Reprinted with permission from Issue #150,
January 1996,
of the Townsend Letter for Doctors and Patients,
Telephone (360) 385-6021

Too Much of -A Good Thing
review by Irene Alleger
When Antibiotics Fail
by Marc Lappé
North Atlantic Books
P.O. Box 12327, Berkeley, California 94712 USA
© 1986, 1995, softcover, $14.95, 246pp.

The age of Miracle Drugs is over; only the-pharmaceutical companies, who hope to continue their billion dollar profits, will deny that antibiotics can no longer be used indiscriminately. The evidence of antibiotic-resistant bacteria has been growing since the early 80's, with once benign infections like pneumococcus and E. coli becoming much more virulent. Doctors are witnessing a startling increase in diseases once easily treated with antibiotics. What has brought about this dangerous situation?

Biologist and toxicologist Marc Lappé describes the many abuses and overuses of antibiotics, particularly in animal husbandry, and in the prophylactic use of antibiotics in hospitals, as contributing to the inevitable mutation and strengthening of common bacteria which humans have evolved with since life began. And, if we are to survive, we must find our way back to a natural balance with these organisms.

Our profligate use of chemotherapeutic agents has left some of us weaker than our so-called enemies. Many mammals are now plagued by a whole new order of viral and bacterial infections that were rare before the antibiotic era. Initially out of ignorance and now out of scientific lethargy, we have let our love affair with chemicals reshape the evolution of the microbial world, to a point of endangering the survival of our species.

Fleming himself warned against using his miracle drug, penicillin, for every imaginable ill. He recognized that penicillin did not kill all bacteria - and those that survived would likely resist subsequent doses. His prudent admonitions fell on deaf ears..."in fact, this is the weakness of our century - an uncritical acceptance of technological breakthroughs as ... free from harmful side effects." But Fleming and his colleagues missed another, even more critical effect: when antibiotics kill or inhibit harmful bacteria, they also eliminate vast numbers of relatively benign and even beneficial, bacteria. When these benevolent counterparts die off, they leave behind large areas previously occupied with normal bacteria which are now free to be colonized by new ones - usually the antibiotic resistant strains.

As one antibiotic after another fell to bacterial resistance, the pharmaceutical giants kept one step ahead by introducing new "miracle" drugs at a rate of 5-10 per year. The western industrialized world has been victimized by blind faith in "modern" medicine, and the physicians who use the drugs are programmed, as well, to ignore scientific laws, and "go with the flow." Now, a few scientists are suggesting that the survival of bacteria as a group, underlies our own.

We now know that thousands of people in the U.S. have gotten Salmonella and E coli infections from farms where the ubiquitous use of antibiotics in food animals has bred virulent, antibiotic-resistant bacteria. The situation promises to become much worse when the R factor is understood: bits of genetic material called, "plasmids" can break off and become incorporated into other bacterium, eventually disseminating the genes for resistance throughout the bacterial world. It has been scientifically documented now that R factors, which permit the transfer of antibiotic resistance from one organism to another, have been found to cross between totally unrelated bacteria.

Marc Lappé cites many studies of hospitals where the incidence of "nosocomial" infections are rising at an alarming rate. Hospital infections appear to be linked to the development of resistant strains of microorganisms within the hospital environment itself, but the author notes ironically that the variety of modern-day lifesaving equipment itself increases the risks of these infections. They include those procedures that introduce additional foreign material into the body, such as airway assist devices, and catheters, etc.

Many European countries have halted the use of antibiotics in animal feed, and in some, Sweden, notably, only a very few antibiotics are used, with the precaution of testing for specificity first, and keeping several antibiotics for life-threatening infection only. In that way, they are hoping to stop the spread of antibiotic-resistant bacteria and retain the efficacy of a few of the drugs.

Sexually transmitted diseases such as the new, penicillin- destroying variant of gonorrhea has swept the world. The Center for Disease Control shows that Neisseria gonorrhoeae (PPNG) has spread to all 50 states and Canada, doubling from 1983 to 1984 to almost 7,000 cases. Canada, previously free of this dangerous pathogen, reported a 335% increase in the same period. Other infections such as Staphylococcus aureus have proven unstoppable by even newer antibiotics like vancomycin and methicillin, a penicillin-like antibiotic that was immune to the penicillin-destroying enzyme made by the staphylococci.

It is not as if clinical researchers had ignorantly neglected the underlying problem of antibiotic resistance. For methicillin- resistant infections alone, over 250 articles were published between 1960 and 1982. No regulatory agency insisted on routine management to limit the ultimately global spread of infection.

Marc Lappé supports vaccines as an alternative to antibiotics, and some clinicians are suggesting "seeding" parts of the body with non-disease producing and antibiotic-sensitive bacteria to reverse the process. It seems that when things "go wrong" with modern medicine, instead of looking at the underlying premise, the researchers are off to another blind alley. Much of the blame must go to public health bureaucrats afraid of rocking the boat with new policies, and well-intentioned physicians preoccupied with practicing defensive medicine and offering "quick fixes" to often complex diseases.

Now we find ourselves in a dangerous, unprecedented position, much like the mad scientist whose genius has brought forth a monster. One thing this epidemic of infections disease points up is that the medical establishment has arrogantly ignored the most basic laws of science and forgotten that in the game of life, Mother Nature bats last.

Townsend Letter for Doctors & Patients, telephone (360) 385-6021
January 1996