[HN Gopher] Australia's overuse of antibiotics driving rate of d...
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Australia's overuse of antibiotics driving rate of drug-resistant
infections
Author : adrian_mrd
Score : 101 points
Date : 2023-11-15 19:21 UTC (3 hours ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| nostromo wrote:
| 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-persi...
| bequanna wrote:
| 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 wrote:
| 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 wrote:
| Do you mean bacteria? Viruses are not treated by
| antibiotics.
| rando_dfad wrote:
| 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. Accessed September 14, 2015.
|
| 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/
|
| 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 wrote:
| _> 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 wrote:
| 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.
| ihattendorf wrote:
| That's great, but unless you can convince the rest of the
| world to pay more for meat or eat less meat nothing will
| change.
| omginternets wrote:
| Sure, same argument applies to fake meat.
| whatshisface wrote:
| Because doctors and farmers have more effective representation
| than anyone who looks at the whole.
| flukus wrote:
| > 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 wrote:
| 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-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.
| alkonaut wrote:
| 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 wrote:
| 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)?
| lozenge wrote:
| > 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 wrote:
| Organic meat generally implies no antibiotics, for example
| under the USDA label.
| alkonaut wrote:
| I just look at the flag and know which countries have good
| meat. E.g. 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.
| peyton wrote:
| Where is metaphylaxis banned? That's like a basic tenet.
| treypitt wrote:
| 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-h...
| bimguy wrote:
| "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.
| tick_tock_tick wrote:
| I mean who wouldn't? It's like asking someone would you
| rather suffer your whole life or live 95% of it but enjoy it.
| mjsweet wrote:
| 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 wrote:
| 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 wrote:
| You feeling better drinking water certainly did help.
| Waterluvian wrote:
| Yeah, like water obviously helps. And the placebo of
| imagining like... "sickness" being flushed out helps too.
| martinky24 wrote:
| Extremely scientific anecdote you got there!
| ricardobeat wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| > 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.
| dj_mc_merlin wrote:
| Here in Germany doctors only give them for bad infections that
| have the potential to turn worse. Cat scratches (actually quite
| dangerous!), bad throat or stomach infections. I've only taken
| them 2-3 times this decade I guess but I've seen them mentioned
| way more often than you. People and doctors here prefer natural
| recovery with some tea and vitamins to pills if possible, which
| is nice.
| alkonaut wrote:
| "Bad infections" I really hope you mean bad _bacterial_
| infections. If doctors give antibiotics for viral infections
| (e.g. respiratory infections they fear will become bacterial
| secondary infections) then we in the rest of the world really
| need to tell Germany to stop it. Preventive antibiotics is
| useful for the really vulnerable and chronically ill _only_.
|
| Here they even stopped for many bacterial infections e.g.
| typical strep infections and so on, so long as the body takes
| care of it. I.e. no antibiotics just to shorten the disease
| period.
| dj_mc_merlin wrote:
| Yes, obviously. They're doctors, they understand that.
| timeagain wrote:
| The reality on the ground for a doctor is that they don't
| always have time to do fancy microscope/lab testing. Skin
| sore looks infected? Antibiotics. If there's a 30%
| likelihood it is a bacterial infection and a .0000000001%
| chance that the patient develops super-MRSA, the choice is
| clear.
| alkonaut wrote:
| In my (quite limited) experience the prescription of
| topical antibiotics like that is not down as much as the
| oral and injected. Not sure why. Perhaps because because
| the diagnostics is difficult. Or it's because that kind
| of antibiotics have lower risk of aiding the development
| of resistant bacteria. Or there just aren't as many
| alternatives.
| BobaFloutist wrote:
| Ah yes a .0000000001% chance that the patient develops
| super-MRSA, the disease that gets its characteristic
| deadliness from _Multiple Resistances_ to antibiotics,
| which bacteria develop when antibiotics are overused.
| Sounds like a great reason to over prescribe antibiotics.
| JTbane wrote:
| My anecdote from the US is that usually my primary care
| doctor will do a rapid streptococcus test if I come in with
| a sore throat, and only prescribe antibiotics if it comes
| back positive. That seems responsible enough for me.
| alkonaut wrote:
| Yeah mine would say "you are in your 40's and healthy so
| I won't prescribe antibiotics unless it doesn't get
| better in a week". But that as I said is fairly new and
| quite specific to sore throat from streps.
| jjcm wrote:
| 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_car...
| [1]
| https://www.servicesaustralia.gov.au/sites/default/files/doc...
| nradov wrote:
| 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 wrote:
| 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.
| caf wrote:
| Call first thing when the office opens (often 8am) and you
| often get something because they tend to save a couple of
| slots for same-day appointments.
| caf wrote:
| The report in question points the finger at hospital
| prescribing rather than GPs, though.
| wdeasy wrote:
| 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 wrote:
| Ah yes. The country that allows you to buy laughing gas cream
| chargers and cadmium filled vapes at every second convenience
| store needs something which is already restricted access to
| fiddle with.
|
| After Codeine, paracetamol packs, will the legal cupidity of
| these people ever be satiated? It is easier for me to get then
| stickiest weed known to man prescribed in this country than it is
| to get pain relief for an ear infection. But sure, we're one more
| rule or guideline away from utopia. Will anyone actually oppose
| the Pharmacy Guild/RACGP/AMA axis in this country, as they are so
| useless?
| iteratethis wrote:
| 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 wrote:
| As an Australian I am surprised of this article. I hardly ever
| take any medications at all let alone antibiotics willy nilly.
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