause of diarrheal illness in the United States. It infects 2 million Americans
each year, usually through contact with raw chicken. Approximately 15 percent
of the germ found in a random sample of Americans was of a strain resistant
to the antibiotic Cipro. It was the same strain of the germ found in at
least 10,000 cases of drug-resistant infection reported in 2001, Tollefson
says.
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- In addition, one strain of the salmonella bacteria --
commonly transmitted to humans through foods such as chicken -- that causes
typhoid fever is now resistant to tetracycline, ampicillin, streptomycin,
sulfonamides and choloramphenicol, she says.
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- The list is long and growing, but since you obviously
can't stop eating, what should you do?
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- Proper food handling and cooking can prevent some infections
caused by food-borne bacteria. Hands, utensils and all surfaces that come
into contact with raw meat or eggs should be washed thoroughly with soap
and water. And all food from animal sources should be thoroughly cooked
or pasteurized before being eaten, health experts say.
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- Vegetarians aren't off the hook either. Vegetables and
fruits are not immune from exposure to food-borne bacteria, and should
be washed thoroughly as well.
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- Ron Phillips, a spokesman for the Animal Health Institute,
contends that the "use of antibiotics in animals is not the 'major
driver' behind the resistance issue. What's amazing is that we've been
using antibiotics in animals for 50 years, and, although we're still using
the same compounds we began with, they are still effective."
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- Phillips and Tollefson took part in a public meeting
sponsored by the Center for Veterinary Medicine last month that was aimed
at completing a new categorization system for antibiotics used in animal
production. The system is designed to discourage the use of antibiotics
in animals that are important human food sources.
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- Even if adopted, the system would provide only guidance,
not regulation.
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- "This is a long process," says Tollefson, adding
that the decision to ban the use of such antibiotics is unlikely to lie
with the U.S. Food and Drug Administration.
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- "I think it's taken several years to convince the
food production industry the problem is real and that they have a role
to play, but we don't have any means to make that societal judgment,"
she says. "That would have to be done by Congress."
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- So, while you're waiting for Congress to act, wash your
knives, cutting boards, hands and tomatoes carefully.
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- What To Do
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- To learn more about antibiotic resistance and food-borne
illness, visit the U.S.
<http://rd.yahoo.com/dailynews/hsn/hl_hsn/inlinks/*http://www.cdc.gov/narms/faq.htm>
Centers for Disease Control and Prevention.
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