Resistance Down on the Farm
Many commenters expressed the concern that medical use of antibiotics in humans is only part of the problem of developing antibiotic resistance. Some believe that antibiotic resistance is not caused by prescriber habits but by excessive use of antibiotics in farm animals and agriculture. Readers mentioned that "industrial farming is the biggest culprit of antibiotic misuse," and that addressing the farm use of antibiotics is the "number-one way to fight antibiotic resistance." A nurse practitioner questions why "we are focusing on a minority of prescribers instead of the food industry." One physician agrees that "antibiotics used in animals that eventually end up on consumers' plates may also contribute to some antibiotic resistance. Studies should be performed on this before attributing so much of the responsibility to clinicians."
Similarly, some clinicians believe that the inappropriate disposal of unused antibiotics is driving the resistance problem, because it permits resistance to thrive outside of the human body in the absence of immunologic pressure. Routine use of antibacterial soaps is also mentioned as a factor in the emergence of resistance.
A dissenting opinion was expressed about this issue as well. "We need comprehensive epidemiologic studies to understand the true risk and how to best provide safe food vs knee-jerk statements on antimicrobial use. Whenever risk assessments are done, farm use is not showing up as where resistance is coming from."
Dr. Spellberg believes that the concern about the use of antibiotics in animals is overstated. "It's not an 'either/or' question," says Dr. Spellberg. "Both contribute to resistance. We don't know what proportion of the problem is attributable to human or animal use, but it's not worth bickering about. This is merely an unhelpful distraction to the problem of resistance."