The farmer is mightier than the physician

When it comes to antibiotics, there is one message for the medical community and a very different message for the agricultural community. And this puts everyone at risk.

By Ken Jaffe

Ok, let’s be fair. They are doing as close to nothing as possible. Last month, the FDA decided to ban 3/1000ths of the antibiotics used in livestock. That’s 0.0032 of the 29 million pounds of antibiotics given to livestock that we eat in the USA. (Yes, that’s 29 million pounds.) Of the 29 million pounds, 87% are from “medically important” classes of antibiotics. And these antibiotics are not being used to treat sick animals but rather to make animals fatten faster and meat a little cheaper.

Overuse of antibiotics creates “superbugs” that survive treatment and develop mutations in their DNA, giving them chemical resistance to the antibiotics. And these bacteria can move back and forth between animals and people. Pig farmers who gave massive quantities of antibiotics to their hogs were found to be 760 times more likely than the average Joe to carry the very nasty germ MRSA (methicillin-resistant staphylococcus aureus).

Research by Dr. Tara Smith, the courageous University of Iowa epidemiologist, showed retail meat in Iowa contaminated with strains of MRSA that originated in livestock. And, the Centers for Disease Control and Prevention (CDC) recently reported a drug-resistant staph that caused a fatal lung infection in a young girl originated in livestock. Perhaps the FDA should pick up the phone, call over to the CDC and have a conversation about protecting human health.

It also looks like all those physicians obsessing about limiting antibiotic use only to situations where it is absolutely necessary are being played for fools. Turns out physicians only control a small fraction of the antibiotics used in this country—about 20%—and that overuse represents an even smaller fraction. And, yes, that also means 80% of the antibiotics used in the U.S. go to fattening industrial livestock faster.

During the 25 years I practiced medicine, I tried my best not to prescribe antibiotics unless absolutely necessary to avoid creating superbugs. Having many times dealt with the very nasty impact of drug resistant bacteria, I did my best to limit this carnage. I’ve witnessed families dressed like space travelers to avoid contact with loved ones being treated for life threatening MRSA in hospital isolation rooms; formerly ‘routine’ urinary tract infections with E. coli untreatable as outpatients because of resistance to Cipro and other quinolones; kids with formerly routine pneumonia, now resistant to penicillin. All these were unheard of a couple years earlier. And all these make physicians very nervous.

The folks at the CDC must feel pretty dumb inveighing against overuse, telling us in a cute video, Don’t Give In and Give Those Antibiotics! A few hundred milligrams here and there in humans seems to warrant a full court press. All I had to do was become a cattle farmer, as I did nine years ago, and suddenly it was okay to sling them by the pound. It seems that getting cattle fat faster is much more important than those foolish little public health instructions that were pounded into me as a physician. Perhaps I’m a stickler for coherence, but having one set of rules for humans and a completely different set of rules for cattle is really not working.

Just two years ago, this is what the FDA said in their well titled Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals:

"...the public health concerns associated with the use of medically important antimicrobial drugs in food-producing animals has been the subject of scientific interest for the past 40 years. FDA has reviewed the recommendations provided by the various published reports and, based on this review, believes the overall weight of evidence available to date supports the conclusion that using medically important antimicrobial drugs for production purposes is not in the interest of protecting and promoting the public health."

Pretty good summary of the public health consensus. Now, with further deliberation, and two years of massive pressure from drug manufacturers and industrial feedlot agribusiness, the FDA basically says, “whatever,” and opts for minimal action.

How much would it cost to protect the public? Agribusiness researchers themselves have quantified the cost of protection and report the loss to be just $5/pig, which amounts to less than 5 cents extra per pound for retail pork.

So I don’t give antibiotics to my cattle. They don’t need antibiotics. They’re not sick. It’s that simple. And we don’t confine them or feed them in a way that makes them sick. They may gain weight a little more slowly, but they still get fat. It turns out that as a farmer, by not giving my cattle antibiotics, I’ve probably played a bigger role in preventing resistant bacteria than in all those years trying to be a careful physician. But what I do won’t really matter unless the FDA does its job.

Ken Jaffe raises grass-fed cattle with his wife, Linda, on their farm in the New York Catskills. Before starting Slope Farms (www.slopefarms.com), Jaffe was a Brooklyn physician for 25 years.

This article originally appeared on Slope Farms' blog: http://www.slopefarms.com/blog/.