Overuse of antibiotics imperils public health

THE ISSUE An antibiotic used to treat gonorrhea has been found no longer effective.

DRUGS first limited to treat a resistant strain of gonorrhea in Hawaii eight years ago have now been recommended for patients nationwide, an alarming development that furthers the argument for curbing nonhuman antibiotic applications.

Data show rapid spread of the "superbug" in 26 cities with dramatic increases in cases from 1 percent of all gonorrhea infections to more than 13 percent in less than five years. In Hawaii, resistant gonorrhea comprised 1.4 percent of cases in 1997 compared with more than 20 percent in 2006.

What's causing concern is that the antibiotic that was the first line of defense against the fast-evolving microbe no longer restrains the disease. The substitute antibiotic now recommended by the Centers for Disease Control and Prevention leaves just the one class of drugs for treatment, with no new antibiotics for gonorrhea being developed.

Antibiotics are one of the most profound achievements in medicine, but decades of widespread and indiscriminate use -- in cosmetics and soaps and food animal production -- has rendered many ineffective.

The practice continues. Last month, the Food and Drug Administration, despite counsel from its own experts and health groups, put on the approval track for treating cattle an antibiotic that is the fourth generation version of the one the CDC is now urging for gonorrhea.

The company that makes the antibiotic contends similar drugs have been used in animals in Europe without harm, but recent data indicate bacteria resistance has grown not only in food animals but in humans as well. Government and private health organizations agree that careful, limited use of antibiotics is crucial to public health as microbes become more and more resistant to them. The spread of gonorrhea is just one indication of the danger.