Antibiotic resistance vs. a nickel a pound

The FDA is about to do the right thing about the routine use of antibiotics in livestock-raising.

For several decades, American agribusiness has been routinely putting antibiotics in animal feed. The result is to breed antibiotic-resistant strains of disease organisms, including the “super-bug MRSA.The spread of multiple antibiotic resistance is perhaps the greatest looming public health crisis, partly because the economics of health care doesn’t create big rewards for inventing new antibiotics.

So why are the animal-growers allowed to put the health of everyone on the planet at utterly unnecessary risk? Because some people think getting rid of the practice might add as much as a nickel a pound to the retail price of pork. (In Europe, the impact wasn’t that big.)

No, this shouldn’t be a hard decision. But somehow the FDA has never gotten around to banning the use of human antibiotics in healthy farm animals. That’s about to change.

I wonder which party controls the White House?

Elections have consequences.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact:

9 thoughts on “Antibiotic resistance vs. a nickel a pound”

  1. I'll admit I'm troubled by the practice of using antibiotics on healthy animals. OTOH, I'm also troubled by the fact that hospitals are so bad at antiseptic practice that people routinely trade infections back and forth while there, creating multiply resistant strains. I'm troubled by the fact that I've TWICE had a respiratory infection return because the course of antibiotics I was prescribed was too short. Once I could understand, but twice, in the same patient?

    As a cancer patient, I've spent a lot of time in hospitals over the last year. I've been immune compromised, too, so I've been very conscious of infectious threats. Seeing what goes on, I'd say that the medical profession has it's own sins to worry about.

    So, yes, perhaps the use of antibiotics in raising livestock should be dramatically curtailed. But it better not stop there, doctors need to clean their own house.


  2. I'm very in favor of stopping routine low-dose antibiotic use in healthy animals.

    However, it seems more likely that "superbugs" like MRSA are selected for by the widespread overuse of antibiotics in people, and by the tendency in humans to use newer antibiotics routinely, rather than saving them until older ones have failed or a resistance culture is done. I'm inclined to think that public awareness campaigns like SAFE (every doctors office I've been in in the past year has SAFE signs up)are likely to do more good.

  3. SamChevre, it's all of the above. However, the FDA has some compelling evidence that use of antibiotics in livestock is directly contributing to the problem — resistant strains of bacteria can be traced to livestock, and since most people don't live on farms, the presence of those strains in livestock suggests the mutation is occurring there in the first instance, and then spreading outward. Of course, there is widespread overutilization of antibiotics and unsafe hospital practices, all of which should be addressed, but the point is, no one will ever eradicate all infections, and when an infection is more likely to be the result of a bug that has been primed to be resistant to antibiotics, that makes all of the other problems so much worse.

    Also, remember that a lot of the increase in drug resistant MRSA is coming outside of hospitals — locker rooms, for instance. I don't know what 5 cents a pound amounts to when it is spread out over every man woman and child, but it could be a lot cheaper than all the spending on prophylactic measures by every school and hospital day in and day out to try to avoid MRSA, and that's not counting the heartbrak and trauma associated with increased deaths from these infections.

  4. One of the first articles I wrote as a science reporter almost 30 years ago was about just this phenomenon. Which is really sad.

    But an important distinction between the misuse/overuse of antibiotics in humans and their misuse in animal production is that the animal doses have typically been "subclinical", i.e. not intended to eradicate infections, but just to knock down bacterial counts so that animals will keep growing consistently amid the horrendous squalor of a factory operation. You might as well be testing bacteria for antibiotic resistance and breeding them up deliberately.

  5. Hospitals and doctors are dumb with antibiotics. Every single doctor's visit that ended with an antibiotic prescription has resulted in me going back to get it changed because it clearly says "if you are allergic to X don't take this." When I was filling out the mountain of forms you gave me to satisfy your insurance liability I didn't realize you weren't going to read it. I think at this point it has become "if Y, prescribe Z, next patient!"

  6. It's good to hear that Americans have the best health care in the world. I should have suspected so, given that we pay about double per capita for the privilege.

  7. I learned over the course of many years of collaborating in study design and analysis with biologists that there are two sorts of biochemicals. One is the sort you buy by the train-car load. The other is the sort you buy by microgram. The first sort (including things like monosodium glutamate and other salts of amino acids) often include the products of fermentation processes. All antibiotics (and SFIK, antivirals) fall into the train-car load category.

    The economies of scale make it not much more expensive to a ton of penicillin than to produce 100 pounds of it. So the drug companies need to/want to have a market for their excess production. It turns out that farm animals are a convenient market.

    To SamC, the general consensus is that you're wrong in most cases. The low-dose regime used on factory farms is exactly the sort of selection environment that evolves antibiotic resistance. There are some exceptions, of course. MRTB seems to be the result of people not finishing their antibiotic therapy: M. tuberculosis is a pretty tough kill and tougher now with the resistant strains.

    Many pathogenic bacteria (especially Staph aureus) cross mammalian species pretty easily.

  8. A bit off-topic, but MRSA (acquired outside of a hospital) almost killed me once while I was abroad. Spent about 48 hours in a Swedish hospital. Was told that in less than 24 hours the infection probably would have been blood-borne and my odds of survival would have been low. (Of course, when I'd gone to see a doctor two days earlier, the nurse in charge of screening patients told me to give it a few days. There are downsides to rationed care, and I say this as someone who is in favor of single payer care.)

    People don't really appreciate how dangerous these infections are unless they or someone they know has been affected. I know I didn't. Resistant bacteria, in addition to being more difficult to kill, are also frequently far more aggressive than non-resistant strains. This type of regulation seems like a no-brainer, yet here we are.

  9. I feel this issue affects me personally, so I'm in favor of guidelines that will protect me, but I'd like also to attack the idea of public well-being in a passive-aggressive way.

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