Lisa Magnusson Spreads Myths about Antibiotics, Acne and Animals
Note: The comment section has additional information highly relevant to the impact of antibiotic use in agriculture (Note added 20160429 00:30 GMT +1).
Today, mainstream media is increasingly distrusted. One aspect of this is their enormously substandard reporting on science and frequent scientific errors in other areas.
Previously, we have examined an article written by journalist and columnist Lisa Magnusson, whereby she claimed that blood donation rules where “pure moralism”. In reality, there is substantial evidence for eligibility criteria, coming both from governmental agencies, independent experts and non-governmental activist groups. Unfortunately, she has repeated this kind of failure to fact-check in yet another article, this time about antibiotics.
In her editorial, Magnusson makes several scientific errors. She claims that antibiotic resistance makes bacteria spread uncontrollably, despite the fact that the largest decline occurred before antibiotics. She blames the antibiotic usage in the animal industry which she claims is given to healthy animals, but this was made illegal in Sweden for almost 30 years ago, and illegal in the entire EU 10 years ago. She also ignores the fact that the most common antibiotics in the Swedish animal industry have very little overlap with the kinds of antibiotics that are used in therapeutic settings, that these resistance genes commonly occur in nature already, and that humans use 4-7x more antibiotics than are used in the meant industry. Magnusson also implies that antibiotics treat inflammation, but this is rarely the case and fails to acknowledge that the celebrity artist herself clearly says that she uses antibiotics for her acne primarily for vanity.
Antibiotic resistant bacteria do not spread “uncontrollably”
Magnusson claims that overuse of antibiotics leads to multi-drug resistant bacteria spreading “uncontrollably”. But this is not entirely accurate. This is because the largest reduction in spread of human pathogens occurred before the advent of antibiotics. In other words, spreading human pathogens (no matter if they are sensitive or resistant) is due to bad routines, not primarily the existence of antibiotic resistance itself.
Feeding healthy animals antibiotics has been banned in Sweden since 1986 and EU since 2006
Next, she regurgitates a common myth about the animal industry in Sweden and the EU (my translation):
The most egregious example of unnecessary, yes purely nonchalant, treatment with antibiotics is the meat industry, were they in preemptively give medication to animals for slaughter so that they will not infect each other with different diseases.
Let’s take it one more time: animals for slaughter. Preemptively. This is the major problem, not that a young woman gets help with her acne.
Unfortunately, the treatment of healthy animals for the purpose growth promotion has been banned in Sweden since 1986, and so Magnusson is 30 year behind scientific and political reality. Here is how the governmental agency Swedish Board of Agriculture describes the issue (my translation):
In 1986, Sweden was the first country in the world that banned all usage of antibiotics for the purpose of growth proportion. Since then, Sweden has participated in ensuring that the same ban was introduced in the whole of EU in 2006. The use of antibiotics for animals is low in an international perspective and has also declined since the middle of the 1990s. The total amount of antibiotics to animals in Sweden has declined with 26% from 2007 to 2011.
So to summarize, Sweden was the first country in the world that banned the use of antibiotics for healthy animals and this happened in the mid-1980s. This has also banned in the entire EU for 10 years. So why does Magnusson claim that antibiotics is used on health animals? As we will see later, she claims that she knows about this already. But then we must ask ourselves why she intentionally wrote something she knew was false.
The types of antibiotics used in animal industry have limited therapeutic usage already
Even people with a limited knowledge of chemistry knows that there are many forms of antibiotics. So what kind of antibiotics is used in the animal industry? It turns out that the most commonly used antibiotics on animals have a very, very weak overlap with the antibiotics that are used therapeutically in humans. The Swedish governmental agency National Veterinary Institute points out that it is mostly Trimethoprim and sulfa:
The figures refer to kilogram active ingredient sold for oral treatment to individual animals. So what is trimethoprim and sulfa? Most people have never heard of these kinds of antibiotics. Why is that? This is because they are some of the earliest antibiotics ever made. Sulfonamide (commonly called sulfa) was discovered in 1930s and resistance emerged after just a few years. Sulfa-like antibiotics are still used for e. g. urinary tract infections, but they are not heavily relied on for a broad range of infections. What about trimethoprim? It was discovered in 1962 and has similar usages as sulfa. Among hospital patients, the resistance may be as high as 20-40%.
So people, like Magnusson, who fear-monger about antibiotic resistant due to usage in the animal industry, rarely distinguish between older antibiotics used in the meat industry and more modern antibiotics used broadly in a therapeutic setting.
Resistance genes for animal industry antibiotics already well-spread in nature
So most of the antibiotics used in the Swedish meat industry is not broadly used in treating infectious diseases in humans. But how should we look at the magnitude of the contribution to antibiotic resistance by the meat industry?
One approach is to look at other sources of these resistance genes. Are they well-spread in nature already? This discussion has close parallels to the discussion about antibiotic resistance markers in the production of genetically modified plants, where anti-GMO activists have fearmongered about these markers and their supposed contribution to antibiotic resistant human pathogens.
In reality, resistance gene to e.g. kanamycin, streptomycin, chloramphenicol, ampicillin and others are widespread in nature and is a result of the evolutionary arms race between different bacteria and fungi. Thus, the magnitude of the influence of antibiotic resistance from the animal industry has to be put into relation to the fact that antibiotic resistance for some of these antibiotics are already well-spread in nature.
Another problem with the narrative that antibiotics used in the meat industry is that it is unlikely to be a problem even if we neglect all the above evidence. This is because the bacteria from slaughter animals that carrying these resistance genes have to survive cooking, survive the mechanical chewing in the mouth and the DNA degrading enzymes and further enzymatic degradation in the digestive tract and about a 2h stay in the stomach itself and after that undergo successful horizontal gene transfer to the gut bacteria. Real scientific studies (as oppose to speculations in a local newspaper by a journalist with questionable scientific knowledge) show that e. g. antibiotic resistance genes from GM feed is not transferred to the gut bacteria in the animal eating it.
Humans get 4-7x the amount of antibiotics as the Swedish animal industry
If this was not enough arguments or evidence, we can also take a look at how much the antibiotic usage in the meat industry compares with the antibiotic use in humans. It turns out that in Sweden, humans get somewhere between four and seven times the amount given to animals, which means that the meat industry is only a minor fraction of the antibiotic given to humans (even if we were to disregard the type). Here is the Swedish Board of Agriculture again (my translation):
In Sweden, the usage of antibiotics in animals is considerably less than in humans. In 2009, the consumption was 64 metric tons to humans and 15 metric tons to animals. This means that the human consumption is calculated to correspond to 106 mg/kg body mass, whereas the animal consumption corresponds to 15 mg/kg body mass.
It should also be pointed out that this antibiotic is used against either human pathogens or commensals and does not require the elaborate path described above.
Does Magnusson mention this in her editorial? No. Instead, she blames it on the meat industry, even though humans use considerably more. Sure, one can focus on more than one issue at a time, but it is irrational to claim that B is a bigger problem than A, if evidence shows that A is a much bigger problem.
Human contributions to antibiotic resistance beyond treatment
Besides taking antibiotics to treat bacterial infections, human usage of antibiotics also involves taking it for things that it does not treat, from the common cold (a virus infection) to non-existent conditions like “chronic” Lyme’s disease as well as antibiotics leaking into the environment from industries. A news item on the Nature website describes the problem like this:
A continual discharge of antibiotic-contaminated water has created a hotspot of bacterial antibiotic resistance in an Indian river. […] n three sites downstream of the plant, the resistance genes made up almost 2% of the DNA samples taken there, the researchers report in PLoS ONE. Because only one or two genes out of the typical genome of around 5,000 genes are necessary to protect the bacterium, that’s a lot of genetic resistance, says Dave Ussery, a microbiologist at the Technical University of Denmark, who was not involved in the work.
So the human effect extends beyond personally eating antibiotics.
Antibiotics do not generally treat “inflammation” directly
Like many mass media personalities, Magnusson harbors severe misconceptions about antibiotics and what it can treat (my translation):
Acne is an inflammation in the skin, and in its more severe form it can and of course should be treated in the same way that inflammation in all other parts of the body is treated.
Here Magnusson seems to believe that antibiotics is a general treatment for inflammation, but this is not at all the case. Inflammation is a response by the body that involves, among other things, swelling, redness, pain, dilation of blood vessels. This is treated by anti-inflammatory drugs, such as aspirin that inhibits the COX enzymes or glucocorticosteroids. Antibiotics in general has no direct effect on inflammation, since antibiotics either stop bacteria from growing (bacteriostatic) or kill them directly (bactericidal). Claiming that antibiotics generally directly treat inflammation, as Magnusson does, is just as ignorant as claiming that antibiotics cure viral infections such as the common cold. There are, however, some antibiotics that may have a discernible anti-inflammatory effect, but this is not a general effect of antibiotics.
Yes, severe forms of acne that involve the sustained infection of the bacteria Propionibacterium acnes should be treated with antibiotics. Acne has a strong genetic component, since about 80% of the variation in acne status can be explained by genetic variation. This means that antibiotics should not be used indiscriminately for what is often a vanity issues where it very well end up not helping. Again, in severe cases where there is widespread infection and where it has substantial negative psychological consequences, antibiotics should be used.
Larsson has 1.2M Instagram followers, not merely a “young woman with acne”
Magnusson thinks this issue is just a way for the patriarchal establishment to oppress a young woman with acne. In reality, the problem is not so much that Larsson, as an individual, uses antibiotics for a vanity issue. The problem is rather than she has a very large following, with about 1.2M follower on Instagram alone. This means that her pseudoscientific vanity message has the power to influence over a million people. Pointing this out is in no way patriarchal oppression and that accusation is merely an emotionally charged manipulation to cover up scientific errors.
Larsson herself confesses that it is partly due to vanity
But is it not just misogyny and sexism to claim that Larsson does it due to vanity? Well, no. This is because she herself said that it was partly due to vanity in the podcast (my translation):
– Antibiotics is not good. You should not eat it if you do not need to, but I am so vain and I want to have a perfect skin and feel incredibly bad over it.
In other words, it appears that Larsson does it primarily because of vanity and a desire for “perfect skin”. Not just skin without sever acne, but “perfect” skin. She even says that the antibiotics have been ineffective for her (my translation):
– I have started to eat antibiotics against my acne. I have not seen that it has worked yet. But I may have gotten a fungal infection in my genital area.
Setting the stuff about vaginal fungus aside, she says that her antibiotic treatment has not worked yet, but perhaps it will in the near future.
It should also be pointed out that treatment against severe acne is not primarily antibiotics, but the vitamin A derivative isotretinoin. This suggests that Larsson, in contrast to what Magnusson tries to imply, does not have a severe form of acne.
Larsson herself harbors misconceptions about antibiotics
To reinforce the conclusion, Larsson make claims in the same podcast that suggests that she has several dangerous misconceptions about how antibiotics work and more importantly how antibiotic resistance works (my translation):
– I was also told that the medicine I take is also medicine against chlamydia. If I would get chlamydia soon, I do not how good the medication would be. You become a bit resistant.
No, you do not become resistant to antibiotics. The pathogenic bacteria (in this case, chlamydia) becomes resistant. The belief that the person himself or herself becomes resistant to antibiotics is a common misconception about antibiotics. This gives additional weight to the idea that Larsson has dangerously flawed ideas about antibiotics.
A to quoque fallacy about role models
Magnusson ends her post with an obvious to quoque fallacy (my translate):
Role model. That is a word that is hardly ever used about men, but constantly recur about young women in the public eye. Usually, the word is hurled out as a reproach, just as in Fredrick Federley’s case above. What one says when one demands that a certain woman should be a role model is that she ought to be more capable; think less about herself and more about others. And now, apparently, women should preferably refrain from being treated for certain physical conditions.
First of all, it is not just female celebrities that are criticized for promoting pseudoscientific beliefs. The American rapper b. o. b. recently came out as a flat-earther on Twitter and posted a large number of flawed arguments and claims about the earth. He has about twice the number of Twitter followers compared with the number of Instagram followers for Larsson and he was vehemently criticized and scolded for it. Particular focus was put on the role model failure by astrophysicist Neil deGrasse Tyson:
In a free society, you can and should think whatever you want, and if you want to think the world is flat, go right ahead. But if you think the world is flat, and you have influence over others, as would successful rappers or even presidential candidates, then being wrong becomes being harmful to the health, wealth and security of our citizenry.
So when Magnusson claims that this is hardly ever done to men, she is either ignorant, dishonest or has simply not paid sufficient attention to the public discourse.
But even if Magnusson was right (she is not), it has almost no relevance to the argument whatsoever. This is because Magnusson committed a fallacy known as argument ad hominem to quoque. Or, to put it plainly, shrieking “look over there, someone else is doing the same thing!” is not a valid argument. More concretely, there are many flaws with the common denialist tactic known as distracting.
Golden hammers, failure to fact-checking and intellectual responsibility
So why did Lisa Magnusson publish such a poorly researched editorial about antibiotics? I explained some of the above counterarguments to her on Twitter, but her response was to ignore almost all of them, and claim that she had acknowledged the Swedish ban from 1986 in a web television discussion. When I pointed out that this does not occur in the original article, she responded by stating that she did not really mean the meat industry in Sweden or the EU, but somewhere else. Again, nowhere in the original article is this stated. She also did not appear to read any of the sources I referenced or respond to any of the multitude of arguments I used. Instead, she ended up blocking me because according to her, she had acknowledged the 1986 ban already. Even if we allow her to escape that argument, there were plenty left that she did not want to interact with.
So why did Magnusson spectacularly fail to fact-check her piece? She has written previous articles that were of high quality from a scientific perspective, such as criticizing Swedish elected politicians who promote the chemtrails conspiracy theory and wants the government to investigate it. However, her past writings are not all success stories. One of her previous failures has also been discussed on this website before, when she in late 2015 claimed that blood donation rules were “pure moralism”, despite the fact that they are strongly evidence-based. So what are the common themes? Although we have a very small and restricted sample, it seems that her political ideology, in particular standing up for underprivileged groups, makes her less likely to do proper fact-checking.
Bigotry should always be steadfastly resisted, but it is quadruply erroneous to object to blood donation rules and the science of antibiotic resistance the way Magnusson does: she incorrectly labels science as bigotry, she promote a false understanding of reality, she gives science-based promotion of social justice a bad name and she opens up for cheap “rebuttals” against her ignorance as if those were valid objections against anti-bigotry (they are not).
In the end, Magnusson (as a journalist) has an intellectual responsibility not to promote scientific falsehood about important topics such as antibiotics and certainly not to defend other celebrities that promote ignorant ideas about it. There is also a widespread distrust of mainstream media, and the kind of scientific errors that Magnusson makes is not exactly going to contribute to changing that perception and may potentially reinforce it.
3 thoughts on “Lisa Magnusson Spreads Myths about Antibiotics, Acne and Animals”
A new paper in PLOS Medicine called Antibiotic Resistance in India: Drivers and Opportunities for Action looks at the different factors that impact antibiotic resistance in India. Although they do mention the animal industry as one factor, they highlight others as the main factors:
This is yet more evidence that although the animal industry should not use antibiotics so carelessly, it is not, as Magnusson claims, the most important factor.
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The arguments I outlined in this blog post made a dangerous simplification by neglecting the possibility of selecting for gene cassettes. So an antibiotic resistance gene against an antibiotic that is not used so much in humans and for which resistance is already widespread in nature can co-localize with a clinically important antibiotic on the same gene cassette, and so selection for e. g. sulfa can indirectly select for resistance to a clinically important antibiotic if they occur together.
More information about this issue can be found in the excellent article Antibiotic resistance: myths and misunderstandings.
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