The following is an editorial published in the current issue of Science
magazine.  It's a little long, and doesn't mention bees directly, but it
does speak to recent discussions on this list.  I'll rely upon the judgement
of the moderators--whose work I do appreciate.

Adrian Barta (and I've already lost more hives by January than I lost all of
last winter) in a cold Wisconsin, U.S.


Science Jan 19 2001: 397. Antibiotics, Animals, and People--Again!
Stanley Falkow and Donald Kennedy*

Nearly 25 years ago, we were both involved in a proposal to terminate
the use of certain antibiotics then being added to animal feeds in the
United States to promote the growth of livestock (the United Kingdom had
wisely restricted the most prevalent uses years earlier). One of us (Don
Kennedy) was commissioner of the U.S. Food and Drug Administration
(FDA); the other (Stanley Falkow) was a member of an expert panel
commissioned by the FDA to assess the associated risks. At that time,
evidence linking antibiotic resistance in bacteria inhabiting livestock
to resistance in human pathogens was indirect, though it was plain to us
and to most microbiologists that using the same antibiotics in people
and animals was a bad idea. The FDA proposed eliminating the
subtherapeutic growth-promotant uses of penicillin and two other
antibiotics, but livestock production interests persuaded Congress to
put the regulation on the shelf.

Science lost that time, but of course science didn't stand still.
Molecular epidemiology was unheard of in 1977, and studies on the
transfer of resistance plasmids among different kinds of bacteria were
in their infancy. Now there are unmistakable links between the
subtherapeutic use of antibiotics and the prevalence of resistant
bacteria. Two studies by the U.S. National Academy of Sciences, while
recognizing that link, found that there was insufficient evidence for a
direct influence on human health, thereby shifting the debate from
molecular genetics to risk assessment. Denmark, Finland, and Sweden have
all eliminated the use of antibiotics for growth promotion, and the
World Health Organization has advised against the practice of dosing
animals with some of the same antibiotics we rely on in human medicine.
Yet the practice continues in the United States and many other nations.

An additional and potentially more serious problem has now emerged. In
1996, the FDA approved the use of fluoroquinolines in chickens and
turkeys, primarily to prevent mortality associated with Escherichia coli
infection. This inexplicable decision was reached despite strong
opposition from the Centers for Disease Control (CDC), which cited the
extraordinary value of these compounds in treating community- or
hospital-acquired enteric infections in humans. Subsequent events showed
that the CDC's concerns were prescient: Fluoroquinoline resistance
quickly appeared in Campylobacter isolated from chickens, and by 1999
17.6% of C. jejuni and 30% of C. coli isolated from human patients
showed fluoroquinoline resistance. Campylobacter infections are the
leading cause of food-borne illness in the United States. Adding to the
human and economic costs are chronic sequelae associated with C. jejuni
infection: Guillain-Barré syndrome and reactive arthritis. Armed with
such evidence, the FDA's Center for Veterinary Medicine proposed on 31
October 2000 to withdraw the approval of fluoroquinolines for animal
use. Of the two manufacturers, Abbott Laboratories agreed voluntarily to
cease manufacture of its product; Bayer Corporation did not, and is
submitting its case for continued marketing along with its request for a
hearing. We think the FDA should pursue its case aggressively to stop
Bayer from marketing.

In the end, the FDA has taken the right stand, and we may dodge this
bullet. The CDC played a strong role in developing the epidemiological
context for the action and deserves to be congratulated. But we will be
wise to reflect on the problems that remain. It is hardly surprising
that compounds useful in human health also help animals. Both humans and
animals are heir to related bacterial pathogens; indeed, most human
bacterial pathogens can be traced in evolution to microbes that infect
animals. Nearly half of the total volume of antibiotics used in the
United States is fed to animals, and this practice continues despite a
strong scientific consensus that it is a bad idea. The resulting
struggle between good science and strong politics has simmered
fruitlessly for a quarter of a century; it's time to end it, and some
entrepreneurial energy might do the trick. In human medicine, the goal
has been to develop broad-spectrum compounds effective against a range
of pathogens, and it is natural for veterinary medicine to deploy these
rather than develop new ones. However, we now know enough about
bacterial genomics and bacterial pathogenesis, and we have enough new
biochemical technologies, to begin developing novel antimicrobials that
work specifically against animal pathogens yet do not create resistance
in human ones. It looks to us like an economic opportunity as well as a
scientific challenge. Anyone out there care to try·