antibiotics
Attempts by the Food and Drug Administration (FDA) to decrease the widespread use of antibiotics in livestock production have seldom succeeded.

An effort to prohibit cephalosporins like Cefzil and Keflex in 2008 was stopped by frenzied lobbyists from the egg, chicken, turkey, milk, pork and cattle industries, who claimed they could not "farm" without the drugs.

Their trade groups, the American Veterinary Medical Association (AVMA) and the Animal Health Institute (AHI) also put pressure on the FDA, which backed down.1

In 2014, the FDA again tried to regulate antibiotics, floating a new plan in which drug makers voluntarily agree to remove "growth promotion and feed efficiency" as approved uses on livestock antibiotic labels so the drugs would only be used in cases of sickness and under the care of veterinarians.2

While drug makers have until the end of 2016 to make the voluntary changes, so far results are very disappointing and use has actually gone up rather than down.

Antibiotic Use in Livestock Is on the Rise

Antibiotics, as they are traditionally used, allow meat producers to add weight on animals for less money because they make feed absorption more efficient. They also prevent disease outbreaks in crowded and extreme housing conditions.

According to the FDA's 2014 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals,3 domestic sales and distribution of cephalosporins for food-producing animals increased by 57 percent between 2009 through 2014.

Lincosamide antibiotics like clindamycin increased by 150 percent and aminoglycoside antibiotics like gentamicin by 36 percent. (Aminoglycosides can have such serious side effects in humans; they are considered a last resort drug.)4

Clearly, unless livestock makers are waiting until the last minute, the FDA's voluntary controls are having no positive effect and may even be having a negative one.

Allowing "disease prevention" to be an approved use may actually be a loophole "big enough to allow farmers to continue with what they have been doing all along [and] raising concerns that the FDA's plan will not amount to much," says Scientific American.5

FDA Proposes New Antibiotic Reporting Requirements

Last spring, the FDA proposed expanding the information animal drug makers are required to report every year under the Animal Drug User Fee Act (ADUFA) to include species breakdowns such as cattle, swine, chickens or turkeys.6

Food Safety News reports:
"Consistent with data collection objectives outlined in the Administration's National Strategy for Combating Antibiotic-Resistant Bacteria, this proposed rule is a step toward providing more detailed information to the FDA ..."

Different species are raised differently, which is why species-specific data are necessary, said Gail Hansen, senior officer of the antibiotic resistance project at The Pew Charitable Trusts.

'They're all forward steps, and no one piece of data is going to tell us everything we need to know,' Hansen said."
Delivering Antimicrobial Transparency in Animals Act

Rep. Louise Slaughter (D-NY), the only microbiologist in Congress, supports the new FDA steps.

More than five years ago, in conjunction with the late Sen. Ted Kennedy, she introduced the Preservation of Antibiotics for Medical Treatment Act (PAMTA), which was supported by over 450 medical and consumer advocate groups7 but blocked with millions of dollars in lobbying money from meat and agricultural interests.

In fact, no issue seems to divide doctors and veterinarians as widely as livestock antibiotic usage — harmful for humans but lucrative for meat producers.

In response to the FDA's expansion proposal, Rep. Slaughter reintroduced a related bill called the Delivering Antimicrobial Transparency in Animals Act (DATA), which requires not only a breakdown of species receiving antibiotics but reporting of the reason for the antibiotic use.

"Knowing how much of the drugs are being used in cattle or pork or poultry will be helpful in identifying the problem areas," Slaughter said.

Slaughter's act is stronger than the FDA's proposal, says Steven Roach, senior analyst for the Keep Antibiotics Working coalition. "The DATA Act actually requires large food producers to report drug use by species and indication and does not rely on estimates [as the FDA's proposal does]," he said.8

Needless to say, both drug makers and meat producers stand to lose a lot of revenue if true reports of antibiotic use on the farm are made available because it will likely lead to further regulation and control.

Food and Drug Makers Oppose New Reporting Proposals

Reaction against the FDA's expanded reporting proposal has been swift and vehement. Elanco, Eli Lilly's animal health unit, which has become the second largest in the world after the 2015 acquisition of Novartis Animal Health,9 said:
"Despite the FDA's caution against making comparisons of sales data reported from animal health companies to the commercially-derived data from private human sales database, misinformation and exaggerated claims continue to escalate in both print and social media.

Elanco is concerned that if the proposed regulation is finalized in its current form, it will only add to the misuse of this information, which is inherently inaccurate due to the provision of 'estimates,' which are not actual data.

Consistent with the AHI [Animal Health Institute] position on this proposal, Elanco agrees that 'asking drug sponsors to estimate sales data will lead to imprecise numbers that will be used as definitive measures of antibiotic use.'"
The National Chicken Council was even more direct in its objection to the proposed FDA reporting expansion. In its comments to the FDA, it wrote:10
"NCC is concerned about the potential for species-specific sales and distribution information to inaccurately degrade the public's perception of animal production agriculture. Statistics from the Report may be misinterpreted or misrepresented, resulting in a skewed understanding of judicious use of antimicrobials.

This possibility is recognized in the most recent Report, which cautions that there are "inherent limitations on how the data provided in this report may appropriately be interpreted and used."
Industry Tries to Defend Rise in Antibiotic Usage

Like the National Chicken Council, the National Pork Board also wrote in its comments that it worries about "misinterpretation" of antibiotic data:11
"Antimicrobial resistance is a complex and multifactorial issue. The data reporting approach suggested by FDA does not allow for the identification of a causal link between antibiotic use in foodproducing animals and antimicrobial resistance of public health relevance.

The pork industry supports rigorous and objective scientific studies as the basis by which to begin to better understand the various contributions to antimicrobial resistance in humans. The pork industry believes it is important to recognize and clearly describe the limitations of the data to prevent misinterpretation."
The American Veterinary Medical Association admits that "agriculture-related sales of antimicrobials [antibiotics] rose one-sixth in five years, including a one-fifth rise in sales of antimicrobials considered medically important,"12 but it does not want the public to jump to conclusions about any links. It says:
"While those rises outpaced growth in meat, dairy, and egg production over the same period, federal officials, academics, and agriculture and drug industry advocates cautioned against assuming that changes in sales necessarily reflect changes in use."
In its press release it quotes Ron Phillips, vice president of legislative and public affairs for the Animal Health Institute, who says there is not "a correlation between antibiotic sales and public health impact" and "Too many people are focusing on sales as an indicator of public health risk — which it is not."13 Pro-livestock antibiotics voices are even implying that just because the drugs were bought does not mean they were used.

Antibiotic Use in Livestock Creates Resistant Bacteria

While antibiotic resistance can result from natural adaptation, it "is exacerbated by inappropriate use of pharmaceuticals, and the prevalence of resistance in the agricultural sector is generally higher in animal species reared under intensive production systems," says the United Nations Food and Agriculture Organization (FAO).14

The risk of resistance "appears to be particularly high in countries where legislation, surveillance, prevention and monitoring are weak or inadequate," says FAO Deputy Director-General Helena Semedo. The routine and indiscriminate use of antibiotics in livestock production has produced "superbugs" that can create life-threatening diseases for humans because the drugs we have relied upon for years no longer work. NewsBlaze reports:15
"Most people have heard of MRSA and the dread gut bacterium Clostridium difficile, but clinicians increasingly worry about vancomycin-resistant enterococci (VRE), and resistant Acinetobacter baumannii — which so plagued US troops in Iraq it was called 'Iraqibacter.'

Klebsiella pneumoniae carbapenemase (KPC) and a family of bugs called Carbapenem-resistant Enterobacteriaceae (CRE) are also growing. KPC broke out in the nation's top research hospitals, the Clinical Center at the National Institutes of Health in Bethesda, in 2011 killing 12. MRSA caused a well publicized infection in Giants tight end Daniel Fells and has been reported found on public beaches by Florida researchers."
Recently, scientists have discovered a gene in bacteria that helps them develop this quick resistance to even last-resort antibiotics. Called the MCR-1 gene, it has been found in pigs and humans in China and other countries including Canada though not yet in the US says the Scientific American.16 The gene likely originated in livestock, but has now been found in human bacterial samples as well.17

Human Risks Associated With Antibiotics Continue to Grow

Dr. Judy Stone recently reported in Forbes18 that she was seeing disturbing amounts of delirium, confusion and hallucinations in patients taking antibiotics, especially elderly and hospitalized patients. Antibiotics can also cause antibiotic-associated encephalopathy (AAE) report researchers in Neurology,19 characterized by seizures and psychosis. Dr. Stone writes:
"Hallucinations were most commonly associated with sulfonamides (68%), quinolones (67%), macrolides (63%), and penicillin procaine (68%). Seizures were most commonly reported in association with penicillin (38%) and cephalosporins (35%). Why are confusion and neurologic symptoms [linked to antibiotics] overlooked?

In hospitalized patients, in particular, it's easy to attribute new confusion to 'sundowning' (where elderly get confused at night) or ICU psychosis.

A study last year by Sharon Inouye et. al., in The Lancet noted delirium affects as much as 50% of elderly people in hospitals and as many as 82% of ICU patients, sometimes resulting in prolonged need for mechanical ventilation. In fact, another study last year in the BMJ reported that a third of patients in the ICU develop delirium, and that these patients had a 2x higher risk of death. The cost of delirium is more than $164 billion per year in the U.S."
Antibiotics Kill Valuable Gut Bacteria

In the last few years, scientists have become aware of the important role that gut bacteria and the human microbiome have on human health. Some have even called it the body's "second brain.""Micro-organisms in our gut secrete a profound number of chemicals ... used by our neurons to communicate and regulate mood, like dopamine, serotonin and gamma-aminobutyric acid (GABA)," reported the New York Times recently.20
"These, in turn, appear to play a function in intestinal disorders, which coincide with high levels of major depression and anxiety. Last year, for example, a group in Norway examined feces from 55 people and found certain bacteria were more likely to be associated with depressive patients."
Antibiotics also make malnutrition worse. Researchers recently reported that the microbiomes of malnourished infants, whether from antibiotic exposures, gut diseases or poor diets will stagnate and not grow into their desirable adult state, undermining world food programs that address hunger.21 Imbalances in gut bacteria may also be linked to obesity and allergy conditions, The Huffington Post reports:22
"Noting that the average child in the U.S. and other developed countries 'has received 10-20 courses of antibiotics by the time he or she is 18 years old,' microbiologist Martin Blaser published some disturbing suggestions in the journal Nature last year.

By killing 'good' bacteria with important roles in the body, 'Overuse of antibiotics could be fueling the dramatic increase in conditions such as obesity, Type 1 diabetes, inflammatory bowel disease, allergies and asthma,' he reports.

Yes, obesity. Mice given low-dose antibiotics that mimic farm use and high-dose antibiotics that mimic infection treatment in children exhibited preliminary 'changes in body fat and tissue composition,' says Blaser. Mice developed as much as a 40 percent increase in fat and a 300 percent increase in fat when given a high-fat diet too, extrapolated Alice Wessendorf on the research.

Denmark researchers found eerie parallels in humans. Babies given antibiotics within six months of birth were more likely to be overweight by age 7."
Surprising Treatment for Resistant Bacteria Found in Ancient Medical Manuscript

Even though some of our most advanced antibiotics have been rendered useless by resistant bacteria, there is possible good news that dates back centuries. The BBC recently reported that a 1,000-year-old English manuscript in the British Library containing instructions on various treatments may hold an exciting and unexpected treatment for at least for one resistant bacterium — MRSA.

While scientists thought the ancient treatment found in the tome — an eye salve — might show a "small amount of antibiotic activity," they were "absolutely blown away by just how effective the combination of ingredients was," which included onion or leeks and wine. As reported by the BBC:23"Scientists recreated a 9th Century Anglo-Saxon remedy using onion, garlic and part of a cow's stomach. They were "astonished" to find it almost completely wiped out methicillin-resistant staphylococcus aureus, otherwise known as MRSA. Their findings will be presented at a national microbiology conference ...

The remedy was found in Bald's Leechbook — an old English manuscript containing instructions on various treatments held in the British Library.

Anglo-Saxon expert Dr Christina Lee, from the University of Nottingham, translated the recipe for an 'eye salve,' which includes garlic, onion or leeks, wine and cow bile. Experts from the university's microbiology team recreated the remedy and then tested it on large cultures of MRSA ... In each case, they tested the individual ingredients against the bacteria, as well as the remedy and a control solution.

They found the remedy killed up to 90% of MRSA bacteria and believe it is the effect of the recipe rather than one single ingredient."

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