Nowadays, we have all absorbed the idea that the overuse of antibiotics may be causing bacteria to become resistant.  But does this mean that we should avoid using antibiotics to help people with a documented infection?  Probably not.

In the past, antibiotics were prescribed freely.  In the 1990′s, a study in JAMA showed that half of all antibiotic prescriptions in America were written for adults with viral infections.  Doctors have learned to reduce the unnecessary use of antibiotics for mildly ill people; this educational effort continues.

But still, antibiotics are dumped into our environment by the ton, every month.  Where does it come from?

One source of antibiotics in our environment is animal feed.  Antibiotics routinely have been added to the food of animals being grown for food.  While this practice increases the weight and yield of animal meat, and helps keep beef, pork, and chicken prices low, it also contributes over 30% of the annual burden of antibiotics into our environment and water supply.

Another big source of antibiotics is in consumer products, such as antibiotic soap, lotions, and laundry detergent.  The addition of antibiotics has been shown not to reduce the transmission of disease; the proper use of soap without “antibacterials” works just as well.  But this practice adds 40% of the annual load of antibiotics into our environment.

Naturally, we don’t prescribe antibiotics unless there’s a clear need.  But there’s also no need to fret that the appropriate use of antibiotics for documented infections is causing antibiotic resistance; there are plenty of other ways we could avoid this serious problem.

–  David Epstein, MD