A major increase in patients who are resistant to antibiotics is alarming Dutch doctors. The number of people being treated in hospitals in the Netherlands who are now antibiotic resistant has risen fourteenfold in the last ten years.

Medical experts say antibiotic-resistant bacteria in food is at the heart of the problem. Doctors from Amsterdam’s VU hospital say there are increasing indications that the bacteria are present in chicken and some vegetables.

Infections in these people are difficult or even impossible to treat and experts are calling for the development of a new generation of antibiotics to deal with the problem. Otherwise, they argue, health care will find itself in a situation comparable to that before the discovery of penicillin.

Worrying trend
Although the actual numbers of patients who are antibiotic resistant is low - the VU hospital is at present seeing between 50 and 60 such patients each year - the trend is a worrying one.

The widespread use of antibiotics in the intensive livestock industry leads to bacteria which are resistant to the drugs being passed on to people.

There seems to be a link between two resistant bacteria that are appearing more and more often in hospitals, namely the much-feared 'hospital superbugs' MRSA and the lesser-known ESBL. Both bacteria are increasingly also found in animal husbandry. 
 
No more antibiotics
Earlier this month, it was decided to administer the antibiotic cephalosporin only in exceptional cases. However, Agriculture Minister Gerda Verburg introduced further measures.
 
"Here we have farms which are going to try doing without any antibiotics. This means they will experiment with different fodder, a different climate in the stables and other such measures. We are going to see whether a number of front runners can set a good example for the whole sector. And everybody else knows: 20 percent must be cut by 2011" 

Too little
Critics say a 20 percent reduction in the use of antibiotics is not nearly enough. In the past few years, antibiotics use has increased by dozens of percentage points. On top of which the measure is no more than an non-binding agreement with the farmers. Only when they fail to live up to these agreements will the minister consider introducing legislation.   
 
And yet, Ludo Hellebrekers, chair of the veterinians’ association KNMvD, says:
 
"We can recommend farmers to take different management measures to improve animal health so they will need less antibiotics. However, these farmers are facing the issue of how to do this in an economically viable way. That’s the dilemma."
 
So that is the real problem. Large numbers of animals are being kept in a small amount of space to facilitate economic production. This means disease can spread quickly and farmers often use antibiotics preventively. In the past, these drugs were even used to stimulate growth.
 
No global regulations
Switching over to much more spacious stables or fully organic operational management will eventually make the meat much more expensive. And then there is competition from abroad. Even though the subject is increasingly high on the agenda of the World Health Organisation, there are still no global regulations regarding the use of antibiotics in farming. Ludo Hellebrekers says this is no reason to do nothing: 

"I think there is a lot of difference in the speed at which different countries are  move on this subject, but here in Europe and in the Netherlands we still need to take responsibility now."
 
Europe has introduced regulations, as has the United States and some other countries, but they are usually not similar. And enforcement of these regulations is not always what it should be. Dutch poultry farmers often complain about South American imports.
 
Last resort
As always, money plays a big role. Nevertheless, the Netherlands has got the wind up. The antibiotic Ceftiotur was used on a large scale to boost the resistance of day-old chicks, but the bacteria are becoming increasingly resistant against the drug which has since almost completely been banned in poultry farming. 
 
It is feared that people who eat chicken meat infected with resistant bacteria may prove impossible to treat. If this is the case, we are facing a much more serious problem. Ceftiotur is used in human medicine as a last resort against serious bacterial infections, when other antibiotics are no longer effective.