Physicians Ask EPA, 'Antibiotics To Cure Sick Apples, Or Sick Children?'

The Environmental Protection Agency (EPA) on Wednesday granted the state of Michigan "emergency" permission to use gentamicin to fight a tree disease called fire blight.

"At a time when bacteria are becoming increasingly resistant to many of our best antibiotics, it is an extremely bad idea to risk undermining gentamicin's effectiveness for treating human disease by using it to treat a disease in apples," said IDSA President Donald Poretz, MD.

Gentamicin is a crucial antibiotic used to treat dangerous gastrointestinal and urinary tract infections, and is particularly valuable for treating blood infections in newborn children. As rates of antibiotic-resistant infections rise across the country, effective drugs like gentamicin become increasingly valuable. The Food and Drug Administration classifies gentamicin as, "highly important." The Environmental Protection Agency (EPA) currently bans its use on imported fruits and vegetables and EPA officials have previously stated that using gentamicin in agriculture could reduce its value in treating human infections.

But in an ill-advised reversal, EPA granted Michigan special permission to use the antibiotic. The reason, ironically, is that fire blight has become resistant to the antibiotic apple growers had been using, streptomycin.

Microbes evolve resistance quickly, whether they cause human disease or apple disease. What worries infectious diseases physicians is that microbes pass those resistance traits on to other microbes. So when some species of microbe inevitably evolves resistance to gentamicin, IDSA is very concerned that that trait will show up in bacteria that cause human infections.

IDSA is urging EPA to rescind its decision. "The threat of antibiotic resistance is growing, and the number of effective antibiotics is dwindling," Dr. Poretz said. "Our priority must be to save these effective antibiotics for whom they are needed most: for humans, not for agriculture."

Congress is currently considering new legislation, the Strategies To Address Antimicrobial Resistance (STAAR) Act, intended to improve the U.S. response to antimicrobial resistance. IDSA and more than twelve other major medical, health care, and public health organizations have endorsed the STAAR Act.