Pediatrics, Volume 136, number 6, December 2015, the official journal of the American Academy of Pediatrics (AAP), posted a “technical report” written by Jerome Paulson, MD, FAAP and Theoklis Zaoutis, MD, MSCE, FAAP, THE COUNCIL ON ENVERONMENTAL HEALTH, THE COMMITTEE ON INFECTIOUS DISEASES titled “Nontherapeutic Use of Antimicrobial Agents in Animal Agriculture: Implications for Pediatrics.”

To quote from the abstract, “Infants and children are affected by transmission of susceptible and resistant food zoonotic pathogens through the food supply, direct contact with animals, and environmental pathways.”

The abstract goes on to say that “The overuse and misuse of antimicrobial agents in veterinary…..medicine is, in large part, responsible for the emergence of antibiotic resistance.”

In the conclusion paragraph, the report ends by saying that “…antibiotics should be used in food-producing animals only to treat and control infectious diseases and not to promote growth or to prevent disease routinely.”

The implication to me is that these Pediatricians are saying we don’t use antibiotics to prevent disease in human medicine, so the DVMs should not either. Evidently “prevention” would fall under the “Nontherapeutic Use of Antimicrobial Agents…”

Interestingly, I had some oral surgery a few weeks ago and was put on Clindamycin for a week to prevent infection.

The next week, my wife had a spinal fusion and received four doses of an IV Cephalosporin to prevent infection.

Were those “nontherapeutic” uses of antibiotics?

In my opinion, there is an overuse of antibiotics in both human and animal medicine, but the main reason for the increasing resistance is simply exposure. Some pathogens, like Staph aureus, mutate to protect themselves when exposed to an appropriate antibiotic, issued in the right dose for the correct length of time.

Other pathogens, like Group B Streptococcus that causes sore throats in kids that may progress to Rheumatic Fever if untreated, remain non-resistant to the drug of choice to treat that infection….plain old Penicillin.

Penicillin is cheap and has few side effects. And is nearly 100% effective for Strep Throat.

So it befuddles me why my ten year old Grandson’s pediatrician, a proud member of the AAP I assume, would prescribe Keflex last Monday for his Strep Throat.

Keflex costs much more, and has more side effects, such as diarrhea produced by killing off the good bacteria in the colon.

Keflex is broad spectrum, killing off both gram positive and gram negative bacteria.

Plain old penicillin is much more like a laser guided drug, attacking only the gram positive bacteria (Strep) and leaving the gram negatives (colonic bugs) alone.

Using a cephalosporin for Strep throat is like taking a 10 gauge shotgun on a quail hunt.

Keflex has far more indications than plain old penicillin, like foodborne Salmonella infections in kids that the AAP report is so concerned about. So why needlessly expose germs to it and possibly cause resistance when Pen V K will do the job?

I hope Drs. Paulson and Zaoutis, and their committees on Environmental Health and Infectious Diseases, can answer that question for me.

Maybe someone needs to look in the mirror

Join for free* to continue reading.