It's hard to imagine that something as distant as a feedlot could have an impact on our health. After all, industrial farming operations are located far from where many of us live.
But the recent news of an antibiotic-resistant salmonella outbreak from poultry products produced in California but distributed in a number of states, as well as a recent report from the Centers for Disease Control and Prevention, bear this out.
The misuse of antibiotics on factory farms puts the health of your kids and ours — of all of us — at risk. The fact is, giving low-dose, medically-unnecessary antibiotics to livestock and poultry to speed up growth and prevent disease breeds dangerous, drug-resistant bacteria. These bacteria end up in our food, our soil, our air, our drinking water, our bodies. They alter the world's and our own microbial landscapes, leading to infections that are increasingly dangerous and difficult to treat. (You'll remember that before the development of effective antibiotics in the 1940s, infections were one of the leading causes of death across the globe.)
As president of MedChi, the Maryland State Medical Society, and head of its public health committee, we want to tell you that to save American lives and to safeguard the efficacy of our nation's limited antibiotic arsenal, our country needs the Food and Drug Administration to step in and prevent industrial meat and poultry producers from abusing antibiotics. Federal law requires this. But in the face of the agency's decades-long foot-dragging, we need Congress to force them to act.
The problem of antibiotic resistance is snowballing. When we were in medical school, it never occurred to either one of us that doctors would see infections that antibiotics couldn't treat. Now, though, MedChi's members see more and more of these infections every day — cellulitis that takes months and several surgeries to heal, patients whose resistant infections land them in intensive care.
Doctors are now sometimes forced to offer patients with resistant infections a Sophie's Choice of treatment options: an antibiotic that might cause their kidneys to fail vs. a limb amputation. That's a choice no one should have to make.
Antibiotic resistance emerges from a number of causes, including the unnecessary prescription of antibiotics to people. Efforts are continually being made to educate physicians on appropriate and evidence-based antibiotic prescribing practices. But livestock and poultry operations are an important part of the equation that we can't leave out, as both the CDC report and almost 40 years of medical research demonstrate.
An astonishing 80 percent of the nation's antibiotics, by weight, are consumed in the often unsanitary, wildly overcrowded industrial facilities where most American meat and poultry are raised. In these places, it's not surprising that antibiotic resistance emerges. Bacteria, by their very nature, evolve to outwit their opponents. When factory farmers give their animals low-dose antibiotics to fatten them up fast or help them survive poor living conditions, but not to cure disease, they kill off susceptible bacteria, creating a niche in which resistant ones thrive. (In fact, only a small fraction of the antibiotics used on factory farms treat sick animals.) This process turbocharges normal evolution.
That's bad news, because this country — the world, in fact — has a limited tool kit of life-saving antibiotics. There are few new antibacterial drugs in the pipeline. To protect the efficacy of ones we still have, our nation's meat and poultry producers can take simple, practical and economical steps to reduce their antibiotic use. They can follow the example set by the European Union, which banned growth promoters and has passed a resolution to end the non-therapeutic use of antibiotics in animal feed in 2006. Denmark has had a ban on all non-therapeutic use in place for some time, and the effort has been a big success, cutting use significantly while increasing production of affordable and safe meat. Unfortunately, most American businesses are not inclined to follow suit, which is why we need government to act.
To help slow the rise of untreatable bacterial infections, the kind that were common before the development of penicillin, the FDA and Congress should ban the routine, non-therapeutic use of antibiotics on farms. Congress should pass S. 1256, the Preventing Antibiotic Resistance Act and S. 895, ADCA (the Antimicrobial Data Collection Act). These are not idle concerns, as many Maryland doctors and patients can tell you.
While the farms that foster antibiotic-resistant bacteria seem remote from many of us, the infections they incubate hit close to home every day.
Dr. Brian Avin, a neurologist, is the immediate past president of MedChi, the state medical society. His email is firstname.lastname@example.org. Dr. Jeffrey Kaplan, a pediatrician, is past president of the Baltimore City Medical Society and chair of MedChi's Environmental Health Committee. His email is email@example.com.
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