Antibiotics in crisis

Critical mass: Bacteria with multiple drug resistance kill around 23,000 people per year in the US alone, and a similar number across Europe. That figure corresponds to the capacity of the Arthur Ashe Stadium in New York shown here, or the O2 Arena in London. (Photo: Wikimedia Commons/davidwboswell) The US Food and Drugs Administration once proposed a regulation to ban the use of three antibiotics in cattle feed, where they act to promote growth, not to fight disease. The industry opposed the measure and won. That was 35 years ago. The practice is still being used today, even though the loss of efficient antibiotics and the return of infectious diseases is now a clear and present danger to the lives of millions. Former editor-in-chief of Science magazine Donald Kennedy was involved in the FDA proposal back then and has recently revisited the issue in an editorial (Science (2013) 342, 777). Around three quarters of antibiotics sold in the US are for veterinary use, says Kennedy. While inappropriate prescriptions for and inadequate use by human patients also contribute to the problem, Kennedy argues that “antibiotic resistance will be solved only when we end the use (or rather, the abuse) of these agents in veterinary medicine.” Kennedy now sees new hope, as a new FDA draft guideline, known as Guidance #213, could be implemented soon. It would be none too early, as a recent report from the US Centers for Disease Control and Prevention (CDC) describes the dramatic extent of the antibiotics crisis (Antibiotic Resistance Threats in the United States 2013, http://www.cdc.gov/drugresistance/ threat-report-2013/) and current research and development offers only very few and faint silver linings.