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Antibiotics: Too much of a good thing turns deadly

ST. PAUL--Antibiotics may have been the wonder drugs of the 20th century, but their improper use now is killing some patients and making others ill. Federal health officials say that misusing antibiotics kills 23,000 Americans and makes another 2...

ST. PAUL-Antibiotics may have been the wonder drugs of the 20th century, but their improper use now is killing some patients and making others ill.

Federal health officials say that misusing antibiotics kills 23,000 Americans and makes another 2 million sick annually. Those figures drew the attention of top Minnesota officials, who Friday announced a five-year program to get antibiotic use under control.

The problem is that antibiotics are being overused, especially when an illness is not one antibiotics are supposed to treat. With the overuse, bacteria develop a resistance and require stronger doses or stronger versions of antibiotics.

"They get used to it so they build up tolerance and resistance to it..." Minnesota Health Commissioner Dr. Ed Ehlinger said about bacteria, which once resistant become harder to control. "We are poised to enter a new era where we suffer great losses due to our inability to fight infections."

While much of the attention of the five-year project will focus on health professionals, such as doctors who write antibiotic prescriptions, the public also will be involved.

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"You should have a good understanding," Ehlinger said. "You should always ask questions of your provider."

For instance, the commissioner said, a patient should not ask for antibiotics when they are not designed to fight a particular illness.

State Epidemiologist Dr. Ruth Lynfield said, as an example, that most bronchitis cases are caused by viruses, and viruses do not respond to antibiotics. However, some patients ask for antibiotics for bronchitis and some doctors prescribe it.

"We're not saying don't use antibiotics," Lynfield said. "We're saying use them appropriately, avoiding overuse and misuse."

Federal health authorities say the options for bacterial infection treatment are becoming increasingly limited, expensive and often more toxic, with stronger or more harmful side effects. Up to half of hospital antibiotic use is not needed, the federal experts say.

"Unless we can find ways to preserve the effectiveness of the antibiotics we have and slow the development of resistance to new antibiotics, we may again see increased numbers of illnesses and death due to our inability to control bacterial infections," Ehlinger said. "Antibiotics are critical public health tools. Their effectiveness can and must be preserved. This can be done through judicious use and diligent stewardship."

The Health Department is joining with the Agriculture Department, Board of Animal Health and Pollution Control Agency to develop plans to combat the antibiotic problem in humans and animals.

Called the One Health Minnesota Antibiotic Stewardship Collaborative, the program is designed to promote a better understanding of the problem, improve human and animal use of antibiotics and reduce environmental consequences of improper disposal of antibiotics.

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Pollution Control Commissioner John Linc Stine said that disposal of antibiotics and other medicines, either via bodily waste or in unused form, is a problem. "It all ends up somewhere."

The new project, apparently a unique collaboration that other state's do not have, is to look into environmental impacts.

Like in humans, proper antibiotic use is good for animals, State Veterinarian Dr. Beth Thompson said. "Antibiotic use in an animal is necessary to maintain the health of that animal."

Agriculture Commissioner Dave Frederickson said that his inspectors do not allow any meat or milk with even a trace of antibiotic to reach the market.

A federal rule that begins next year will require farmers to talk to their veterinarians before using feed containing antibiotics. Unlike with humans, use of antibiotics in livestock and poultry has not required a veterinarian prescription.

The development of antibiotics was "one of the greatest medical and public health breakthroughs of the 20th century," Ehlinger said.

It "changed our way of life," he added, but eventually medical experts discovered some bacteria no longer were being treated by antibiotics.

"Bacteria are quite hardy and adaptable," Ehlinger said.

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Minnesota State Veterinarian Dr. Beth Thompson
Minnesota State Veterinarian Dr. Beth Thompson says Friday that federal rules soon will require farmers to consult with veterinarians before using antibiotics on many of their animals. (Forum News Service photo by Don Davis)

Related Topics: HEALTH
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