FDA not doing enough to combat increase in antibiotic-resistance from overuse of antibiotics in livestock

We’ve all heard or read at least one disaster story about. infections in hospitals—someone goes to the hospital to get treated for something minor, but then ends up dramatically more sick from an infection they got at the hospital, one that spread because it was resistant to antibiotics.  This is scary enough, but what about getting that same infection from handling meat? 

A recent study sampled 136 samples of meat and poultry and found an astounding 47% of them contained antibiotic-resistant strains of Staph. bacteria, and that overall almost 25% of the 136 samples contained Staph. bacteria resistant to 3 or more antibiotics.  Of course, scientists have known for a long time that meat sold at retail is routinely infected with antibiotic-resistant bacteria, such as Salmonella and E. coli—for example the highlights of the latest Meat Annual Report from the National Antimicrobial Resistance Monitoring System point out that 38% of chicken breasts and 51% of ground turkey samples tested contained strains of Salmonella bacteria resistant to 3 or more types of antibiotics—but the new study emphasizes yet another dimension of the problem: that our food exposes us not only to drug-resistant strains of bacteria like Salmonella that cause food-borne sickness, but also to drug-resistant strains of bacteria such as Staph. that can cause other kinds of diseases.* 

Recently, I blogged about the introduction of a bill in Congress to eliminate use of antibiotics in animals that are not sick—that is, the routine and low-level use of antibiotics for promoting faster weight gain and preventing diseases associated with crowded, unsanitary conditions.  Such nontherapeutic uses are linked to the rise of antibiotic-resistant bacteria that imperil our health.  A person who becomes sick because of antibiotic resistant bacteria becomes that much harder to treat with our current toolkit of antibiotics and thus faces greater health risks.  In some cases, treatment is no longer possible.  Just as an unfinished course of prescribed antibiotics poses a greater risk of creating superbugs resistant to antibiotics, low level or suboptimum doses of antibiotics used in livestock production pose a greater risk of creating antibiotic resistance in bacteria—essentially, what doesn’t kill them, makes them stronger. 

Groups like the World Health Organization (WHO) and the US Centers for Disease Control (CDC) have recognized growing antibiotic resistance in bacteria as a major public health threat.  The CDC calls antibiotic resistance one of its “top concerns.”  The WHO focused on antibiotic resistance for World Health Day 2011 and recommends the reduced use of antibiotics in food-producing animals to combat antibiotic resistance. 

With livestock use responsible for an astonishing 80% of all antibiotic use in the US, it is an obvious place to reduce misuse of antibiotics.  Perhaps even more astounding is that an estimated 70% of all antibiotics used in the US are used at low levels for non-therapeutic purposes on livestock. The Food and Drug Administration (FDA), which is supposed to safeguard our health, has acknowledged the problems with the misuse of antibiotics and recognized the threat that it poses.  But FDA has done very little except suggest to the politically powerful livestock industry that it might think about changing its practices. 

FDA actually concluded in the mid-1970s that the non-therapeutic use of some antibiotics poses a risk to human health, but has done little of substance to follow up on that conclusion  in the intervening 30 plus years.  FDA’s Deputy Commissioner told a Congressional Subcommittee in 2010 that “FDA 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.”  FDA has even recognized that “it is critically important that antimicrobial drugs be used as judiciously as possible in an effort to minimize resistance development.”  But that hasn’t prompted FDA to do much except rely on largely voluntary measures.

And the irony is that where non-therapeutic uses have been eliminated, industry has benefited.  In Denmark, the world’s largest pork exporter, pork production has actually increased since antibiotic use for growth promotion was ushered out in the mid 1990s, while antibiotic use has fallen drastically, by almost 40%, in the same period.

The magazine Scientific American recently published an editorial calling for the elimination of non-therapeutic use of antibiotics in livestock and explained exactly how the Danish meat producers met the challenge, as did this Grist piece:  the open secret is weaning pigs later so that they build up greater immunity before being separated from their mothers, making sure that the pigs are housed in cleaner, less crowded, more sanitary conditions, and improving the quality of their feed.

You know FDA is behind the times when even many in the industry are out ahead of it.  Even major food chains (like McDonald’s and Dairy Queen) and some very large poultry producers (like Tyson Foods, Perdue Farms, Foster Farms, and Gold Kist) are taking steps that the FDA is too hesitant to take—McDonald’s announced in 2003 that it will not buy chicken from producers that use antibiotics for routine disease prevention, and the four poultry producers state that they have stopped using antibiotics for growth promotion.  Chipotle, the Mexican food chain, has even gone so far as to urge FDA to impose mandatory restrictions on the non-therapeutic use of antibiotics in livestock.  The problem is so obvious that even kids are trying to do something about it (see this story about an enterprising 11-year old), while FDA waits.

The fact that many have felt the need to turn to Congress on this issue, even though FDA has the authority to fix the problem on its own, should be embarrassing for the agency.  But instead it is just part of the pattern of inaction and failure to protect public health that is all too common at FDA, as this fact sheet illustrates.

*Note: protecting yourself from the hazards of antibiotic resistant bacteria in meat requires the same kind of care as any other bacterial hazard in food:  wash your hands and any surface that comes into contact with meat thoroughly with ordinary soap and water, thoroughly cook meat before eating, avoid cross-contamination, and refrigerate food promptly.