Wednesday, January 9, 2013

Antibiotics and Politics

Well, I promised I would weigh back in when the moment struck and struck it has. My Facebook blew up this morning with the loud proclamations from more- and less- educated peers on the topic of Antibiotics. Most of them are just on megaphone repeat over the claims of an esteemed doctor that the banning of antibiotics would result in catastrophe for the livestock production world and that the people and media are out to ruin our livestock industry. Being one who believes in the "invisible hand" and "natural selection", if the people and media actually wanted to take out the livestock industry, they can go for it. That road only leads to nutrition deficiencies, asymptotic food costs, and eventually the realization that we need to take some steps backwards. But I really don't think that's what they're after more than some accountability and the reprieve of some of their fears. I'm not going to waste time getting offended over it. Fear is hard to control, and rational discussion or brash arguments are not going to help it. Just listen.

But I do want to address some statements and conspiracy claims made in the article, starting with the usage of antibiotics in the United States. Dr. Raymond is of the opinion that we use far less antibiotics than reported in livestock production. I'm pretty sure he's wrong, especially given the statistics out there, and I'll provide an example from my swine research. Per the most recent NAHMS survey, swine farmers reported usage of antibiotics by over 90%. But before you overreact, that isn't 90% of animals, that is 90% of farms using antibiotics on 1 or more animals. Out of that whole group, we're talking about 37% that actually use antibiotics for growth promotion or preventative medicine. This is a far smaller number, and this is what Raymond is trying to point out in the article. However, what he refuses to adhere to is that weight is the only method by which we can quantify antibiotic usage. He does a good job pointing out that ionophores comprise a significant amount of that weight and are not really a good idea for usage in the human. Further, human medicine involves dosage treatments of smaller creatures, and the animal population is far in excess of the human population in the United States. I think Raymond's point about the proportion of antibiotic usage in humans versus animals could have better been made if he accentuated that there is a greater percentage of human usage of antibiotics, so while doses are larger and less frequent in a larger population, resulting in more antibiotic usage in animals (which he dodges around), the treatment usage is far greater in humans.

He is also right in pointing out that early antibiotic resistance is not attributable to animals. We used antibiotics in humans first and started seeing antibiotic resistance soon after. This also occurred when we started using antibiotics for animals in the 50's. THIS IS NATURAL. Consider for a moment that microorganisms produce antibiotics to kill each other. But they're not all dead yet, and this is because they long ago possessed the ability to resist antibiotics from their competitors. We increased the dose and were pretty good at treating most infections, but we didn't create these antibiotic resistance problems. They were already coded in the genetics for the bacteria. The problem is that we have perpetuated this issue by less judicious usage of antibiotics - the focus of the FDA. By using antibiotics appropriately and only when needed for prevention on health risk farms and for treatment with sick animals, we can reduce our usage and be more strategic in our attacks on the bugs. When we widely distribute antibiotics we are not actually sure if we are preventing disease or not, we could just be wasting money. I would prefer to see farms consulting with their veterinarians for prevention strategies when necessary, and treatment plans which use the correct antibiotics for the correct afflictions.

Contrary to Raymond's claim, the antibiotic issue is not "new" and is not part of a media scheme to handicap America's animal-based food producers. All we're talking about here is that people think more about where they use antibiotics and where they don't. That is pretty reasonable to me.

The issue of human antibiotic resistance is an entirely different ballgame to me, and not linked to whether or not we should limit our use of antibiotics in animals. Do I believe that reducing animal antibiotic usage will decrease antibiotic resistance seen in hospitals and human medicine? Absolutely not. I refer you to the efforts of Europeans over the past 20 years to eliminate animal antibiotic usage and the lack of efficacy observed within human medicine. Instead, the human medicine problem reflects back on doctors who prescribe medicine thoughtless. It falls on the minute clinics that hand out antibiotics for viral infections and then can't figure out why ineffective abuse of antibiotics results in allergies and resistance later. It lies in the hands of the parent who calls in for drugs from the doctor without a visit, on the nurse and doctor who comply based on a patient relationship, and on the parent or child who keep old antibiotics and use them injudiciously down the road. The blame lies with the desire of a culture to take a pill, gel, paste, powder, syrup or injection to fix ANYTHING! There is no antidote for stupid recklessness, and no regulation of animal antibiotics can take away decades of negligence.

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