Friday, October 18, 2013

FRONTLINE - Hunting the Nightmare Bacteria

October is National Breast Cancer Awareness month here in the US. Breast cancer kills about 39,000 women each year.  Antibiotic resistance probably kills about the same number (in spite of a completely underestimated number of 23,000 from the CDC recently).  Do we have an antibiotic resistance awareness day?  Do we wear red armbands and run in the parks or march in Washington or have local parades to promote research on antibiotic resistance? Do we pay the same price for antibiotics (that work) that we do for cancer therapies (that frequently don’t)?

On October 22, FRONTLINE and PBS will air a very important show called Hunting the Nightmare Bacteria.  I am hoping that this will help inspire people to do something – but I know that I am almost certain to be disappointed.  For example, in our area, the show will air at 10 pm.  I’m usually in bed by then (just kidding)!  But I would have preferred an 8 pm time slot.  But the 8-10 pm time slots are taken up with a review of shows (Just Seen It), an art magazine (Open Studio) and Julie Andrews on Great Performances.  I’m sure that we will all agree that these shows are more important than anything we could say about antibiotic resistance.

About a year ago, the Frontline folks approached me with the idea for their show.  I spent several hours with them discussing the perfect storm – not the book or the blog – but the actual problems surrounding antibiotics and antibiotic resistance today.  Early on, they were very uninformed but were clearly trying to catch up quickly.  I can report that they have mostly succeeded.  In this show that I highly recommend to any and all, Frontline takes from the bedside of patients infected with these highly resistant pathogens to the council rooms of the CDC and to those of the pharmaceutical industry.  In doing so, we see the conundrum facing patients, their physicians and clinicians. The lack of data coming from CDC is highlighted as is the fact that about half of the (human – they fail to qualify this) use of antibiotics in the US is probably unnecessary.

Left out of the show are minor problems like the use of antibiotics in agriculture, the incomprehensible approach taken by FDA for antibiotics for human use, and any kind of perspective on how to make progress in the future.  About 70% of all antibiotic use is in agriculture – mostly for growth promotion in animals where small amounts of antibiotics are added to feed to increase growth rates and get animals to market faster.  Every other country in the world (almost) has given up this practice without suffering economic hardship – but not us more advanced Americans.  This is another area where the FDA must act but has successfully avoided doing so since major reports on this topic came out in 1976 and even earlier.

The most disappointing aspect of the show is that it leaves us hanging.  The show presents only half of the key problems around antibiotic resistance, does not provide any sort of concise summary for us, and also provides no way forward.  The bottom line for most viewers will be that it’s hopeless – so why bother?  Drink and be merry! So – Frontline – good job overall but lets get it a little more together next time! I give them a B.


  1. Thanks very much for your overview on the Frontline piece , and your important work. Such a crucial issue. I am trying to find citizen groups in Canada who are working on this. I started a Facebook page to promote Antibiotic Awareness Week in November, its called "Canadians for the Preservation of Antibiotics. I was not sure what to call it and landed up with this name. Once again, thank you.

  2. Hi David, thanks a lot for your response. I have been told there is not one citizen org here doing advocacy. I have been calling news outlets, journalists and some professional organizations etc to get them to issue a press release to boost coverage for the Awareness week. The CBC News Network has done some very good coverage.

    ....... There is a Facebook page for Americans operated by The Pew Charitable Trust, they are supporting the The Preservation of Antibiotics for Medical Treatment Act) The page has 38,00 followers, (the focus is agriculture) and some of the followers are very engaged in this topic.

    I sent them your blog link last night. I also contacted the manager of the Pew Campaign on Human Health and Industrial Farming (Nicole Tidwell) in order to get some pointers for a campaign. Meanwhile, I'll continue to look for other Canadians to start up a group. Onwards and upwards, Hope you get the FDA job!!! Keep well!


  3. David, pardon my brashness, would you be interested in being a guest blogger for ? Her life was saved by antibiotics. I have spoken to her manger and they are interested in having this topic explored. You will have lots of views and she is very well known in Canada (TV, author etc) She does many television spots, social media postings not to mention tours for her books etc. Let me know what you think. Thanks

  4. I'm curious whether you know anything about positive effects of banning antibiotics for animal growth promotion in the European Union vs the US scenario.

  5. The placement of the Frontline program and the depth in which they explored some aspects of the enormous problem of antibiotics resistance were far from ideal, but I have to say that I heard people talking about it today. Not as many as I would like, but they were health care professionals who were oblivious to the depth of the antibiotic development crisis. I think that's something, even if it's not exactly what we want.

  6. Positive effects of the EU ban on the use of antibiotics for growth promotion in animals - virtual elimination of vancomycin-resistant enterococcus and many fewer food-borne outbreaks due to resistant strains (in spite of a very famous and large one last year starting in Germany).

  7. I thought the program, available for streaming online now, wasn't bad. I had suggested that they try to cover some of the efforts that had been made in the area - especially with new beta-lactamase inhibitors-beta lactam combinations. It was a sobering and scary look at the state of the problem - but, as you say, didn't touch sufficiently on agricultural use, regulatory questions and the way forward.

  8. David
    You forget about all the industrial chemicals used in consumer goods that can trigger antibiotic resistance- triclosan, bis-phenol A and a host of others never even mentioned. Then you all go on and on about growth promotants and chemicals used used in agriculture- some of which are over 60 years old and are cleared from the organism before brought to market.
    In short, you all need to look for ALL causes of AR induction and stop beating the usual horses. Good cause, similar results and the need for new antibiotics is needed.

    But all I ever hear are biologists talking over the same points- where are the chemists? I know, they have been laid off from Pharma and supplanted by CROs overseas-