Are You Taking Antibiotics Without Knowing It?

Shelly J. Park, PharmD Candidate 2008
Shenandoah University
Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

Antibiotics are no longer as effective as they used to be.  When you take too many antibiotics or do not take them correctly, you can create “super bugs.”  These bacteria are known as being “resistant.”  This means that antibiotics cannot kill the bacteria.  These resistant bacteria can then spread and infect people around us. 

Resistant bacterial infections are dangerous and life threatening.  In 2005, almost 19,000 people in the U.S. died from such an infection called MRSA (methicillin-resistant staphylococcus aureus).  CNN reported in October 2007 that a high school student in Virginia died from the infection.  Twenty-two Virginia schools closed down to try to clean out the bacteria. 

The MRSA bacteria is a good example of a “super bug” that is killing people.  These bacteria are able to fight off antibiotics because they have built up a resistance by being exposed to low levels of antibiotics over a long period of time.  They can thrive in the presence of antibiotics.  They can even multiply to produce more bacteria that will not respond to antibiotics. 

A study of patients in four Minneapolis area hospitals was done in October 2006.  The patients either had resistant bacterial infections or non-resistant bacterial infections.  They found that patients with the resistant bacteria were “more than seven times more likely to have used an antibiotic in the previous six months.”  This proved that using antibiotics put people at a higher risk for getting resistant bacterial infections.

The U.S. is taking steps to reduce needless antibiotic use.  Not long ago, governmental health agencies released an action plan to fight antibiotic resistance.  The World Health Organization also published a report to raise awareness about the dangers of antibiotic resistance and the overuse of antibiotics.

Everyday exposure to antibiotics

Antibiotics are prescription medicines.  No one should take antibiotics without the approval of a medical professional.  However, consumers are taking small amounts of antibiotics everyday without realizing it. 

Antibiotics in meat

We must remember that antibiotics are not just used by people.  They are mixed with food to feed livestock.  According to the FDA, in the early 1950’s, farmers discovered that adding antibiotics in animals’ foods made the animals grow bigger and faster.

Research has found that 40% of all antibiotics sold in the U.S. are for agricultural use.  Most of the antibiotics used in agriculture are used to speed up the growth of livestock.  The antibiotics are “not used to cure sick animals but to promote ‘feed efficiency.’”  This means that they “increase the animal’s weight gain per unit of feed.”  This helps to lower meat prices at the food market. 

Many studies have confirmed that antibiotics fed to livestock show up in the meat.  And then we eat that meat.  The FDA has recently reported that chicken and turkeys given fluoroquinolone antibiotics produced specific fluoroquinolone-resistant bacteria.  And this bacteria infects over 10,000 people in the U.S. every year.  It is scary because fluoroquinolones are a very commonly-used antibiotic.  This has become such an important issue that health groups are taking action:

1. In 1977, FDA proposed an end to using low levels of the antibiotics penicillin and tetracycline in animal feeds.
2. In 1984, the Natural Resources Defense Council proposed an immediate stop to using low levels of penicillin and tetracyclines in food-producing animals.
3. In 1997, the World Health Organization recommended a stop to using antibiotics in livestock feed if those antibiotics are the same ones or related to ones used to treat humans.
4. In 1998, the Center for Science in the Public Interest recommended that the FDA stop the approval of fluoroquinolones in chickens.

Antibiotics in vegetables

Antibiotics can also be found in vegetables and fruits.  The U.S. Department of Agriculture funded a study to test this.  Scientists took manure from animals that were given antibiotics.  They grew different plants in the manure and then tested its leaves.  What they found was alarming: 

1. The antibiotic was present in fruits, vegetables as well as the vegetable leaves. 
2. The amount of antibiotic in the plant was directly related to the amount in the soil. 
3. The plants absorbed antibiotics in the soil as it grew.
4. Crops that grow underground might absorb even more antibiotics from the soil.  Examples of such crops include potatoes, radishes, and carrots.

Antibiotics in water

Our struggle to keep antibiotics effective in treating diseases does not stop with animals and produce.  Antibiotics are also in our streams and rivers.  In 2002, the U.S. Geological Survey tested 139 streams in 30 states.  They found that 80% of the streams had traces of chemicals used for human and animal medicines.  They also found dozens of pharmaceuticals and other chemicals in streams and rivers across the U.S.  This is not only animal feed antibiotics but also antibiotics and other drugs that we flush down the toilet without a second thought.

It might seem that “traces” of an antibiotic does not sound that dangerous.  But “traces” of an antibiotic is exactly what helps bacteria become resistant.  The bacteria gradually fight off the antibiotic when it is confronted with it again.  Furthermore, such bacteria can also more easily learn how to resist other antibiotics.

How can you protect yourself?

So what is the best way to get rid of medicines we no longer need?  You can ask your local pharmacy if they can dispose of unused medicines for you.  Also, your city or state might have drug disposal programs that you can take advantage of.  Contact your city or state government to ask if they provide this service.

If these options are not available, the Office of National Drug Control Policy advises mixing unwanted medicines with undesirable substances.  These can be anything from cat litter to used coffee grounds.  This is done so that children or animals will not eat them.  You can then place them in sealable bags and throw them in the trash.  Medicines should never be flushed down the toilet unless the accompanying patient information specifically says so.

Decreasing the amount of antibiotics you eat from food is also a good idea.  You can do this by choosing organic meats and vegetables when possible.  Even when you dine out, you can ask the restaurant if they use organic products.  Some restaurants now have organic menu options to meet this demand.

We all know that washing your hands is important to avoid infections.  Scientists are now studying if using soaps labeled as “antibacterial” can cause resistance in bacteria.  There are more antibacterial soaps now than ever before.  But that does not mean they are better than regular soaps.  A recent study found no benefit of using such soaps compared to regular soaps.  The Centers for Disease Control recommends the following steps to wash your hands:

1. Hands should be washed using plain soap and warm, running water.
2. Hands should be rubbed vigorously during washing for at least 20 seconds with special attention paid to the backs of the hands, wrists, between the fingers and under the fingernails.
3. Hands should be rinsed well while leaving the water running.
4. With the water running, hands should be dried with a single-use towel.
5. Turn off the water using a paper towel, covering washed hands to prevent re-contamination.

Lastly, it is important that you use antibiotics only when you need them.  If your doctor does not give you an antibiotic for an illness, it probably means that you do not need one.  Do not demand antibiotics from your doctor.  If your doctor does give you an antibiotic, follow the directions carefully.  Antibiotics need to be taken at regular intervals and for the full length of time so that more bacteria are killed and less resistance develops.

Bacteria are all around us.  Since it is impossible to avoid them, it is important that we each try to protect ourselves so that antibiotics will still be able to fight these bacteria.  Scientists are working hard to come up with stronger antibiotics, but it is not easy.  There are already many resistant bacteria that antibiotics cannot kill.

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