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From McDonald's To Obama To Prizes, Efforts Ramp Up To Save Antibiotics

You know the antibiotics issue is really getting serious when even the biggest fast food chain in the world gets on the bandwagon — joining the president of the United States, among a great many others.

Last week, McDonald's announced that it would phase out serving chicken raised with medically important antibiotics. Slate argues that we can surely thank Chipotle, which has long offered antibiotic-free meat, for this move. But whatever the motive, Slate writer Alison Griswold says that when the fast-food behemoth that buys up to 4 percent of the nation's chicken "decides it’s done with certain antibiotics, you can bet that the agriculture industry is going to listen."

Meanwhile, President Obama recently proposed doubling the federal funding for research on how to fight antibiotic-resistant bacteria, to $1.2 billion. The CDC estimates that 23,000 Americans die each year from antibiotic-resistant infections. And a headline last week in the journal Science asks if we're headed back to the bad old pre-penicillin days: A Return to the Pre-Antimicrobial Era?

Got your attention yet? If so, now is the moment to read "Preventing An Antibiotic Apocalypse," an interview with Boston University health law professor Kevin Outterson. He co-authored a recent Health Affairs piece on economic reforms needed to spur development of more new antibiotics, a theme also explored in a recent New York Times op-ed. Two of Outterson's most striking excerpts:

If superbug bacteria become endemic in US hospitals, it will shake our health care system at its foundations. Why would you get a hip replacement, or a cardiac stent, or do anything else in a hospital that wasn’t a life-saving emergency, if you knew these infections could kill you?

We have MDR (multidrug-resistant) gonorrhea in the US and around the world. Only one drug remains against the nastiest strains. On the CDC’s threat assessment list in 2014, gonorrhea made the list of the three most dangerous resistant pathogens. We’re close to having no effective treatment for gonorrhea.

We’re almost back to the 1930s. The same is true with XDR (extensively drug-resistant) tuberculosis. Our best treatments for malaria are showing signs of resistance, too. For a number of serious hospital infections, we are down to the last-ditch treatment.

Right now, antibiotic resistance is a very slow moving train wreck. It might take another decade for this to become a true disaster, or it might be tomorrow. Boston has several underwater tunnels. If we stop investing in tunnel maintenance, one day the tunnels are going to fill with water—we know it will happen, but don’t know when.

And his iPhone comparison:

What do iPhones have to do with antibiotic development?

Imagine you are Apple and you are ready to sell the latest iPhone, but the experts insist that no one is permitted to buy the iPhone 6 until all of the existing phones don’t work anymore. No sales until the iPhone 3s, 4s and 5s and every Android phone are completely obsolete. If cell phone markets worked that way, Apple would stop selling them. You’d kill the innovation system. Would we ever have gotten the first iPhone if that were the system? No.

That is the situation faced by companies bringing new antibiotics to market, except that the experts are absolutely correct to insist that we conserve new antibiotics through careful stewardship. Resistance makes antibiotic markets behave in remarkably problematic ways.

Read the full interview here.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth blog.

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