STANFORD, CALIF. — Bacteria are no longer just resistant, but have learned how to live on antibiotics as their only food source, according to the first study to analyze bacterial resistance in soil samples.
Dr. Alan Greene, a pediatrician with a special interest in the environment, found this study in Science while reviewing journals for articles that affected the practice of pediatrics. This article revealed that antibiotics excreted from humans and livestock are plentiful in soil (Science 2008;320:100-3).
“We're treating not just our patients but the environment, and it's beginning to have an impact,” Dr. Greene said at a pediatric update sponsored by Stanford University.
Reducing U.S. beef consumption by 10% or replacing 10% of conventional livestock with organic beef sources would eliminate 2.5 million pounds of antibiotics from the environment and soil, more than twice the amount of antibiotics prescribed by U.S. physicians each year, said Dr. Greene of the university.
About 40% of health care dollars spent on drugs in pediatrics buy antibiotics, which has got to change, Dr. Greene said. He reported having no financial relationships relevant to his presentation.
A subsequent issue of Science devoted entirely to drug resistance recommended drastically reducing the prescribing of antibiotics, and saving them for when they are really needed (2008;321:313-423). Rather than completing a 7- to 10-day course of antibiotics, it may be better to treat for a day or two until the patient is feeling better, then stop the drug and rely on the immune system, some of the authors suggested.
“I'm not ready to say that we should do that,” but antibiotic prophylaxis is being deemphasized for some pediatric medical problems, Dr. Greene said. Recent guidelines recommend limiting antibiotic prophylaxis for infective endocarditis to select patients, and say prophylaxis will not prevent pyelonephritis and renal scars in children with vesicoureteral reflux.
'We're treating not just our patients but the environment, and it's beginning to have an impact.' DR. GREENE