AMA, Disinfect Thyself

Editor's Note: Welcome to the debut of our new column, Junk Science, where writer Steve Milloy will take a careful — and sometimes opinionated — look at some of today's more controversial science stories.

Physicians wash their hands to avoid spreading germs between patients. Lately, physicians have been washing their hands of the American Medical Association; and for good reason. The AMA has turned goofy: now the association is asking the Food and Drug Administration to make homes safer for germs.

The AMA has suffered a string of embarrassments in recent years. It paid $10 million to Sunbeam Corp. for reneging on a controversial endorsement deal. The editor of the Journal of the American Medical Association was fired for publishing a survey reporting college students didn't think oral sex was sex during President Clinton's impeachment.

The AMA's latest gaffe is an effort to shift blame in the growing controversy over antibiotic resistance away from physicians who hand out antibiotics like candy. It's no wonder the AMA loses thousands of members every year. Only one-third of physicians are members, down one-half since the 1970s.

The World Health Organization warned recently that bacteria are becoming increasingly resistant to antibiotic medicines. Once treatable diseases like gonorrhea, tuberculosis and malaria may become incurable as a result. Food poisoning is already more difficult to treat. Infections caught in hospitals, killing an estimated 88,000 annually, often resist at least one antibiotic.

The bacteria streptococcus pneumoniae, the cause of most acute ear infections in U.S. children, was susceptible to all penicillins and cephalosporins until 1974. By 1996, 21 percent and 9.3 percent of pneumococci resisted those drugs.

The problem of antibiotic resistance isn't new but the WHO's alarm rightly spotlights one of the major causes of the growing resistance: physicians who prescribe unnecessary antibiotic drugs.

The WHO says haphazard prescribing causes drugs to lose effectiveness almost as quickly as they are discovered. David Heymann, WHO's communicable disease program chief said, "[we] may only have a decade or two to make use of many of the medicines presently available to stop infectious diseases."

The AMAs reaction? Educate physicians about over-prescribing antibiotics? Nope. Incredibly, the AMA urged the FDA to expedite regulation of anti-microbial consumer products such as hand lotions, soaps and body washes. But there is no scientific evidence consumer anti-microbial products have caused any increase in antibiotic drug resistance.

"The American Medical Association's caution to consumers about using anti-microbial soaps and washes is a mistake," said Dr. Charles Gerba, professor of Environmental Microbiology at the University of Arizona and a world renowned expert on bacteria. "It is irresponsible for credible medical professionals to dismiss the entire category of anti-microbial products that fight disease-causing germs based on speculative scientific theories. These products dramatically reduce the risk of contracting infections from common bacteria, such as salmonella or E.coli, in the home," Gerba added.

In contrast, the association between the antibiotic drug overuse and drug resistance is well-documented and the AMA is well aware of the problem of antibiotic drug overuse. A study in the Journal of the American Medical Association recently reported that doctors wrote — in a single year — 12 million antibiotic prescriptions for colds, bronchitis and other respiratory infections. But the study noted more than 90 percent of such infections are caused by viruses impervious to antibiotics. Another recent study in the Journal concluded as many as half of all antibiotic prescriptions are not needed.

Dr. Stuart Levy of Tufts University Medical School in Boston, who has been sounding the alarm on drug-resistant germs for more that a decade, recently said, "The major problem is the overuse of antibiotic [medicines]."

Consumers are fortunate that anti-microbial products, used in hospitals and doctors offices for generations, are available for home use. Though anti-microbial products aren't substitutes for thorough hand-washing, they provide an added margin of germ-fighting capability.

We've been fighting germs since Louis Pasteur developed the germ theory of disease in 1864, and enjoying tremendous success. Now we need to solve the problem of antibiotic resistance. But instead of fighting bacteria by educating its members, the AMA has opted to befriend bacteria by fighting home hygiene.

— Steven Milloy is a biostatistician, lawyer, adjunct scholar at the Cato Institute, and publisher of