9 ms·

Australia's overuse of antibiotics driving rate of drug-resistant infections

218 points by adrian_mrd 3y ago

nostromo 3y ago
73% of antibiotics globally are used for livestock production, not for human use, and yet we tend to only hear about how humans need to cut back. How about we require ranchers to decrease their animal density so they don't need to use so many antibiotics? https://www.nrdc.org/resources/us-livestock-industries-persist-high-intensity-antibiotic-use#:~:text=An%20estimated%2073%20percent%20of,have%20repeatedly%20found%20that%20the https://www.nrdc.org/resources/us-livestock-industries-persi...
- bequanna 3y ago
  I agree with you on high density confinement livestock production. But is there evidence of antibiotic resistant strains in animals causing issues for humans?
  - rtkwe 3y ago
    There are a number of bacteria that have made the jump from animals to people so creating a huge breeding pool for very antibiotic resistant bacteria that have generated human viruses in the past seems like a poor choice.
    - kungfufrog 3y ago
      Do you mean bacteria? Viruses are not treated by antibiotics.
  - rando_dfad 3y ago
    Yes, a quick google turned up these: Antibiotic Resistance from the Farm to the Table. September 11, 2014. Available at: http://www.cdc.gov/foodsafety/from-farm-to-table.html http://www.cdc.gov/foodsafety/from-farm-to-table.html. Accessed September 14, 2015. https://www.who.int/news/item/07-11-2017-stop-using-antibiotics-in-healthy-animals-to-prevent-the-spread-of-antibiotic-resistance https://www.who.int/news/item/07-11-2017-stop-using-antibiot... ANTIBIOTIC RESISTANCE—LINKING HUMAN AND ANIMAL HEALTH https://www.ncbi.nlm.nih.gov/books/NBK114485/ https://www.ncbi.nlm.nih.gov/books/NBK114485/ Much of modern medicine depends on antibiotics. The above resources give clear and compelling evidence that overuse of antibiotics in livestock is associated with increases in drug-resistant infections in humans.
- FirmwareBurner 3y ago
  >How about we require ranchers to decrease their animal density so they don't need to use so many antibiotics? That would massively drive up meat prices and anger voting consumers who won't be able to afford meant anymore, and also anger voting meat producers who will go bankrupt from slumping sales and have to lay off workers, all of which who will direct their anger at the politicians who restricted the use of antibiotics in animal farms. So not gonna happen politically. Consumers have to either accept higher meat prices (not gonna happen), or accept that we're too many consumers on the planet for everyone to be fed with organically grown meat (also not gonna happen), so we just kick the can down the road and sweep the dirt under the rug until the titanic hits the iceberg and there's no way forward anymore. Here in the rich EU countries we have some rules and regulations on meat production, but enforcement is very lax and it's an open secret that those certification seals of approval are basically worthless as animals are still caged together crowded in their own filth, with massively infected open wounds full of puss, and pumped full of antibiotics just to stay alive long enough to become burgers. You should Google those images if you want to become vegan but lack the motivation. It's a political tragedy of the commons that's found in a lot of other areas in our lives/society which we know for a fact are wrong and are harming us (or others from less fortunate parts of the world), but we still stick to them because they're very profitable industries generating $$$ and jobs, and they're such a tight part of our daily lives, they're nearly impossible to undo today, like all the pollution from car dependence, microplastics, the cheap cocoa and coffee industries driven by slave labor, etc. See the dead body spaghetti episode from Rick and Morty, it's pretty good satire on our collective hypocrisy on this topic. We know those are all bad, but we choose to look the other way and not do anything about it because we love our lifestyles with cheap car traveling, cheap shipping, cheap meat, cheap coffee, cheap clothing, etc. and all the associated profits.
  - omginternets 3y ago
    I’d rather pay a bit more for meat than be forced down the path of questionable meat-substitutes. Maybe meat has been unsustainably cheap for a long time? I am quite far from the vegan ideology, but still willing to recognize that there is something untenable about our current relationship with livestock.
- whatshisface 3y ago
  Because doctors and farmers have more effective representation than anyone who looks at the whole.
- flukus 3y ago
  > yet we tend to only hear about how humans need to cut back There's also financial reasons to do so, with livestock the financial reasons are likely reversed. Beside that, anti-biotics also have side effects that can make you more sick, their use is not just unnecessary but counter productive. Some of the side effects can be serious and long term, like changing your gut bacteria.
- meany 3y ago
  At least in the US there has been recent progress on this. The USDA just released new rules on June 11, 2023. https://extension.umn.edu/news/over-counter-livestock-antibiotics-are-moving-prescription-only-june-11-2023 https://extension.umn.edu/news/over-counter-livestock-antibi... Starting June 11, 2023, all currently available over-the-counter antibiotics for livestock will be available only as prescription medications. This new rule will impact all livestock species. Over-the-counter antibiotics are moving to prescription only to provide more veterinary oversight. Similar to the Veterinary Feed Directive, placing antibiotics under the supervision of veterinarians should result in more judicious use and less antibiotic resistance. This change includes but is not limited to the following: Penicillin, Oxytetracycline, Sulfa antibiotics and Mastitis tubes. Some medications are not considered crucial for human medicine and will remain over-the-counter. This includes the following: Ionophores including Rumensin and Bovatec, Parasiticides, such as Ivermectin, Oral pre/pro/postbiotics, and topical non-antibiotic treatments. Livestock producers must have a valid Veterinary-Client-Patient Relationship (VCPR) in place before they can be prescribed antibiotics by a veterinarian. A VCPR is a working relationship between a veterinarian (veterinary clinic) and a client. Ideally, a VCPR is a documented agreement between both parties that includes a dedicated visit to the animal location(s) the client operates. This visit and documentation must occur at least once every year to maintain the VCPR.
  - deleted 3y ago
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  - KennyBlanken 3y ago
    This is progress but still drastically short of EU regs where livestock/poultry are subject to stricter vaccination requirements. For example, vaccination for salmonella. In the US, poultry industry and federal/state governments have spent endless effort "programming" people to think that it's their responsibility if they get sick because the meat or eggs they purchased were contaminated and they didn't take enough preventative steps (like cooking it to the point of it being nearly inedible.) Most US poultry is rinsed in chlorinated water, eggs are washed as well (which ends up destroying the egg's natural coating, so they have to be refrigerated) and so on.
- alkonaut 3y ago
  I don't buy meat from anywhere you can give healthy livestock antibiotics, period. It's really easy (obviously in case you live in such a country you'd be forced to not buy meat or buy imported, which is more expensive and worse for the environment).
  - renewiltord 3y ago
    How to determine this? Do you have to analyse supply chain or do you just have no chain (i.e. you are near farm and you know farm owner)? EDIT: Thank you to responses below.
    - lozenge 3y ago
      > In January 2022, the routine use of antibiotics was banned in the EU, and preventative use was restricted to exceptional treatments of individual animals EU law is pretty strict about labelling meat coming from the EU/outside the EU so that could be one way.
    - layer8 3y ago
      Organic meat generally implies no antibiotics, for example under the USDA label.
    - alkonaut 3y ago
      I just look at the flag and know which countries have good meat. E.g. https://ourworldindata.org/grapher/antibiotic-usage-in-livestock https://ourworldindata.org/grapher/antibiotic-usage-in-lives... There may be local regulations or labellings to (e.g. some organic labeling means no antibiotic and so on). But as a first rule I just try to avoid meat from "bad" countries. E.g. we get quite a lot of imported Brazilian beef in stores and I know it's terrible both for deforestation and antibiotics so I avoid that completely. Some interesting differences in the map is e.g. between Australia And NZ.
      - willsmith72 3y ago
        So all your meat is imported from another country? Surely in the long run there are better more sustainable ways
- treypitt 3y ago
  Obviously because that would require people cut back on meat consumption. I was struck by a recent study indicating most men would rather die young than stop eating meat: https://www.menshealth.com/uk/nutrition/a36261605/red-meat-health/ https://www.menshealth.com/uk/nutrition/a36261605/red-meat-h...
  - bimguy 3y ago
    "most men would rather die young than stop eating meat" Seriously, you're going to phrase it like that? How about this, I enjoy a balanced diet and if that is going to kill me young then so be it. If I was scared of dying I would be much more worried about the coat of plastic dust that lines the entire planet, including vegetables being grown and the grass/feed that animals eat, and the fact that I'm extremely likely to die of cancer due to plastics everywhere, metal particles everywhere, chemicals everywhere... if the meat doesn't get me first.
    - artimaeis 3y ago
      What if it wasn’t about you dying? What if it was to make the world better? What amount of suffering in the world would cause you to even consider the option of eating less meat? Is it something you’re willing to contemplate? Not just animal suffering either. Think of the complicated web of problems that come out of people eating too much meat. The antibiotic use discussed in this thread. The methane byproduct discussed in countless others. The inhumane conditions of most butchers (for workers! Let’s forget the animals still). It’s okay if none of that bothers you. We’re only human. I’m a former vegan, I’ve likely considered it all more than strictly necessary. I don’t think anyone _has_ to be anything. But for what it’s worth it _could_ be about more than an individual’s health.
      - bimguy 3y ago
        "What if it wasn’t about you dying? What if it was to make the world better?" That would be a different discussion, with a different answer. I was only replying to the comment above mine. Yes... animals produce waste & suffer from infections... Inhumane conditions exist in the minority in every industry. You're claiming most butchers/abattoirs have inhumane conditions in an industry that I'm certain you've never worked in. You're a former vegan but I see that you're still brain-washed by the material that you were hand fed.
- rqtwteye 3y ago
  Same for water. We are told to have shorter showers while farmers use most of the water for inefficient practices to grow unsuitable plants for the region.
- rmccue 3y ago
  I don’t believe this is true in the Australian context though: > Australian animal industries are one of the lowest users of antimicrobials in the world https://www.amr.gov.au/about-amr/amr-australia/animal-health https://www.amr.gov.au/about-amr/amr-australia/animal-health
  - knifie_spoonie 3y ago
    Another commenter below posted this map: https://ourworldindata.org/grapher/antibiotic-usage-in-livestock https://ourworldindata.org/grapher/antibiotic-usage-in-lives... Assuming the data is accurate, it would seem antibiotic use (not sure how that compares with antimicrobials in general) is not particularly low compare to other countries.
    - rmccue 3y ago
      Interesting! From the cited paper itself: > The top 5 consumers in 2020 were China, Brazil, India, USA, and Australia But also: > In contrast, Australia now also appears among the top 5 –however, in the absence of any public report of AMU since 2010 [29], usage for Australia was obtained through extrapolation, as with other countries that do not report data. Therefore, predictions may not accurately reflect the current country efforts to reduce AMU. So it's not clear if the data actually is accurate (and the paper really is about how accurate data is missing for many countries).
- BurningFrog 3y ago
  How much does livestock eating antibiotics really affect the problem of resistant bacteria infecting humans? Farmers don't use antibiotics for fun. It increases meat production by 5-10%. So expect meat prices to go up by about that amount if the practice gets banned.
  - GeekyBear 3y ago
    > How much does livestock eating antibiotics really affect the problem of resistant bacteria infecting humans? Bacteria transfer genes from one species to another, so an innovative new genetic mutation that allows one kind of bacteria to shrug off antibiotics more effectively won't stay only in that species of bacteria or only on that farm. > Horizontal gene transfer is the movement of genetic information between organisms, a process that includes the spread of antibiotic resistance genes among bacteria, fueling pathogen evolution. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536854/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536854/
- seunosewa 3y ago
  This means more expensive food. Are the poor willing and able to pay more?
  - bromuro 3y ago
    Are “the poor” and “the rich” willing to have an healthier diet? Meat should be an expensive food. it’s costs for the environment and the humanity are too high.
mjsweet 3y ago
I had a chest infection lasting months from mid-june to mid-October, and despite a run of Moxy, then Augmentin, then Roxy, and finally Cefalexin, nothing worked. Out of options, I tried a friend's suggestion: raw garlic and honey. After three weeks, my symptoms and long COVID issues improved. It was a stubborn infection that caused me to over-relying on antibiotics, as the article suggests. Makes me wonder about GP's exploring alternatives, especially with rising drug resistance.
- Waterluvian 3y ago
  I found that three weeks + water worked when I had a similar issue. To be honest the water felt good. I envisioned peeing as a way to flush the badness out despite knowing that’s just not really how it works.
  - mantas 3y ago
    You feeling better drinking water certainly did help.
    - Waterluvian 3y ago
      Yeah, like water obviously helps. And the placebo of imagining like… “sickness” being flushed out helps too.
      - mantas 3y ago
        Yes. Placebo is one of the strongest drugs we got. The problem is how to make a strong placebo… But I remember an interesting study that placebo works even if patient doesn’t believe in it. Ot as effectively though.
- martinky24 3y ago
  Extremely scientific anecdote you got there!
  - deleted 3y ago
AniseAbyss 3y ago
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ricardobeat 3y ago
1/3 of the population in one year? That's insane. I've only taken antibiotics once in my entire life, and can count on my fingers the amount of times someone mentioned taking them in the last decade. Are doctors prescribing antibiotics for the flu?
- siquick 3y ago
  Lived in Australia for over 10 years and can confirm that GPs here are, on the whole, pretty useless. Most appointments last under 2 minutes and end with a script, usually antibiotics of some kind. I had covid recently and a woman at work who had identical symptoms but wasn’t testing positive went to the GP and was prescribed antibiotics.
  - tppiotrowski 3y ago
    I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. In the US, you would demand them from your doctor and they would say no. Whether it was placebo or not, it did usually seem to make me feel better.
    - ykonstant 3y ago
      > I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. Those two sentences contradict each other; it is a very irresponsible thing to do. Also, yes, if every time you have a cold, you get antibiotics and they make you feel better, it is placebo.
      - fl0ki 3y ago
        An even simpler explanation is return to mean. They were going to get better in a few days anyway, with or without antibiotics. But if they keep getting antibiotics each time, they're always going to think that they helped. Confirmation bias comes in here too, why not. What's even worse is that unnecessary use of antibiotics can affect someone's gut biome and leave them worse off for months, in some extreme cases years. I have had antibiotics only a couple of times in my life (for bleeding injuries) and I noticed the effect on my gut each time. To think that people create this problem when they don't have to is alarming. I hope for their sake their doctors _are_ prescribing them placebos so it's harmless ignorance.
jjcm 3y ago
I found this to be pretty true while Living in Australia. I was always surprised at how cavalier doctors were about giving these out. I think it stems from two things - one is what they quoted in the article, that there's a "cultural expectation in Australia that there’s a pill or a tablet for every problem". People who go to the doctor expect a solution. I suspect the other thing is how often Australians go to the doctor. Americans tend to be pretty hesitant to see doctors due to pricing of health care. In Australia, if you're sick, you go to the doctor. This is true even for common colds. Some stats, in 2010 Americans saw the doctor on average around 3.9 times a year (and this number is on a downward trend from the previous survey)[0]. In Australia this number is a bit harder to break down. Some politicians have cited that on average people see a doctor 11 times a year. Medicare stats breakdowns put that number at somewhere closer to 7[1]. Either way, it's a significant increase in comparison to Americans. It's more common to go see the doctor. Unfortunately the article doesn't cite their sources here. One thing I'd be very curious about is what percentage of doctor visits result in antibiotics when comparing Australia vs the United States. My hypothesis is that despite cultural pressures, it may actually be that prescription rates per visit are quite similar between the two countries, and it's just that Australians seen the doctor more often. [0] https://www.census.gov/newsroom/releases/archives/health_care_insurance/cb12-185.html https://www.census.gov/newsroom/releases/archives/health_car... [1] https://www.servicesaustralia.gov.au/sites/default/files/documents/medicare-benefits-scheme-bulk-billing-net-statistics-1-july-2010-30-june-2011.pdf https://www.servicesaustralia.gov.au/sites/default/files/doc...
- nradov 3y ago
  I don't have the reference handy, but I read a study of US healthcare which found patient satisfaction to be highly correlated with whether they got a prescription at the end of an office visit. With a prescription the patients felt like they were getting their money's worth.
- climb_stealth 3y ago
  Hah, I wonder how people do it. The past few times I wanted to see my GP the appointments had lead times of 6 weeks or more. And they weren't bulk-billed. I'd joke that by then the issue would have either gone away or I'd be dead.
wdeasy 3y ago
I can confirm, they hand it out at the doctors in Australia for almost anything. I used to get sinus infections more than twice a year and they would give me antibiotics without testing if it was bacterial of viral. I started to refuse them few years ago and start to use salt water rinse which worked way better
lysndr 3y ago
[flagged]
iteratethis 3y ago
I'm from the Netherlands and once visited our Brazil office. One of my colleagues there seemed to be having a pretty bad cold so he exited our meeting. One hour later he was back, said he took antibiotics, and felt fine now. My jaw dropped. Dutch doctors are the opposite, as expats commonly complain about. Our first method of treatment (for various symptoms) is to send you back home and sit it out for a few days. Or just take some aspirins. The idea being that your body will heal itself over various ills, and that this is the preferred way. My mind was also blown when I heard that in many countries, people have medical cabinets at home. It being common that the typical non-senior adult has a stock with a wide array of medicines. I was raised on zero medicines, unless there's something critically wrong. Even taking an aspirin makes you a bit of a wimp. Cultural differences I guess.
- NoPicklez 3y ago
  As an Australian I am surprised of this article. I hardly ever take any medications at all let alone antibiotics willy nilly.
  - batiudrami 3y ago
    My partner is a GP and it is very common for patients to come in and, rather than describing symptoms, will ask directly for antibiotics. They can be quite pushy when she says no, so I imagine some doctors take the path of least resistance and just prescribe them.
    - anakaine 3y ago
      As an Aussie I've had the odd amusing chats with my GP on this topic. His response it usually a flat "antibiotics fix a problem which you don't have. Right now they will most likely make you worse by destroying bacteria which are helping you. Do you want to get worse?".
- meepmorp 3y ago
  The main reason why Dutch doctors don't prescribe antibiotics for colds is probably because colds are viral infections, not bacterial, so the antibiotics don't do anything. There's very little you can do for most colds apart from supportive treatment (pain meds, antipyretics, decongestants) and rest.
Blackadderz 3y ago
I have probably only been to the GP once or twice in my life... but that changed after having two kids. I believe some of this can be tied to the very rapidly changing demographics in Australia. I have no data to back this up, but I do see quite often amongst parents that they will shop around for a GP that gives them antibiotics because back *home*, that's what they were expected to do. So it is not uncommon for people to drive 30 minutes to their favourite GP somewhere to get exactly what they want...
aatd86 3y ago
Australia already has super animals and now it's getting super bugs...
Sophistifunk 3y ago
Bollocks, there's about seven of us, we're not going to drive anything. And we don't feed them to otherwise-healthy livestock, unlike some other countries.
1letterunixname 3y ago
That's right MSM, blame individuals, not Australian or global doctors or pharmacies. And definitely don't mention meat global agriculture for abusing antibiotics to grow animals faster while also making them less effective by evolving pathogens as well.
BeetleB 3y ago
> Australia ranks seventh-highest in the developed world for antimicrobial community prescribing rates. And the other 6 countries are...?
- nf17 3y ago
  I bet, India is on the top3. Pharmacy culture in India is liberal. U can walk into any pharmacy without prescription and buy most meds including Antibiotics. It's a different story online, but even then there are ways to get around.
Eumenes 3y ago
I don't understand this - I haven't had antibiotics since I was a young child. What is the average case we're talking about here? Most colds I've had go away in 3-5 days max. Old and vulnerable people with infections, I get, but no reason anyone under the age of 40 should be taking any unless very serious case.
stubish 3y ago
How do you breed antibiotic resistant gonorrhea without giving antibiotics to someone with gonorrhea? Giving someone a mild dose to treat some other infection, but not enough to properly treat the gonorrhea? I think if we are serious about antibiotic use in humans, we need to test for pathogens before or during treatment. Is there a mechanism to affordably do a broad spectrum screening of infections?
keepamovin 3y ago
What if it wasn’t antibiotics alone but the use of some pesticide that is interacting with them and the immune system and bacteria to make this more likely? Is the rate of resistance formation, the same as what you would expect from looking at other countries with the same usage profile of antibiotics? Have all other variables been controlled for?
Andaith 3y ago
Just some more anecdata, but it depends which GP practice you go to. There's a GP practice near us that pays really poorly, always young doctors, they never last more than a year, and the owner (an older GP who also works there) just wants happy return customers who are in-and-out. So yeah, they'll prescribe whatever. There's a better GP practice near me which won't actually do that though, most visits take the full 15 mins, they'll ask loads of questions and give you some tests and/or recommend over the counter stuff, and it's always "come back if it gets worse or doesn't get better by X". They charge for the first consult, but typically just bulk-bill for every visit related to that problem. Even chronic issues they typically bulk-bill. So yeah, quality varies. it'd be interesting to see some stats around what sort of GP practices prescribe the most antibiotics - Total visits per year, average doctor turnover, etc etc.
sho 3y ago
As an Australian originally, this article is pretty hard to take seriously. I have a great many problems with Australia's medical system, especially the GPs-then-hospitals-with-nothing-in-between idea, but overprescribing drugs has not been one of them. If anything it's been the opposite, it's ridiculously hard to get anything out of a doctor there, especially antibiotics and double especially anything that could conceivably be abused in some way. The experience overseas is so much more loose that I wonder what the author is on, no pun intended. In Indonesia the health care system was so broken that I actually became kind of a low level expert in antibiotics myself, and would regularly self-diagnose and "prescribe" myself whatever, which I could just walk into any pharmacy, demand, and get. In Thailand it's a little stricter but not much. So with two much larger countries right nearby with much laxer rules it's hard for me to take seriously the notion that tiny, isolated Australia's moderately bad GP habits, if that is even true, is having much of an effect on anything.
- cscurmudgeon 3y ago
  > Report finds more than a third of population had at least one antimicrobial prescription subsidised by Australian government in 2022 Thats right there in the heading. No country should have freaking 1/3 of the population using antimicrobials in a single year.
  - sho 3y ago
    I found this surprising as well. Here's the actual report, which the Guardian did not think to link: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health-report https://www.safetyandquality.gov.au/publications-and-resourc... OK, I have to admit I'm surprised it's that high. As you'd expect, it's heavily biased towards the elderly. It's good that a light is being shone on it. But the article is written as if Australia is some kind of global prime suspect in driving resistance trends, and I continue to doubt whether that is actually the case.
    - soroushjp 3y ago
lynx23 3y ago
In my life, I declined or threw away roughly 50% of officially recommended antibiotics prescriptions from doctors and hospitals. Worst was the first doctor I visited regularily after moving out from my childhood home. Whenever I came to him with any sort of flu to get the necessary papers for staying away from work for a few days, he prescribed antibiotics for the slightest cough I might have. I played along for two or three iterations, until I noticed my overall health would actually get worse from taking antibiotics. So I started to simply drop his prescriptions into the bin, and go back to drinking tea and eating fruits to get better. I had similar experiences with other doctors later. Our health system is such that you can actually make your health worse if you always listen to everything your doctors say. Sad, but unfortunately true. This is in part because people are not willing to ride out an infection at home. They expect from their doc to give them something magicaal which at least shortens their recovery time down to a day or two at most. And doctors, having learnt that their customers are expecting this, basically force feed the remedies to everyone. These days, you have to explicitly declare that you'd prefer to get better mostly on your own...
KuhlMensch 3y ago
Oi, get staphed ya mutt! Father was a vet, and he made me respect antibiotics. Including, IF you take them THEN finish the entire course as directed. DO NOT stop taking them because you feel better. I think we gotta normalize being sick, and sitting at home watching Netflix.
iamlolz 3y ago
Apart from the other observations in this thread I wonder if part of the issue is the work culture here. If you call in sick there is often an expectation or requirement that you will go to the GP to get a medical certificate to "prove" you're sick, and having a "cold" isn't typically an acceptable reason for not showing up for work. I haven't had to worry about this in years but while working in retail I periodically found myself at a GP and being prescribed antibiotics when I would have otherwise stayed home to rest, if I didn't need that medical certificate.
- dsomers 3y ago
  That’s still on the GP and the general public health policy of Australia. If I go to my GP with a cold here in the Netherlands, there is a snowball’s chance in hell that I get prescribed antibiotics.
  - iamlolz 3y ago
    I wasn't disagreeing, just adding some more context to this thread.

218 points by adrian_mrd 3y ago

73% of antibiotics globally are used for livestock production, not for human use, and yet we tend to only hear about how humans need to cut back. How about we require ranchers to decrease their animal density so they don't need to use so many antibiotics? https://www.nrdc.org/resources/us-livestock-industries-persist-high-intensity-antibiotic-use#:~:text=An%20estimated%2073%20percent%20of,have%20repeatedly%20found%20that%20the https://www.nrdc.org/resources/us-livestock-industries-persi...

bequanna 3y ago
I agree with you on high density confinement livestock production. But is there evidence of antibiotic resistant strains in animals causing issues for humans?
- rtkwe 3y ago
  There are a number of bacteria that have made the jump from animals to people so creating a huge breeding pool for very antibiotic resistant bacteria that have generated human viruses in the past seems like a poor choice.
  - kungfufrog 3y ago
    Do you mean bacteria? Viruses are not treated by antibiotics.
- rando_dfad 3y ago
  Yes, a quick google turned up these: Antibiotic Resistance from the Farm to the Table. September 11, 2014. Available at: http://www.cdc.gov/foodsafety/from-farm-to-table.html http://www.cdc.gov/foodsafety/from-farm-to-table.html. Accessed September 14, 2015. https://www.who.int/news/item/07-11-2017-stop-using-antibiotics-in-healthy-animals-to-prevent-the-spread-of-antibiotic-resistance https://www.who.int/news/item/07-11-2017-stop-using-antibiot... ANTIBIOTIC RESISTANCE—LINKING HUMAN AND ANIMAL HEALTH https://www.ncbi.nlm.nih.gov/books/NBK114485/ https://www.ncbi.nlm.nih.gov/books/NBK114485/ Much of modern medicine depends on antibiotics. The above resources give clear and compelling evidence that overuse of antibiotics in livestock is associated with increases in drug-resistant infections in humans.
FirmwareBurner 3y ago
>How about we require ranchers to decrease their animal density so they don't need to use so many antibiotics? That would massively drive up meat prices and anger voting consumers who won't be able to afford meant anymore, and also anger voting meat producers who will go bankrupt from slumping sales and have to lay off workers, all of which who will direct their anger at the politicians who restricted the use of antibiotics in animal farms. So not gonna happen politically. Consumers have to either accept higher meat prices (not gonna happen), or accept that we're too many consumers on the planet for everyone to be fed with organically grown meat (also not gonna happen), so we just kick the can down the road and sweep the dirt under the rug until the titanic hits the iceberg and there's no way forward anymore. Here in the rich EU countries we have some rules and regulations on meat production, but enforcement is very lax and it's an open secret that those certification seals of approval are basically worthless as animals are still caged together crowded in their own filth, with massively infected open wounds full of puss, and pumped full of antibiotics just to stay alive long enough to become burgers. You should Google those images if you want to become vegan but lack the motivation. It's a political tragedy of the commons that's found in a lot of other areas in our lives/society which we know for a fact are wrong and are harming us (or others from less fortunate parts of the world), but we still stick to them because they're very profitable industries generating $$$ and jobs, and they're such a tight part of our daily lives, they're nearly impossible to undo today, like all the pollution from car dependence, microplastics, the cheap cocoa and coffee industries driven by slave labor, etc. See the dead body spaghetti episode from Rick and Morty, it's pretty good satire on our collective hypocrisy on this topic. We know those are all bad, but we choose to look the other way and not do anything about it because we love our lifestyles with cheap car traveling, cheap shipping, cheap meat, cheap coffee, cheap clothing, etc. and all the associated profits.
- omginternets 3y ago
  I’d rather pay a bit more for meat than be forced down the path of questionable meat-substitutes. Maybe meat has been unsustainably cheap for a long time? I am quite far from the vegan ideology, but still willing to recognize that there is something untenable about our current relationship with livestock.
whatshisface 3y ago
Because doctors and farmers have more effective representation than anyone who looks at the whole.
flukus 3y ago
> yet we tend to only hear about how humans need to cut back There's also financial reasons to do so, with livestock the financial reasons are likely reversed. Beside that, anti-biotics also have side effects that can make you more sick, their use is not just unnecessary but counter productive. Some of the side effects can be serious and long term, like changing your gut bacteria.
meany 3y ago
At least in the US there has been recent progress on this. The USDA just released new rules on June 11, 2023. https://extension.umn.edu/news/over-counter-livestock-antibiotics-are-moving-prescription-only-june-11-2023 https://extension.umn.edu/news/over-counter-livestock-antibi... Starting June 11, 2023, all currently available over-the-counter antibiotics for livestock will be available only as prescription medications. This new rule will impact all livestock species. Over-the-counter antibiotics are moving to prescription only to provide more veterinary oversight. Similar to the Veterinary Feed Directive, placing antibiotics under the supervision of veterinarians should result in more judicious use and less antibiotic resistance. This change includes but is not limited to the following: Penicillin, Oxytetracycline, Sulfa antibiotics and Mastitis tubes. Some medications are not considered crucial for human medicine and will remain over-the-counter. This includes the following: Ionophores including Rumensin and Bovatec, Parasiticides, such as Ivermectin, Oral pre/pro/postbiotics, and topical non-antibiotic treatments. Livestock producers must have a valid Veterinary-Client-Patient Relationship (VCPR) in place before they can be prescribed antibiotics by a veterinarian. A VCPR is a working relationship between a veterinarian (veterinary clinic) and a client. Ideally, a VCPR is a documented agreement between both parties that includes a dedicated visit to the animal location(s) the client operates. This visit and documentation must occur at least once every year to maintain the VCPR.
- deleted 3y ago
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- KennyBlanken 3y ago
  This is progress but still drastically short of EU regs where livestock/poultry are subject to stricter vaccination requirements. For example, vaccination for salmonella. In the US, poultry industry and federal/state governments have spent endless effort "programming" people to think that it's their responsibility if they get sick because the meat or eggs they purchased were contaminated and they didn't take enough preventative steps (like cooking it to the point of it being nearly inedible.) Most US poultry is rinsed in chlorinated water, eggs are washed as well (which ends up destroying the egg's natural coating, so they have to be refrigerated) and so on.
alkonaut 3y ago
I don't buy meat from anywhere you can give healthy livestock antibiotics, period. It's really easy (obviously in case you live in such a country you'd be forced to not buy meat or buy imported, which is more expensive and worse for the environment).
- renewiltord 3y ago
  How to determine this? Do you have to analyse supply chain or do you just have no chain (i.e. you are near farm and you know farm owner)? EDIT: Thank you to responses below.
  - lozenge 3y ago
    > In January 2022, the routine use of antibiotics was banned in the EU, and preventative use was restricted to exceptional treatments of individual animals EU law is pretty strict about labelling meat coming from the EU/outside the EU so that could be one way.
  - layer8 3y ago
    Organic meat generally implies no antibiotics, for example under the USDA label.
  - alkonaut 3y ago
    I just look at the flag and know which countries have good meat. E.g. https://ourworldindata.org/grapher/antibiotic-usage-in-livestock https://ourworldindata.org/grapher/antibiotic-usage-in-lives... There may be local regulations or labellings to (e.g. some organic labeling means no antibiotic and so on). But as a first rule I just try to avoid meat from "bad" countries. E.g. we get quite a lot of imported Brazilian beef in stores and I know it's terrible both for deforestation and antibiotics so I avoid that completely. Some interesting differences in the map is e.g. between Australia And NZ.
    - willsmith72 3y ago
      So all your meat is imported from another country? Surely in the long run there are better more sustainable ways
treypitt 3y ago
Obviously because that would require people cut back on meat consumption. I was struck by a recent study indicating most men would rather die young than stop eating meat: https://www.menshealth.com/uk/nutrition/a36261605/red-meat-health/ https://www.menshealth.com/uk/nutrition/a36261605/red-meat-h...
- bimguy 3y ago
  "most men would rather die young than stop eating meat" Seriously, you're going to phrase it like that? How about this, I enjoy a balanced diet and if that is going to kill me young then so be it. If I was scared of dying I would be much more worried about the coat of plastic dust that lines the entire planet, including vegetables being grown and the grass/feed that animals eat, and the fact that I'm extremely likely to die of cancer due to plastics everywhere, metal particles everywhere, chemicals everywhere... if the meat doesn't get me first.
  - artimaeis 3y ago
    What if it wasn’t about you dying? What if it was to make the world better? What amount of suffering in the world would cause you to even consider the option of eating less meat? Is it something you’re willing to contemplate? Not just animal suffering either. Think of the complicated web of problems that come out of people eating too much meat. The antibiotic use discussed in this thread. The methane byproduct discussed in countless others. The inhumane conditions of most butchers (for workers! Let’s forget the animals still). It’s okay if none of that bothers you. We’re only human. I’m a former vegan, I’ve likely considered it all more than strictly necessary. I don’t think anyone _has_ to be anything. But for what it’s worth it _could_ be about more than an individual’s health.
    - bimguy 3y ago
      "What if it wasn’t about you dying? What if it was to make the world better?" That would be a different discussion, with a different answer. I was only replying to the comment above mine. Yes... animals produce waste & suffer from infections... Inhumane conditions exist in the minority in every industry. You're claiming most butchers/abattoirs have inhumane conditions in an industry that I'm certain you've never worked in. You're a former vegan but I see that you're still brain-washed by the material that you were hand fed.
rqtwteye 3y ago
Same for water. We are told to have shorter showers while farmers use most of the water for inefficient practices to grow unsuitable plants for the region.
rmccue 3y ago
I don’t believe this is true in the Australian context though: > Australian animal industries are one of the lowest users of antimicrobials in the world https://www.amr.gov.au/about-amr/amr-australia/animal-health https://www.amr.gov.au/about-amr/amr-australia/animal-health
- knifie_spoonie 3y ago
  Another commenter below posted this map: https://ourworldindata.org/grapher/antibiotic-usage-in-livestock https://ourworldindata.org/grapher/antibiotic-usage-in-lives... Assuming the data is accurate, it would seem antibiotic use (not sure how that compares with antimicrobials in general) is not particularly low compare to other countries.
  - rmccue 3y ago
    Interesting! From the cited paper itself: > The top 5 consumers in 2020 were China, Brazil, India, USA, and Australia But also: > In contrast, Australia now also appears among the top 5 –however, in the absence of any public report of AMU since 2010 [29], usage for Australia was obtained through extrapolation, as with other countries that do not report data. Therefore, predictions may not accurately reflect the current country efforts to reduce AMU. So it's not clear if the data actually is accurate (and the paper really is about how accurate data is missing for many countries).
BurningFrog 3y ago
How much does livestock eating antibiotics really affect the problem of resistant bacteria infecting humans? Farmers don't use antibiotics for fun. It increases meat production by 5-10%. So expect meat prices to go up by about that amount if the practice gets banned.
- GeekyBear 3y ago
  > How much does livestock eating antibiotics really affect the problem of resistant bacteria infecting humans? Bacteria transfer genes from one species to another, so an innovative new genetic mutation that allows one kind of bacteria to shrug off antibiotics more effectively won't stay only in that species of bacteria or only on that farm. > Horizontal gene transfer is the movement of genetic information between organisms, a process that includes the spread of antibiotic resistance genes among bacteria, fueling pathogen evolution. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536854/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536854/
seunosewa 3y ago
This means more expensive food. Are the poor willing and able to pay more?
- bromuro 3y ago
  Are “the poor” and “the rich” willing to have an healthier diet? Meat should be an expensive food. it’s costs for the environment and the humanity are too high.

mjsweet 3y ago

I had a chest infection lasting months from mid-june to mid-October, and despite a run of Moxy, then Augmentin, then Roxy, and finally Cefalexin, nothing worked. Out of options, I tried a friend's suggestion: raw garlic and honey. After three weeks, my symptoms and long COVID issues improved. It was a stubborn infection that caused me to over-relying on antibiotics, as the article suggests. Makes me wonder about GP's exploring alternatives, especially with rising drug resistance.

Waterluvian 3y ago
I found that three weeks + water worked when I had a similar issue. To be honest the water felt good. I envisioned peeing as a way to flush the badness out despite knowing that’s just not really how it works.
- mantas 3y ago
  You feeling better drinking water certainly did help.
  - Waterluvian 3y ago
    Yeah, like water obviously helps. And the placebo of imagining like… “sickness” being flushed out helps too.
    - mantas 3y ago
      Yes. Placebo is one of the strongest drugs we got. The problem is how to make a strong placebo… But I remember an interesting study that placebo works even if patient doesn’t believe in it. Ot as effectively though.
martinky24 3y ago
Extremely scientific anecdote you got there!
- deleted 3y ago

AniseAbyss 3y ago

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ricardobeat 3y ago

1/3 of the population in one year? That's insane. I've only taken antibiotics once in my entire life, and can count on my fingers the amount of times someone mentioned taking them in the last decade. Are doctors prescribing antibiotics for the flu?

siquick 3y ago
Lived in Australia for over 10 years and can confirm that GPs here are, on the whole, pretty useless. Most appointments last under 2 minutes and end with a script, usually antibiotics of some kind. I had covid recently and a woman at work who had identical symptoms but wasn’t testing positive went to the GP and was prescribed antibiotics.
- tppiotrowski 3y ago
  I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. In the US, you would demand them from your doctor and they would say no. Whether it was placebo or not, it did usually seem to make me feel better.
  - ykonstant 3y ago
    > I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. Those two sentences contradict each other; it is a very irresponsible thing to do. Also, yes, if every time you have a cold, you get antibiotics and they make you feel better, it is placebo.
    - fl0ki 3y ago
      An even simpler explanation is return to mean. They were going to get better in a few days anyway, with or without antibiotics. But if they keep getting antibiotics each time, they're always going to think that they helped. Confirmation bias comes in here too, why not. What's even worse is that unnecessary use of antibiotics can affect someone's gut biome and leave them worse off for months, in some extreme cases years. I have had antibiotics only a couple of times in my life (for bleeding injuries) and I noticed the effect on my gut each time. To think that people create this problem when they don't have to is alarming. I hope for their sake their doctors _are_ prescribing them placebos so it's harmless ignorance.

jjcm 3y ago

I found this to be pretty true while Living in Australia. I was always surprised at how cavalier doctors were about giving these out. I think it stems from two things - one is what they quoted in the article, that there's a "cultural expectation in Australia that there’s a pill or a tablet for every problem". People who go to the doctor expect a solution. I suspect the other thing is how often Australians go to the doctor. Americans tend to be pretty hesitant to see doctors due to pricing of health care. In Australia, if you're sick, you go to the doctor. This is true even for common colds. Some stats, in 2010 Americans saw the doctor on average around 3.9 times a year (and this number is on a downward trend from the previous survey)[0]. In Australia this number is a bit harder to break down. Some politicians have cited that on average people see a doctor 11 times a year. Medicare stats breakdowns put that number at somewhere closer to 7[1]. Either way, it's a significant increase in comparison to Americans. It's more common to go see the doctor. Unfortunately the article doesn't cite their sources here. One thing I'd be very curious about is what percentage of doctor visits result in antibiotics when comparing Australia vs the United States. My hypothesis is that despite cultural pressures, it may actually be that prescription rates per visit are quite similar between the two countries, and it's just that Australians seen the doctor more often. [0] https://www.census.gov/newsroom/releases/archives/health_care_insurance/cb12-185.html https://www.census.gov/newsroom/releases/archives/health_car... [1] https://www.servicesaustralia.gov.au/sites/default/files/documents/medicare-benefits-scheme-bulk-billing-net-statistics-1-july-2010-30-june-2011.pdf https://www.servicesaustralia.gov.au/sites/default/files/doc...

nradov 3y ago
I don't have the reference handy, but I read a study of US healthcare which found patient satisfaction to be highly correlated with whether they got a prescription at the end of an office visit. With a prescription the patients felt like they were getting their money's worth.
climb_stealth 3y ago
Hah, I wonder how people do it. The past few times I wanted to see my GP the appointments had lead times of 6 weeks or more. And they weren't bulk-billed. I'd joke that by then the issue would have either gone away or I'd be dead.

wdeasy 3y ago

I can confirm, they hand it out at the doctors in Australia for almost anything. I used to get sinus infections more than twice a year and they would give me antibiotics without testing if it was bacterial of viral. I started to refuse them few years ago and start to use salt water rinse which worked way better

lysndr 3y ago

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iteratethis 3y ago

I'm from the Netherlands and once visited our Brazil office. One of my colleagues there seemed to be having a pretty bad cold so he exited our meeting. One hour later he was back, said he took antibiotics, and felt fine now. My jaw dropped. Dutch doctors are the opposite, as expats commonly complain about. Our first method of treatment (for various symptoms) is to send you back home and sit it out for a few days. Or just take some aspirins. The idea being that your body will heal itself over various ills, and that this is the preferred way. My mind was also blown when I heard that in many countries, people have medical cabinets at home. It being common that the typical non-senior adult has a stock with a wide array of medicines. I was raised on zero medicines, unless there's something critically wrong. Even taking an aspirin makes you a bit of a wimp. Cultural differences I guess.

NoPicklez 3y ago
As an Australian I am surprised of this article. I hardly ever take any medications at all let alone antibiotics willy nilly.
- batiudrami 3y ago
  My partner is a GP and it is very common for patients to come in and, rather than describing symptoms, will ask directly for antibiotics. They can be quite pushy when she says no, so I imagine some doctors take the path of least resistance and just prescribe them.
  - anakaine 3y ago
    As an Aussie I've had the odd amusing chats with my GP on this topic. His response it usually a flat "antibiotics fix a problem which you don't have. Right now they will most likely make you worse by destroying bacteria which are helping you. Do you want to get worse?".
meepmorp 3y ago
The main reason why Dutch doctors don't prescribe antibiotics for colds is probably because colds are viral infections, not bacterial, so the antibiotics don't do anything. There's very little you can do for most colds apart from supportive treatment (pain meds, antipyretics, decongestants) and rest.

Blackadderz 3y ago

I have probably only been to the GP once or twice in my life... but that changed after having two kids. I believe some of this can be tied to the very rapidly changing demographics in Australia. I have no data to back this up, but I do see quite often amongst parents that they will shop around for a GP that gives them antibiotics because back *home*, that's what they were expected to do. So it is not uncommon for people to drive 30 minutes to their favourite GP somewhere to get exactly what they want...

aatd86 3y ago

Australia already has super animals and now it's getting super bugs...

Sophistifunk 3y ago

Bollocks, there's about seven of us, we're not going to drive anything. And we don't feed them to otherwise-healthy livestock, unlike some other countries.

1letterunixname 3y ago

That's right MSM, blame individuals, not Australian or global doctors or pharmacies. And definitely don't mention meat global agriculture for abusing antibiotics to grow animals faster while also making them less effective by evolving pathogens as well.

BeetleB 3y ago

> Australia ranks seventh-highest in the developed world for antimicrobial community prescribing rates. And the other 6 countries are...?

nf17 3y ago
I bet, India is on the top3. Pharmacy culture in India is liberal. U can walk into any pharmacy without prescription and buy most meds including Antibiotics. It's a different story online, but even then there are ways to get around.

Eumenes 3y ago

I don't understand this - I haven't had antibiotics since I was a young child. What is the average case we're talking about here? Most colds I've had go away in 3-5 days max. Old and vulnerable people with infections, I get, but no reason anyone under the age of 40 should be taking any unless very serious case.

stubish 3y ago

How do you breed antibiotic resistant gonorrhea without giving antibiotics to someone with gonorrhea? Giving someone a mild dose to treat some other infection, but not enough to properly treat the gonorrhea? I think if we are serious about antibiotic use in humans, we need to test for pathogens before or during treatment. Is there a mechanism to affordably do a broad spectrum screening of infections?

keepamovin 3y ago

What if it wasn’t antibiotics alone but the use of some pesticide that is interacting with them and the immune system and bacteria to make this more likely? Is the rate of resistance formation, the same as what you would expect from looking at other countries with the same usage profile of antibiotics? Have all other variables been controlled for?

Andaith 3y ago

Just some more anecdata, but it depends which GP practice you go to. There's a GP practice near us that pays really poorly, always young doctors, they never last more than a year, and the owner (an older GP who also works there) just wants happy return customers who are in-and-out. So yeah, they'll prescribe whatever. There's a better GP practice near me which won't actually do that though, most visits take the full 15 mins, they'll ask loads of questions and give you some tests and/or recommend over the counter stuff, and it's always "come back if it gets worse or doesn't get better by X". They charge for the first consult, but typically just bulk-bill for every visit related to that problem. Even chronic issues they typically bulk-bill. So yeah, quality varies. it'd be interesting to see some stats around what sort of GP practices prescribe the most antibiotics - Total visits per year, average doctor turnover, etc etc.

sho 3y ago

As an Australian originally, this article is pretty hard to take seriously. I have a great many problems with Australia's medical system, especially the GPs-then-hospitals-with-nothing-in-between idea, but overprescribing drugs has not been one of them. If anything it's been the opposite, it's ridiculously hard to get anything out of a doctor there, especially antibiotics and double especially anything that could conceivably be abused in some way. The experience overseas is so much more loose that I wonder what the author is on, no pun intended. In Indonesia the health care system was so broken that I actually became kind of a low level expert in antibiotics myself, and would regularly self-diagnose and "prescribe" myself whatever, which I could just walk into any pharmacy, demand, and get. In Thailand it's a little stricter but not much. So with two much larger countries right nearby with much laxer rules it's hard for me to take seriously the notion that tiny, isolated Australia's moderately bad GP habits, if that is even true, is having much of an effect on anything.

cscurmudgeon 3y ago
> Report finds more than a third of population had at least one antimicrobial prescription subsidised by Australian government in 2022 Thats right there in the heading. No country should have freaking 1/3 of the population using antimicrobials in a single year.
- sho 3y ago
  I found this surprising as well. Here's the actual report, which the Guardian did not think to link: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health-report https://www.safetyandquality.gov.au/publications-and-resourc... OK, I have to admit I'm surprised it's that high. As you'd expect, it's heavily biased towards the elderly. It's good that a light is being shone on it. But the article is written as if Australia is some kind of global prime suspect in driving resistance trends, and I continue to doubt whether that is actually the case.
  - soroushjp 3y ago

lynx23 3y ago

In my life, I declined or threw away roughly 50% of officially recommended antibiotics prescriptions from doctors and hospitals. Worst was the first doctor I visited regularily after moving out from my childhood home. Whenever I came to him with any sort of flu to get the necessary papers for staying away from work for a few days, he prescribed antibiotics for the slightest cough I might have. I played along for two or three iterations, until I noticed my overall health would actually get worse from taking antibiotics. So I started to simply drop his prescriptions into the bin, and go back to drinking tea and eating fruits to get better. I had similar experiences with other doctors later. Our health system is such that you can actually make your health worse if you always listen to everything your doctors say. Sad, but unfortunately true. This is in part because people are not willing to ride out an infection at home. They expect from their doc to give them something magicaal which at least shortens their recovery time down to a day or two at most. And doctors, having learnt that their customers are expecting this, basically force feed the remedies to everyone. These days, you have to explicitly declare that you'd prefer to get better mostly on your own...

KuhlMensch 3y ago

Oi, get staphed ya mutt! Father was a vet, and he made me respect antibiotics. Including, IF you take them THEN finish the entire course as directed. DO NOT stop taking them because you feel better. I think we gotta normalize being sick, and sitting at home watching Netflix.

iamlolz 3y ago

Apart from the other observations in this thread I wonder if part of the issue is the work culture here. If you call in sick there is often an expectation or requirement that you will go to the GP to get a medical certificate to "prove" you're sick, and having a "cold" isn't typically an acceptable reason for not showing up for work. I haven't had to worry about this in years but while working in retail I periodically found myself at a GP and being prescribed antibiotics when I would have otherwise stayed home to rest, if I didn't need that medical certificate.

dsomers 3y ago
That’s still on the GP and the general public health policy of Australia. If I go to my GP with a cold here in the Netherlands, there is a snowball’s chance in hell that I get prescribed antibiotics.
- iamlolz 3y ago
  I wasn't disagreeing, just adding some more context to this thread.