The Overuse of Antibiotics in Livestock Feed Is Killing Us
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The 2000s were go-go years for antibiotic resistance. Thanks to the overprescription of antibiotics in medical settings and the non-therapeutic use of antibiotics in concentrated animal feeding operations (or CAFOs), we've aided the emergence of 'superbugs' -- or drug resistance microorganisms. Antibiotic resistance (AR) has led to the deaths of 70,000 Americans a year.
You'd think this would elicit some immediate action to prevent this public health nightmare from growing. But in 2007 when the (now) late Sen. Edward Kennedy introduced legislation to discourage the overuse of the antibiotics responsible for AR, it gained no traction. The reason? Kennedy stepped directly on the toes of two of the country's most powerful lobbying interests -- Big Ag and Big Pharma.
Agribusiness, it seems, cannot keep up its unsustainable feedlot system of raising thousands of animals in confinement, with poor sanitation and unhealthy diets, if it the animals weren't being pumped full of copious amounts of antibiotics.
"It seems scarcely believable that these precious medications could be fed by the ton to chickens and pigs," said the bill's background text. "These precious drugs aren't even used to treat sick animals. They are used to fatten pigs and speed the growth of chickens. The result of this rampant overuse is clear: meat contaminated with drug-resistant bacteria sits on supermarket shelves all over America."
Worse, when the FDA issued a directive in 2008 to ban non-therapeutic use of cephalosporin antibiotics in livestock (drugs also used in humans) to curtail resistance, irate lobbyists stormed Capitol Hill and the Bush administration backed down.
Now, with a new administration and Congress, Kennedy's bill has a House version, support from 300 organizations including the American Medical Association, American Public Health Association, American Academy of Pediatrics and American College of Preventive Medicine—and a good chance of passage.
The Preservation of Antibiotics for Medical Treatment Act (PAMTA) sponsored in the House by Rep. Louise M. Slaughter, D-NY (who has degrees in both microbiology and public health) would phase out non-therapeutic use of "medically important antibiotics" in livestock and strengthen standards for approval of new livestock antibiotics while still allowing their use in sick animals. Eighty-four percent of grower-finisher swine farms, 83 percent of cattle feedlots and 84 percent of sheep farms currently use antibiotics non-therapeutically, according to the bill. Seventy percent of antibiotics are fed to livestock, not humans, in the U.S.
Nor is use in livestock the only resistance culprit. Antibiotics are also abused by hospitals, clinics and doctors to prevent infection and to "treat" viruses when patients, especially parents of young children, want the psychological reassurance of a pill. Even antibiotic hand sanitizers and laundry detergents contribute to resistance, as do natural antibiotic treatments like tea tree oil. In fact AR might be the ultimate biological demonstration of the principle, "That which doesn't kill you makes you stronger."
Europe banned human-use antibiotics in livestock in 1998 and all non-therapeutic use of antibiotics in livestock in 2006, making it a test kitchen for AR reduction, particularly in Denmark, the world's largest pork exporter. In Denmark, antibiotic use is down 51 percent and bacteria and AR bacteria are also down, says the Pew Campaign on Human Health and Industrial Farming, with no increase in the cost of meat. Sweden, Norway and the Netherlands have also reported AR reductions as has Australia.
Reductions of antibiotic use are also underway in European hospitals. In Norway, testing and isolating patients with MRSA (methicillin resistant S. aureus, considered the granddaddy of resistant microbes) and prescribing fewer antibiotics has brought down the AR rate, according to an in-depth AP report in January.
On the surface, a bill addressing AR that could return us to pre-antibiotic medicine circa 1908 looks like a no-brainer. That's why the Animal Health Institute (AHI) and newly merged Pfizer/Wyeth (Fort Dodge) and Merck/Schering-Plough (Intervet) animal drug giants are lobbying hard against it. In fact, Rep. Slaughter's PAMTA may be the only bill that pits veterinarians against doctors.
Of course, Big Ag is fighting back. Agribusiness insists that antibiotics aren't causing AR and even if they are, we're not using human drugs, and even if we are using human drugs, we're cutting down on them. and even if we're not cutting down on them, the drugs are FDA-approved and undergo vigorous risk assessment. This parody of defenses includes everything but denying the use of antibiotics in the first place.
Actually, Big Ag's use of antibiotics increased 13 percent from 2006 to 2007 according to the AHI, to offset "high grain prices" and "capture both the economic efficiencies and the health benefits derived from the use of these products," the agribusiness weekly Feedstuffs reported in November 2008. Those "efficiencies" included feeding 10 million pounds of tetracycline—a broad-spectrum human antibiotic used for pneumonia, eye, ear and urinary tract infections, and gonorrhea—to livestock in one year.
In addition to worrying about Rep. Slaughter, agribusiness worries about the public health bent FDA is taking under its new directors, Commissioner Margaret A. Hamburg, MD, a former New York City health commissioner and Deputy Commissioner Joshua Sharfstein, MD, the number two officer and a former food safety staffer for Rep. Henry Waxman, D-CA. Especially since Sharfstein announced FDA's support of PAMTA at a House Rules Committee on the legislation in June, without even briefing agribusiness.
"You deliberately tried to blindside some of us on this committee, and we don't appreciate that," said Rep. Leonard Boswell, D-IOWA, to the FDA's new senior adviser on food safety, Michael Taylor after determining that Sharfstein's remarks had White House Office of Management and Budget seal of approval. Boswell, who was chairman of the House agriculture subcommittee on livestock last year, was the only pro-antibiotic voice at the PAMTA rules hearings.
Antibiotics are popular with CAFOs and lucrative for agribusiness for two simple reasons: less space and less feed.
Raising turkeys without antibiotics "would result in a decrease in density or an increase in the amount of land needed to raise the additional turkeys needed to meet the consumer demand," said National Turkey Federation's Michael Rybolt at the 2008 cephalosporin hearings, admitting antibiotics enable crowding. It would create greater feed needs, "an increase in manure" and tie up more land for crop production, said Rybolt.
While antibiotics do squeeze more nutrients out of feed by killing gut bacteria and causing "growth" say scientists, a Johns Hopkins University study in Public Health Reports in 2007 found their cost canceled out profits for chicken farmers.
Evidence of AR infections—urinary tract, intestinal, upper and lower respiratory, ear, skin, and even TB and STDs—is not hard to find in hospitals and communities. In fact, MRSA was reported plentiful on Florida swimming beaches at the American Association for the Advancement of Science annual meeting in 2009.
Antibiotic-resistant microbes are also found in ground water, soil, and in crops and workers near manure lagoons and industrial farms and are in many of the foods we eat. Consumer Reports found over 60 percent of microbes detected in chickens from 22 states were resistant and an FDA inspection found cephalosporin—the antibiotic it tried to ban in 2008—directly injected into eggs at a U.S. hatchery. Bon appetit!
But don't look for many new antibiotics in the pharmaceutical pipeline. There's less money in developing drugs taken for 10 days (unless you're an animal) than in heart, arthritis, diabetes and psychoactive meds taken for life. And recent antibiotic development disasters like Ketek (black-boxed for hepatotoxicity), Trovan (severely restricted for hepatotoxicity) and Zyvox (part of the biggest fraud settlement in U.S. history), don't raise hopes.
Of course there are other ways to attack bacteria. Scientists are looking at algeliferin, isolated from sponge, which can break down bacteria's biofilm barrier, and radiation, ultrasound, chlorine dioxide and ammonia are already in use. (The New York Times reported last month that ammonia gas treatment was shown to produce E. coli-laced "pink slime" in meats used for the school lunch program.)
But scientists are also looking at seraticin, an antibiotic from green bottle fly maggots and bacteriophages, intracellular parasites that multiply inside bacteria like viruses—century-old therapies used before antibiotics were even invented.
Few miss the irony that in using antibiotics when they aren't necessary, we lose the ability to use them when they are.