Super bugs or super hype?

Nicholas D. Kristof in his March 7 Op-Ed column in the New York Times continued his unscientific, diatribe against the use of antibiotics in livestock production. Favoring the anecdotal over substance and emotion over known scientific fact he paints a picture of impending doom for humanity as a result of alleged misuse of antibiotic growth promoters and therapeutics. On the subject of antibiotics he is way off base and is merely amplifying half-truths and misstatements.

The requirements for registration of a dietary antibiotic growth promoter for livestock are onerous. Applicants, invariably multinational pharmaceutical companies, have to exhaustively demonstrate efficacy and safety. Most of the compounds currently used do not have human therapeutic counterparts.

Studies have shown that organisms present in the intestinal tract of hogs and poultry have a different genetic profile from organisms isolated from hospital wards. Although transmissible drug resistance is an accepted reality, epidemiological studies do not support the contention that there is a direct correlation between the use of antibiotics in livestock production and the emergence of drug resistant infections in the human population.

Detailed risk analyses on the use of virginiamycin demonstrated a multi-million dollar cost associated with the potential saving of only a fraction of one human life. While the banning of fluoroquinolone antibiotics in livestock production was based on flimsy evidence and the application of the Precautionary Principal there is no evidence that this action resulted in any amelioration of the problem of nosocomial (hospital-acquired) infection. Similarly proponents of banning antibiotics are currently embroiled in an academic dispute with their opponents over the consequences, both intended and otherwise, of banning antibiotic growth promoters in Denmark.

The concern over antibiotics has been further heightened by publication of a report “Health-Related Costs From Food Borne Illness in the United States” funded by the Pew Charitable Trust. This document attempts to establish the cost of foodborne illness in the United States at $152 billion per year. Previous U.S. government estimates have progressively increased from $7 billion to $30 billion, essentially based on a Centers for Disease Control (CDC) study “Food-Related Illness and Death in the United States” published 10 years ago. This document assumed 76 million illnesses, 325,000 hospitalizations and 5,000 deaths each year.

The Pew Charitable Trust study produced by Dr. Robert Scharff of Ohio State University places individual costs of treatment of the significant foodborne diseases, only some of which are associated with animal products. The report fails to distinguish between infections acquired from contaminated water, produce, meat products and eggs. The reports also incorporate the CDC “fudge factor” of one diagnosed case for every 20 unreported cases.

The result of biased or slanted reports appearing the media, including a recent television segment, is influencing legislators at both the state and federal levels. This has the potential to result in politically expedient regulations and bans on procedures which may be detrimental to both producers and consumers alike. The FDA has a responsibility to determine, based on scientific evaluation, whether growth-promoting compounds are or are not deleterious. The medical profession has the obligation to resolve issues relating to over-prescription and contamination of medical facilities including ICUs and neonatal units. Balance is required in assessing risks and quantifying the consequences of antibiotic use. Supplanting scientific fact with emotion is unhelpful.

Consumers have the choice between food produced using conventional management systems or in accordance with the rules of the National Organic Program. The differential in price indicates the incremental cost of producing organic-labeled products. There is no evidence that the organic label provides any assurance of increased food safety or freedom from infection.
Producers wishing to market “drug-free” products derived from livestock can do so using non-antibiotic alternatives including probiotics and prebiotics in combination with enhanced biosecurity and vaccination. Specialty products sell at a premium, reflecting the higher cost of production.

Differentiation among production systems with appropriate labeling should allow consumers both information and choice in their purchases. Imposing blanket bans on products without adequate scientific justification is unjustified. Commentators such as Kristof do not advance either public health or maintaining an adequate supply of food at an acceptable price. By the same token massaging statistics and cost values to inflate the magnitude of a manageable problem is destructive.