The Trouble with Antibiotics, PBS Frontline

The latest from this documentary series trains its high-beam scrutiny on a health crisis that rivals the Ebola scare.

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John Sullivan
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While America frets over a potential Ebola outbreak in Texas, another crisis already plagues the country’s health-care system: bacteria that have become resistant to antibiotics are cropping up in hospitals nationwide. These superbugs infect more than 2 million patients annually, of whom at least 23,000 die. In “The Trouble with Antibiotics,” the PBS documentary series “Frontline” examines how the medical establishment deals with infection by ever-morphing infectious agents, confronting the federal government’s slow pace in taking on the problem and private industry’s denial that it is likely one of the primary causes. Against the unstated backdrop of the current Ebola threat, the program portends a day when outbreaks of superbugs could bloom into a full-blown panic in hospitals across the globe.

In exploring this developing emergency, “Frontline” correspondent David E. Hoffman looks first at a decades-old controversy, the use of antibiotics in food animals. Because much of the meat consumed in the United States is produced at industrial-scale farms where thousands of chickens, turkeys, and pigs spend their lives confined in huge sheds, it is generally acknowledged that lacing the food and water of these captive animals with antibiotics helps industrial farmers check the spread of disease. But using antibiotics for such purposes also had an unforeseen benefit: the animals got bigger faster, needing less feed.

Acknowledging that the consequent reduction in cost benefits consumers, the program also brings up the disturbing possibility that use of antibiotics may be linked to an increase of infection in humans by such bacteria as MRSA (Methicillin-resistant Staphylococcus aureus), an antibiotic-resistant superbug. Hoffman quotes public-health researchers who have shown a troubling incidence of MRSA infection among people living near confined pig farms in northwestern Pennsylvania, where the antibiotic-laden manure from such operations is spread over crop fields. As expected, farm industry representatives dismiss the research as flawed because the manure was not tested for the presence of MRSA. Even the federal Centers for Disease Control and Prevention admits that linking a particular herd of animals with an outbreak of a particular disease among a human population is “very challenging.”

From there, Hoffman makes the leap (at least implied) that such practices in agribusiness nevertheless are responsible, to one degree or another, for the superbug dilemma affecting many large hospitals across the U.S. Relying on a study of urinary tract infections in Flagstaff, Ariz., Hoffman points to one researcher’s conviction that an unusual spike in antibiotic-resistant infections were coming from meat sold in local stores. It’s an interesting premise, but one that (he notes) is not entirely thoroughly borne out by scientific testing — at least not yet.

As part of the backstory, the program details the U.S. Food and Drug Administration’s decades-old concern about superbugs contaminating the food supply, and the resistance it has met through the years from such industry organizations as the Animal Health Institute, as well as skeptical farm-state politicians. Today, the FDA is still struggling to find a path to resolve the conflict; its latest measure, a policy whereby industrial meat producers voluntarily pledge to reduce and ultimately end their use of antibiotics, has resulted, conversely, in a 16 percent increase in sales of antibiotics to those producers.

The program concludes with a segment about how one superbug, KPC (Klebsiella pneumoniae Carbapenemase) — which has not been linked to a drug-resistant organism in the food supply — has swept across hospitals in the United States and worldwide. Harking back to a “Frontline” episode aired in 2013, the second part of this program shows how an outbreak at the clinical center of the National Institutes of Health ended up killing six patients at the facility in Bethesda, Md., among them a 20-year-old man who was infected after receiving a bone-marrow transplant. Though the program includes interviews with the young man’s parents and shows a poignant human dimension to all of the scientific data and graphs, the NIH segment feels tacked on, not really related to the first part’s premise of how superbugs affecting humans may be related to overuse of antibiotics in food animals.

Though the program explains clearly and with crisp precision many of the complex issues involving the superbug crisis, Hoffman’s glib interviewing style grows a bit tiresome after a while. But that seems to be the “Frontline” style: facts first, flak later. At least Hoffman avoids for the most part the “60 Minutes”-style gotcha, where interviewees are made to squirm at some uncomfortable truth. The program also shows images that are confusing rather than revelatory: a woman in plain clothes (lacking the surgical garb Hoffman dons while visiting the same commercial chicken operation) walks through a cavernous barn, its floors awash in chickens, spraying something from a bucket. Is this some grim antibiotic, an antiseptic, or another concoction altogether? Likewise, many frames show lab and hospital workers seemingly dealing with the KPC crisis at the NIH. But are they really, or are these scenes merely stock footage unrelated to the story as narrated? The shots, including one of a reverend in clerical collar, add an unnecessary melodrama to the already chilling story presented.

Those quibbles aside, “The Trouble with Antibiotics” raises to a new level of awareness an emerging health crisis in the United States. Although it doesn’t articulate a game plan for confronting this challenge to the nation’s well-being, it does what a good investigative documentary ought to, underscoring the urgency for action in the face of a looming threat.

John Sullivan

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