Organic Chicken Has as Many Antibiotic-Resistant Bacteria as Conventional Chicken

Tom Philpott has a post at Mother Jones today about a Consumer Reports finding that, surprisingly, certified organic (and therefore antibiotic-free) chicken has as many “superbugs” (antibiotic-resistant bacteria) as chicken raised conventionally with antibiotics. The finding is clear but the reasons behind it aren’t at this point.

What got me was that chicken samples labeled “organic” or “no antibiotics” (list of all brands tested here) were just as likely to contain these potentially deadly, drug-defying pathogens. Notably, organic and antibiotic-free chicken both carry substantial premiums over conventional—at my local H-E-B supermarket in Austin, organic boneless chicken breast is fetching $7.97 per pound—vs. $4.99 for no-antibiotic and $1.97 for regular.

My surprise wasn’t based on some romantic notion that organic food is cleaner. Bacteria develop the ability to withstand to antibiotics by being exposed to them regularly. US Department of Agriculture code forbids antibiotics in organic meat production, and the “no antibiotics” label means just that, and is also regulated by the USDA.

Eighty percent of antibiotics used in the United States are given to animals raised for meat, dairy and eggs. Nearly all are given routinely, with the intent of preventing disease in these farmed animals, rather than as treatment for sick animals. The remaining 20 percent are used in human medicine.

Public health officials fear that if antibiotic resistance continues to accelerate at its current trajectory, we may find ourselves in a post-antibiotic age in the near future. If and when this happens, many infectious diseases that were fatal or caused permanently damage before the invention of antibiotics will be much more difficult to treat, as was the case prior to the 1940s.

The routine use of antibiotics in animal agriculture is an area ripe for reexamination.

Prescribing Antipsychotic Drugs to Kids

Consumer Reports looks at current practices and finds them alarming:

The number of children taking powerful antipsychotic drugs has nearly tripled over the last 10 to 15 years, according to recent research. The increase comes not because of an epidemic of schizophrenia or other forms of serious mental illness in children, but because doctors are increasingly prescribing the drugs to treat behavior problems, a use not approved by the Food and Drug Administration (FDA). And a disproportionate number of those prescriptions are written for poor and minority children, some as young as age 2.

Doctors are prescribing antipsychotics even though there’s minimal evidence that the drugs help kids for approved uses, much less the unapproved ones, such as behavioral problems. And to make matters worse, the little research there is suggests the drugs can cause troubling side effects, including weight gain, high cholesterol, and an increased risk of type-2 diabetes.

This pattern repeats itself throughout the medical system. A drug that may be helpful for certain severe cases is prescribed for vastly greater numbers of people. As we move down the severity scale, the risk-benefit ratio gets worse and worse. Milder cases (even assuming the diagnosis is correct) are those least likely to benefit from drug treatment and most likely to have a cost-benefit ratio that’s underwater.

New Cholesterol Calculator Tells Healthy People They Need Statins

The cholesterol guidelines released last week are already poised to drastically increase the number of people prescribed statin drugs, and this calculator that the American College of Cardiology just unveiled will help people miscalculate their risk (substantially upwards, of course) even more.

This is beyond the beyond. Worth reading this whole article if you or a loved one are considering taking statins.

“[It] overpredicted risk by 75-150%, depending on the population. A man whose risk was 4 percent, for example, might show up as having an 8 percent risk. With a 4 percent risk, he would not warrant treatment…..  Miscalibration to this extent should be reconciled and addressed before these new prediction models are widely implemented. If real, such systematic overestimation of risk will lead to considerable overprescription.”

“Something is terribly wrong,” Dr. Nissen said. Using the calculator’s results, he said, “your average healthy Joe gets treated, virtually every African-American man over 65 gets treated.”…

Antibiotic-Resistant Germs in Supermarket Meats

One more reason to just stop eating it. Also a clarion call to drastically overhaul the industrial model of animal agriculture that considers antibiotics a normal part of animal feed.

More than half of samples of ground turkey, pork chops and ground beef collected from supermarkets for testing by the federal government contained a bacteria resistant to antibiotics, according to a new report highlighting the findings.

The data, collected in 2011 by the National Antimicrobial Resistance Monitoring System — a joint program of the Food and Drug Administration, the Agriculture Department and the Centers for Disease Control and Prevention — show a sizable increase in the amount of meat contaminated with antibiotic-resistant forms of bacteria, known as superbugs, like salmonella, E. coli and campylobacter.

Many animals grown for meat are fed diets containing antibiotics to promote growth and reduce costs, as well as to prevent and control illness. Public health officials in the United States and in Europe, however, are warning that the consumption of meat containing antibiotics contributes to resistance in humans. A growing public awareness of the problem has led to increased sales of antibiotic-free meat.

The Agriculture Department has confirmed that almost 80 percent of all antibiotics sold in the United States are used in animal agriculture, and public health authorities around the world increasingly are warning that antibiotic resistance is reaching alarming levels.

Arthritis Drugs May Trigger Shingles

Because arthritis affects so many people as they age, this finding is important for health practitioners to add to their diagnostic radar screens. This is particularly true for those who deal primarily with musculoskeletal conditions.

Patients with rheumatoid arthritis (RA) undergoing treatment with agents such as Enbrel (etanercept), Remicade (infliximab) or Humira (adalimumab) appear to have a significantly increased risk for developing shingles.

The incidence of shingles among patients on anti-tumor necrosis factor (TNF) treatment was 1.6 per 100 patient-years, compared with an incidence of 0.8 per 100 patient-years among those receiving traditional disease-modifying anti-rheumatic drugs (DMARDs), according to Kimme L. Hyrich, MD, of the University of Manchester in England, and colleagues.

 

NY Times Article: Flu Shot Benefits Substantially Overrated

I have never found the hype behind flu shots convincing. Here’s new evidence supporting that skepticism.

It’s flu-shot season, and public health officials are urging everyone over 6 months of age to get one. Many businesses provide on-site flu shots, and some hospitals have told staff members that they have to wear masks if they do not get the vaccine. By 2020, United States health leaders want 80 percent of the population to get yearly shots.

For vaccine manufacturers, it’s a bonanza: Influenza shots — given every year, unlike many other vaccines — are a multibillion-dollar global business.

But how good are they?

Last month,, in a step tantamount to heresy in the public health world, scientists at the Center for Infectious Disease Research and Policy at the University of Minnesota released a report saying that influenza vaccinations provide only modest protection for healthy young and middle-age adults, and little if any protection for those 65 and older, who are most likely to succumb to the illness or its complications. Moreover, the report’s authors concluded, federal vaccination recommendations, which have expanded in recent years, are based on inadequate evidence and poorly executed studies.

“We have overpromoted and overhyped this vaccine,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy, as well as its Center of Excellence for Influenza Research and Surveillance. “It does not protect as promoted. It’s all a sales job: it’s all public relations.”

It’s my impression that it’s people over 65 to whom these vaccines have been most strongly promoted. And those are the folks who derive “little if any protection.”

 

 

In Study on Heart Patients, Exercise as Effective for Depression as Antidepressant Medication

Considering the side effects and costs of taking the medication, exercise is by far the better choice.

From a Reuters story on an article published August 1, 2012 in the American Journal of Cardiology:

People with heart disease who are also depressed may get as much relief from their depression symptoms with regular exercise as with medication, according to a U.S. study.

Researchers writing in the Journal of the American College of Cardiology found that of 101 heart patients with signs of depression, those who exercised for 90 minutes per week and those who started taking Zoloft both improved significantly compared to participants assigned to drug-free placebo pills.

 

Obamacare Has Saved Seniors $4 Billion On Drug Costs

While I would love to see much less dependence on medications and much more on healthy lifestyle changes, the fact that the Affordable Care Act has already kept $4 billion in the bank accounts of American seniors and out of the hands of the drug companies strikes me as a positive development that deserves to be widely publicized.

That’s what a new report from the Centers of Medicare and Medicaid Services has documented.

The Medicare agency released figures showing that millions of seniors and people with disabilities have saved $3.9 billion on medications since the law was enacted.
The data also showed that since the beginning of the year, more than 1 million Medicare beneficiaries have saved an average of $629 on prescriptions in the “doughnut hole” coverage gap. 

“Millions of people with Medicare have been paying less for prescription drugs thanks to the healthcare law,” said Marilyn Tavenner, the head of the Centers for Medicare and Medicaid Services.

“Seniors and people with disabilities have already saved close to $4 billion. In 2020, the doughnut hole will be closed thanks to the Affordable Care Act.”

To close the doughnut hole, the government will cover more and more of the value of brand-name and generic drugs until 2020, when seniors will be responsible for 25 percent of the cost for each.

When the Medicare drug benefit was passed by the Republican-controlled Congress in 2004, it was structured so that 100% of the costs were added to the federal deficit. In contrast, the Affordable Care Act of 2010 (aka Obamacare) was structured so as to decrease the deficit, in accordance with the estimates by the nonpartisan Congressional Budget Office.

 

 

FDA Endorses Industry-Sponsored Physician Education on Opioid Prescribing

The upside is that there is a clear recognition of the scale of the problem of over-prescription and inappropriate use of addictive painkillers. As noted in this Medpage article, “the prescription painkiller epidemic … was responsible for about 15,600 deaths in 2009, the latest year for which there are data.”

But industry sponsorship is a major red flag, leading some to opine that these educational programs fall far short of constituting an adequate response to the problem.

“The FDA’s goal is to ensure that healthcare professionals have the education they need to prescribe opioids and that patients have the know-how to safely use these drugs,” FDA Commissioner Margaret Hamburg said during a press call.

But critics cite a number of problems with the guidance, including its reliance on industry sponsorship of education, even with middle-man medical education companies. Also, extended-release and long-acting opioid analgesics training will not be mandatory for prescribers.

Finally, the program will not cover powerful short-acting opioids such as hydrocodone (Vicodin) that have an equally high potential for abuse.

“These educational programs are likely going to do more harm than good,” said Andrew Kolodny, MD, chair of psychiatry at Maimonides Medical Center in New York City. “Nowhere does it say that prescribers should tell patients these drugs are addictive. And these programs give the implied message that there’s evidence for using opioids in long-term, noncancer chronic pain.”