Ronald McDonald for Surgeon General

Once again, it was a chilly winter in the Mid-Atlantic and Northeastern regions of our fair land. And once again, I ask myself why all ophthalmologists haven’t moved to Southern California or southern Florida (as opposed to only 95% of them).

As I write this, two of my family members are on antibiotics for sinusitis and other sequelae from the waning cold and flu season. Within 24 hours of starting their medicines, their symptoms were noticeably improved. Fortunately, no resistant organisms here.

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Antibiotic-resistant “super bugs,” however, are frequently mentioned in the lay press. The Centers for Disease Control and Prevention says that at least 2 million people become infected each year in the United States, and at least 23,000 die as the direct result of these infections. Many more die from other conditions complicated by an antibiotic-resistant infection.¹ Although other countries have the same problem, the magnitude is substantially greater in the United States.

Antibiotic resistance may relate to overuse of antibiotics by physicians in patients with viral illnesses. The major culprit is thought by many to be use of these drugs in farming. Staggering amounts are used not as treatment of infected animals, but as prophylaxis in feed and drinking water to encourage faster growth of larger animals.

For every antibiotic prescription written for a human being in our country, the rough equivalent of a dump truck full of antimicrobials is being used on our farms. In most other countries of the world, antibiotic usage in healthy animals is either discouraged and limited or specifically banned. Many experts cite this as the key reason why patients in those nations experience fewer infections with super bugs.

Recently, McDonald’s announced it would stop purchasing chickens treated with antibiotics commonly used in humans. Because this purveyor of fast food buys an estimated 3% to 4% of all chicken produced in the United States, the decision is expected to put pressure on the industry overall to remove these drugs from the diets of their fowl.

“This is a landmark announcement in the fight to keep life-saving antibiotics working for us and our children,” said Jonathan Kaplan, director of the Natural Resources Defense Council.²

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Time will prove whether this decision has a measurable beneficial impact on public health on the United States. If it does, I think we are led to only one reasonable plan of action.

In a room full of physicians, I asked each if he or she could name the Surgeon General of the United States. Every respondent did not know the name, except for one who asked whether we even have a surgeon general now.

“Who is the last surgeon general whose name you can remember?” I asked.

One physician in the room thought of C. Everett Koop, whereas another could recall the name of Jocelyn Elders.

My concern is this person is intended to be “the leading spokesperson on matters of public health in the federal government of the United States.” Yet, very few physicians in the United States know whether we have one-or can even name the person, let alone articulate what he or she has done to improve public health.

Hence, my proposal: If this ban on antibiotic-fed chicken results in fewer infections and deaths from resistant organisms, I nominate Ronald McDonald (no relation) for Surgeon General.

References

1.      www.cdc.gov/drugresistance/threat-report-2013

2.     McDonald’s to ban chicken treated with human antibiotics. USA Today. March 5, 2015.