Doctor Knows Best: Why Antibiotics Are NOT Always The Answer

Two important questions I often hear from my patients are, “Should I buy organic foods for my family?” and “Does my child need an antibiotic?” A recent report from the American Academy of Pediatrics on antimicrobial resistance has helped answer both questions.

Antibiotic-resistant bacteria is becoming a growing health crisis

Lauren Adler MD

Lauren Adler, MD, FAAP

The AAP report, “Nontherapeutic Use of Antimicrobial Agents in Animal Agriculture: Implications for Pediatrics,” identifies antimicrobial drug resistance as a growing public health crisis and points to a common farming practice as a contributing cause. “According to the AAP, adding antibiotics to the feed of healthy livestock to promote growth, increase feed efficiency or prevent disease among herds in crowded conditions often leaves the drugs ineffective when they are needed to treat infections in people,” the report states.

It has been estimated that 80% of the overall tonnage of antibiotics sold in 2012 were for animal use. Worryingly, 60% of these antibiotics are the same as the medicines used in humans. This persistent use of low doses of antibiotics causes the development of a significant amount of antibiotic resistance.

Our children are then exposed to these resistant bacteria through the food supply, through direct contact with these animals on a farm and through environmental contamination. When animal feces are used in fertilizer or water runoff is used to irrigate crops, our fruits and vegetables can become contaminated with drug-resistant bacteria as well.

Young children are particularly at risk for antimicrobial-resistant infections

More than 2 million Americans become ill with antimicrobial-resistant infections each year, with more than 23,000 resulting in death, according to the federal statistics cited in the report. Yet, most troubling to pediatricians, our patients and their families is this statistic: For most types of infections reported to the Center for Disease Control and Prevention’s Foodborne Diseases Active Surveillance Network (FoodNet) in 2013, the highest incidence was among children younger than 5 years old.

“Children can be exposed to multiple-drug resistant bacteria, which are extremely difficult to treat if they cause an infection, through contact with animals given antibiotics and through consuming the meat of those animals,” said the report’s lead author, Jerome A. Paulson, MD, FAAP, the AAP’s immediate past chair of the executive committee of the Council on Environmental Health. “Like humans, farm animals should receive appropriate antibiotics for bacterial infections,” Dr. Paulson said. “However, the indiscriminate use of antibiotics without a prescription or the input of a veterinarian puts the health of children at risk.”

Resistance to antibiotics is caused by genetic changes in the bacteria themselves. When antibiotics are used, the susceptible bacteria are killed, leaving the resistant bacteria behind to multiply even faster.

When antibiotics should be used and when they should not

As pediatricians, we have been trained to be cautious about how often we prescribe antibiotics. Only bacterial infections need to be treated with antibiotics, such as:

  • ear infections
  • pneumonia
  • strep
  • UTI

If a child has a cold or virus, antibiotics will not help and using them in these cases simply promotes resistance.

Two solutions: buy organic and avoid the unnecessary use of antibiotics

Having read this report, I am more confident than ever that buying organic or at least antibiotic-free foods is one important step we can take toward our families’ health. And remember, when your pediatrician explains to you that your child does not need an antibiotic for his/her cough, your doctor is not trying to be difficult, he/she is trying to do the best thing for your child and for society.

If we all work together — farmers, legislators, pediatricians, parents, kids — I am confident that we can change this situation for the better.

By Lauren Adler, MD, FAAP, Lead Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners

by WHA-Admin