It is so easy for newspapers and former government officials (of which I am one) to simplify a topic and confuse an issue. I applaud Drs. Kennedy and Kessler for their call in The New York Times and Washington Post for FDA to finish up on their work in Guidance 213. However, they are behind the curve. FDA and the animal drug companies have already worked for orderly phaseout of growth promotion uses of medically important antibiotics. In the near future, all medically important antibiotics used in food animals will be used only for therapeutic purposes under the supervision of a veterinarian.

However, what concerns me is the misinformation they are using to promote FDA’s action. This information may damage my patients, the animals. I understand it makes good headlines, but they know good policy cannot be made with a 20-second sound bite or an inflammatory headline. Therefore, I must correct some of information about on-farm antibiotic use. I will use the Wired article as basis for discussion.

First, the picture of drugs on a plate is an inflammatory and inaccurate visual which distorts the truth. Additionally, it is not even related to the real concern here: bacteria resistant to a specific antibiotic due to on-farm use. As we recently discussed on this blog, current FDA regulations on drug use require animal treatment to be discontinued in time for the medicine to leave the system (called a withdrawal period). USDA, which collects data every year, shows the withdrawal systems works very well. So THERE ARE NO DRUGS ON THE DINNER PLATE.

I do not support antibiotic overuse or misuse in agriculture or any other field, including human medicine. Thirty years ago, when I started veterinary practice, we were well-trained in prudent antibiotic use techniques, as antibiotics are a valuable on-farm resource to keep animals healthy until arriving at your dinner table. However, the companies which sell antibiotics report that only 13 percent of all product sold were sold under the “performance enhancement,” or growth promotion, label. The rest is for animals who need medicine to prevent and treat illness! Therefore, looking at the total volume of product sold is not meaningful to this debate. Although everyone continues to harp on this 80 percent number, it is important to understand that there are many more livestock in the U.S. than there are people; most are larger and need a larger dose. Also critical to this discussion, the types of antibiotics used in humans are much different than those used in animals.

My biggest concern is this broad-brush antibiotic bashing will harm my patients, the livestock who feed us. Readers need to understand that a livestock production is like running a day care or nursery. It is full of fresh, fragile babies.  When a pig goes to market, it is only six months old and a chicken is only six weeks old! Whether they are raised indoors or out, organic or conventional, they all can get sick. It is wrong and unethical to withhold that treatment.

At the recent state fair, a turkey grower told me of removing 300 dead birds from his barn in one morning. They had “MG,” and he could not get the correct antibiotic. Drug companies are moving out of the animal health business due to the silly ideas like those in the Wired article and many others. Most of the antibiotics used on-farm are because sick and dying animals need medicine, not so the farmer can make a quick buck. ANIMALS NEED MEDICINE ALSO.

  • SteveKDC

    Dr. Hurd once again has hit it on the head; Drs. Kennedy and Kessler should and do know better. Rather than parrot the propaganda of groups opposed to the use of ANY antimicrobial in agriculture, they should have done the independent research necessary to inform an opinion. I’m also reminded Dr. Kennedy was sworn in as FDA commissioner and trumpeted his goal of having saccharin banned as a carcinogen. The science won out when Dr. Kennedy was proven wrong.

  • Now & Then

    In the “2010 Summary Report by the FDA on Antimicrobials Sold or Distributed for Use in Food-Producing Animals” there are eight classes of drugs, reported separately (except ionophores) they include drugs approved for human use. The NIR category includes drugs of all levels of importance .

    In 2010, 70 percent of antibiotics sold for use in food animals were ionophores or tetracyclines. To claim antibiotics used in food animals are not for human use would be inaccurate and false. Drugs marketed to humans may be under a different name than drugs used for an animal; however, the molecular structure of the drug may be similar or exact, they are known as “me too” drugs for legal of patents.

    A drug used in food animals but not in humans can still select for resistance to drugs that are essential to public health.  This is because the same gene can encode resistance to multiple drugs or because two genes, each encoding resistance to a different drug, may be linked. Information found in an article published on “Food Safety News Jan, 15, 2013 by Dr. Robert Lawrence and Tyler J. Smith of Johns Hopkins Center” “For a Livable Future.”

    Animals like humans should be treated for their illness only when it occurs. Drug companies should not be allowed to market drugs for the claims of a larger profits in food producing animals which they have done.

  • Re: the Wired photo.

    There’s no such thing as a real talking rabbit in the pictures of Alice in Wonderland…I think most people understand the concept of artistic interpretation.

    And there’s a big difference between the therapeutic application of drugs, and wholesale drug use to compensate for poor livestock practices or to artificially stimulate growth.

    • oldcowvet

      Drug use is rarely effective to’compensate’ for poor practices. A large percent of ontimicrobials, has been often stated, are ionophores. Ths effect of this class is to push the rumen microbial fermentation over to a more favorable volatile fatty acid ratio, improving the efficiency. Also, some work out of Minnesota suggests that the growth promotion effect in hogs withother antibiotics may be in fact a similar mode of action. Which seems to also be acommon thread in the press lately about obseity and gut microbes in humans.
      This notion that all livestock live in abject squalor on a modern farms just is not real, at least not with the clients are serve.

      • Michael Bulger

        So, you are saying that the sub-therapeutic antibiotics are often administered to promote growth? If they aren’t effective measures to remediate poor conditions on farms, then using them as prophylactics is not the primary objective of their use in herds?

      • Mike_Mychajlonka_PhD

        A great deal is often made of the fact that animals are often treated with antibiotics (such as ionophores) that have never been given to humans. The implication is that use of such (animal-only) antibiotic should cause no consternation for humans at all. However, what seems to be routinely ignored is the fact that the resistance to such ionophores that eventually develops also predisposes (for molecular genetic reasons) to the development of significant (for humans) antibiotic resistant problems that go far beyond ionophores. For example, resistance to the ionophore Narasin is known (ISBN 978-91-576-7595-8) to also bring about the development of vancomycin resistance in enterococci. Infection with Vancomycin Resistant Enterococcus (VRE) can be a very serious threat to the human so infected.

        • jkolb

          Several comments may help: Avoparcin, the ionophore in the paper cited, has never been used in the US. As for VREs, perhaps our medical malpractice laws and their impact on the wide spread use of vancomycin in invasive surgery, especially thoracic surgery, beginning in the 1980’s, might also contribute to resistance in nonsocial infections – VREs emerged in the late 1980s. For the amount of meds used, active ingredient levels are different than gross amounts – we can take a small tablet readliy; you cannot mix small amounts of active ingredients (<1#) into a 2000# batch of feed, so meds are diluted with inert carriers to make the mixing process more efficient. For those doubting withdrawal times in feed, they are rigorously followed in commercial agriculture – if you violate residues, you may have your license removed, functionally ending your business. "Hobby" farmers may or may not be as serious, but commercial farms do follow the rules – oldcowvet is spot on in terms of actual farming reality, not stereotypes or "religious" biases about food production.

          • Mike_Mychajlonka_PhD

            Hold on here! Avoparcin is NOT an ionophore. It is an glycopeptide antibiotic which shares some structural similarity to vancomycin. Indeed, some consider it a vancomycin analogue. Antibiotic residues are not the issue. The issue is the wisdom of allowing poorly thought out agricultural practices (like the use of avoparcin for growth promotion in Australia and the EU to establish a reservoir of antibiotic resistance harmful to humans. We need to be smarter about this than we have been.

      • fearnot

        do NOT expect Shelly to understand this

    • fearnot

      really?? you would never know it by the ads that the HSUS ( your employer) put out in CA when pushing prop 2.. we had dancing pigs, singing cows and talking chickens..what do you know about it anyway Shelly are you a vet? or a framer? or a rancher.. ?? nope just an HSUS vegan shill

  • Oginikwe

    It appears that the real problem is not antibiotic use as much as it is the way the animals are raised. That is, the need for antibiotics is a direct result of raising too many animals in a too small of a space–a symptom of CAFOs.

    • Jessica Collins

      Exactly. CAFOs are the real problem here. Antibiotics are merely a side effect of unsustainable and downright stupid farming practices. Ever see an industrial chicken coop? There are no words, honestly. It’s DEPLORABLE.

  • oldcowvet

    I would disagree that only 10 birds were ‘treated’ Of that number, how many are too early to be showing showing signs, and yet are infected. If it in fact is infectious, many more will be on the way to full blown clinical infection, so to say ‘prophylaxis.

    • Mike_Mychajlonka_PhD

      According to “Prophylaxis Definition. A prophylaxis is a measure taken to maintain health and prevent the spread of disease.” In the example I gave, that definition is precisely what I meant by prophylaxis. Are infectious agents invasive? Of course they are. If they were not, they would not be infectious, in the first place. If ten birds were found to have an infectious disease, is it possible that some (unknown) fraction of the other 19,990 (who are showing no ill effects) harbor the same pathogen, which made the first ten sick? Certainly. However, the mere carriage of an infectious agent in an otherwise healthy animal does not imply the existence of an infectious morbidity. Likewise, antibiotic treatment of an animal that is not sick cannot be considered treatment, it is prophylaxis and should be recorded as such. I am not saying that prophylaxis is useless. I am saying that I agree with Drs. Kennedy and Kessler on the need of obtain detailed information of antibiotic usage. I am also saying that just because we have always conducted our prophylactic regimens by administering antibiotics doesn’t mean that we have to continue a short-sighted practice that threatens to spread antibiotic resistant pathogens everywhere in an environment that already contains too few effective antibiotics. There are smarter ways to get the prophylaxis job done.

  • carole davis

    You make a comment that the antibiotics used in the animal industry are a “different” type. Bull. I raise dogs and many of the perscriptions are filled at a pharmacy and are the exact same anti biotics used for humans in a different dose and I don’t believe all livestock owners stop using the antibiotics in time or before they are shipped for slaughter. Where are tests at the slaughterhouses, that i where the control neds to be, the litmus test so to speak…
    Your assumptions are not realistic. Farmers and all businessmen are driven by $$$$ not the rules laid down by the lame and useless FDA

    • kantexmama

      Right. I worked for a country vet with a cow-calf practice, and while they were free-range until sold to feed lots, they were given antibiotics mainly to create weight gain, as well as prophylactically. Some, but probably not all, farmers withdrew drugs 30 days before sale, but as they went directly to auction & then feedlots, I doubt any were checked. Feedlots really emphasize antibiotics, again for weight gain but especially since their cattle are kept in pretty squalid and overcrowded conditions. I’ve never heard of any adequate testing program for antibiotics in beef after slaughter, so what may be ideal rules may not be carried out in actuality. And then there’s the notorious runoff from these sites too. I don’t think Dr. Hurd has much actual practice in the field on which to base his theories.

  • peaceginger

    Thank you for all your good information. I will share this with all my friends so that they can pass it on and hopefully it will continue to get passed on and on.
    My husband and his parents and one of his brothers were in the dairy business for over 50 years. Starting in 1958 when my husband graduated from Davis. I know the hard work that goes into a dairy and taking care of sick cows. Our dairy was small my husband milked about 50 while others were in the dry cow pen. Besides milking the cows my husband processed and bottled all the milk and made the best chocolate milk around every Saturday. I love to go down to the dairy for hot chocolate and a sweet roll. We sold milk, cream etc. out front at the cash and carry. His brother took care of the route. We were the last owner operater, cash and carry dairy in Chino, Ca. So you could say we are are a part of the Chino dairy history. We retired 8 years ago.
    Thanks again for the excelent information.