Dr Stuart Levy, 'Father of Antibiotic Stewardship,' Dies at 80

Troy Brown, RN

September 24, 2019

Stuart Levy, MD, a "gifted scholar" and "gentleman" who was widely known as the father of antibiotic stewardship, died September 4 at the age of 80 years.

Levy first demonstrated that routine use of antibiotics to promote growth in farm animals could cause antibiotic resistance in animals and humans in 1976. He worked tirelessly to warn the world about the dangers of misusing antibiotics, according to an obituary published online September 19 in The Lancet.

Levy died on September 4 from Parkinson's disease, his daughter Suzanne said in an obituary published September 19 in the Washington Post.

Dr Stuart Levy (The Boston Globe/Getty Images)

He was an emeritus professor of molecular biology and microbiology at Tufts University School of Medicine in Boston, Massachusetts, where he was a professor of molecular biology and microbiology, and of medicine from 1971 until his retirement in 2018. He was the director of the Center for Adaptation Genetics and Drug Resistance at Tufts University School of Medicine, according to an obituary published online September 11 in The Scientist.

He cofounded the Alliance for the Prudent Use of Antibiotics (APUA) in 1981, of which he was president. In an obit on the organization's site, Levy was remembered by APUA chair Pierre Tattevin, MD, PhD, as the "father of antibiotic stewardship."

Levy was also a past President of the American Society for Microbiology. He wrote more than 300 papers, including a significant study in 1978 identifying the "active efflux" mechanism by which tetracycline becomes resistant to E. coli and some types of cancer become resistant to cancer-treating drugs, according to a Tufts obituary published online September 13.

Helen Boucher, MD, FACP, FIDSA, an infectious disease physician and director of the Infectious Diseases Fellowship Program at Tufts Medical Center, told Medscape Medical News that she has known Levy since she began working at Tufts in 2002 but has been familiar with his work since the beginning of her career during the 1990s.

Levy trained some of the fellows when Boucher was the fellowship director there and she worked with him "more on the policy side" to combat antibiotic resistance during the last 10 to 15 years, she said. She worked with Levy most recently as they established the Tufts Center for Integrative Management of Antimicrobial Resistance — of which Boucher is director.

"[W]e really established that center in hopes of carrying on Stuart's legacy here at Tufts," she explained.

A "gentleman" and an "outstanding scholar," Boucher said Levy "was willing to stand up in a very respectful way to the status quo. He was the first one to really call into question the use of antibiotics in feed animals and when he did, it was really unpopular. He managed to stick to the science and present his ideas in a way that was well-received."

The US Food and Drug Administration banned the use of antibiotics for growth promotion in animals in 2017, according to The Bureau of Investigative Journalism.

Boucher recalled a "really special event" they had to honor Levy in March. "We had a symposium to kick off our center in Stuart's honor that was just a beautiful day, really well-attended by the scientific community but also by Stuart's family and Stuart himself."

Antibiotics in Chicken Feed

Levy studied English at Williams College in Williamstown, Massachusetts, and graduated magna cum laude in 1960. He graduated with a medical degree from the University of Pennsylvania in Philadelphia in 1965, did his medical residency at Mt. Sinai Hospital in New York City, and conducted postdoctoral research at the National Institutes of Health in Bethesda, Maryland.

Levy received honorary degrees in biology from Wesleyan University and Des Moines University. He received the American Society for Microbiology's Hoechst-Roussel Award for esteemed research in antimicrobial chemotherapy in 1995, the International Society of Chemotherapy's Hamao Umezawa Memorial Award, and the Abbott-ASM Lifetime Achievement Award in 2012, according to information provided to Medscape Medical News by a Tufts spokesperson.

In 1976, Levy set out to demonstrate the effects of feeding small amounts of antibiotics routinely to chickens to fatten them up, in a groundbreaking study published September 9, 1976, in the New England Journal of Medicine.

He gathered two groups of chickens: one group was given feed containing small amounts of antibiotics and the other group was given feed with no antibiotics. The results were stunning: The chickens given antibiotics showed developing antibiotic resistance, but the chickens given the antibiotic-free chicken feed — and the human farm workers — subsequently also developed evidence of antibiotic resistance.

Levy spent his life talking to anyone who would listen — the media, scientists, politicians, and health organizations including the Centers for Disease Control and Prevention and the World Health Organization — about the dangers of antibiotic misuse.

In 1992, he published his book The Antibiotic Paradox: How Miracle Drugs Are Destroying the Miracle. That book has since been updated to The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers.

"Never Had a Bad Day"

In 1996, Levy recognized that new antibiotics would be needed in the future yet pharmaceutical companies were not developing them, so he cofounded Paratek Pharmaceuticals with Walter Gilbert, PhD.

"Stuart was a distinguished physician who was the forefront of antibiotic development and a dedicated champion for the prudent use of antibiotics," Evan Loh, MD, Paratek chief executive officer, said in a company news release. "More importantly, he was a dear friend and mentor to so many and his passion lives on in each of us as we work to continue his mission of combating the daily threat of life-threatening infections. We will greatly miss him."

He said that Japanese scientist Tsutomu Watanabe was responsible for his interest in antibiotic resistance. Watanabe identified newly antibiotic-resistant bacteria capable of spreading antibiotic-resistant genetic material among themselves and to different species by the early 1960s, according to the Washington Post. In 1964, while in medical school, Levy spent a summer in Watanabe's research laboratory in Tokyo and collaborated with the researcher on several papers.

"[Levy] worked until the very end of his career, that's how dedicated he was to this problem, and I think that's really inspiring, especially for younger people," Boucher said.

His eldest son, Arthur, said at the memorial for his father that he was a loving, attentive dad, who "never had a bad day, or at least his kids didn't know it."

Recalling that Levy had "deep ties and friends all over the world," Arthur recounted to Medscape Medical News that he said, "Whether I was studying abroad in Amsterdam, on a family vacation in Paris, or on a father-son trip to the Berkshires, there was always someone Dad knew who wanted 'to stop and meet his son.' Maybe he met them 30 years ago at the Pasteur Institute in France, or in Indonesia where he lived for a summer, or on a boat in Croatia...but they always became life-long friends."

Levy is survived by his wife of 35 years, Cecile; his three children, Suzanne Levy Friedman of Washington, Arthur Levy of San Francisco, and Walter Levy of Boston; and his sister and twin brother.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: