In August 2017, PBS News featured a concise overview of how concentrated animal feeding operations (CAFOs) serve as breeding grounds for antibiotic-resistant superbugs — and how farmers have the power to change that by raising their animals in a more natural way. Perhaps most disturbing is the U.S. Food and Drug Administration’s (FDA) lack of action on this issue, even as antibiotic-resistant disease becomes a pressing public health threat.

Low doses of antibiotics are added to CAFO feed as a matter of course, not only to stave off inevitable infectious diseases created by the cramped, unsanitary conditions but also because they cause the animals to grow faster on less food. The U.S. Food and Drug Administration (FDA) issued voluntary guidance on agricultural antibiotics in 2013, asking drug companies to remove indications for “feed efficiency” and “weight gain” from the labels of their antibiotic products.

They also required veterinarians to oversee any addition of these drugs to animal feed and water. Most companies agreed to comply with the guidelines and state they no longer use antibiotics for growth promotion purposes, but there’s a major loophole being exploited. Instead of saying the drugs are being used to promote growth, they simply state they use the antibiotics for disease prevention and control, a use that is still allowed under the FDA’s guidance.

Many CAFOs Still View Routine Antibiotics Use as Essential

In 2017, the FDA officially banned the use of antibiotics on CAFOs for the purpose of growth promotion and now requires a veterinary prescription for antibiotics on the farms. Yet, CAFOs saw little ramifications from the ban, which allows them to continue dispensing antibiotics as usual. The New York Times reported:¹

“[T]he new rules were designed in cooperation with drug companies and industrial farm groups. ‘That didn’t affect us,” Mr. [Paul] Defoor of Cactus [Feeders, a feedlot giant] said of the ban; his company sees the antibiotics added to feed as a preventive health measure. Similarly, Zoetis, a major livestock drugmaker, said on its website that farmers ‘will see little difference’ in its tetracycline feed additives, beyond needing the appropriate paperwork from veterinarians.”

As noted by the Times, “The Cactus feedlot is hamburger central, the middle passage of cattle’s industrial journey.” This is where they go in the months before slaughter, eating a diet of grain meant to make them gain weight the fastest.

But cows are meant to eat grass. Grain feeding them encourages the growth of E. coli in the animals’ gut, as it leads to a more acidic environment. Grain-fed cows also live in a state of chronic inflammation, which increases their risk of infection and disease and necessitates low doses of antibiotics in feed for disease-prevention purposes.²

“Tylosin [an antibiotic] controls liver abscesses, and Rumensin, another antibiotic feed additive, fights intestinal disease,” The New York Times reported.³ In all, an estimated 80 percent of the antibiotics used in the U.S. are used by industrial agriculture, with industry veterinarians continuing to support their use. “For now, the view from the feedlot is that the risks are not evident enough to stop using drugs like tylosin,” according to the Times.⁴

Yet, in a Consumer Reports study of 300 raw ground beef samples, grass fed beef raised without antibiotics was three times less likely to be contaminated with multidrug-resistant bacteria compared to conventional CAFO samples.⁵ The grass fed beef was also less likely to be contaminated with E. coli and Staphylococcus aureus than the CAFO meat.

Meanwhile, in November 2017 the World Health Organization (WHO) called on farmers and the food industry to stop the use of antibiotics for growth promotion and disease prevention in healthy animals. WHO explained, “The new … recommendations aim to help preserve the effectiveness of antibiotics that are important for human medicine by reducing their unnecessary use in animals.”⁶

They cited a 2017 study published in The Lancet Planetary Health, which found reducing antibiotic use in food-producing animals reduced antibiotic-resistant bacteria in the animals by up to 39 percent and may similarly reduce such bacteria in humans, particularly those who are directly exposed to food-producing animals.⁷

As it stands, the excessive use of antibiotics among CAFO animals has turned them into veritable “disease factories”⁸ and, in the U.S., when the FDA tests raw supermarket chicken, they routinely find antibiotic-resistant bacteria to be present.⁹ According to WHO, use of all classes of medically important antibiotics should be reduced in food-producing animals, while their use for growth promotion and disease prevention without diagnosed illness should be completely restricted.

Outrageously, USDA Agricultural Research Service administrator Chavonda Jacobs-Young said in a statement, “The WHO guidelines are not in alignment with U.S. policy and are not supported by sound science. The recommendations erroneously conflate disease prevention with growth promotion in animals.”¹⁰

Antibiotic Use Rose 65 Percent Over 15-Year Period

Between 2000 and 2015, human consumption of antibiotics has risen by 65 percent, reaching 42 billion doses a year, according to research published in the Proceedings of the National Academy of Sciences.¹¹ The increase was driven by low- and middle-income countries and, if no policy changes are made, it’s estimated that global antibiotic consumption will rise up to 200 percent higher by 2030.

Use of antibiotics in high-income countries still remains higher than in most low- and middle-income countries (despite the latter having more cases of bacterial disease), but their use is rising fast — a concern, in part, because antibiotics are often available without a prescription in lower-income countries, making the potential for abuse high.

In the U.S., meanwhile, while rates of antibiotics didn’t rise sharply, they also didn’t fall, which shows efforts to scale back inappropriate usage may have failed. Lance Price, director of the Antibiotic Resistance Action Center at George Washington University, told NPR:¹²

“The biggest driver for the evolution of superbugs is the use of antibiotics … The more we use antibiotics, the more we are going to encourage the growth of these bacteria that are resistant to them … [Already] you have these extreme cases like the woman [in Nevada] just about a year ago who died of an infection that was resistant to 26 different antibiotics … So the bacteria are out there that are resistant to everything, and they are becoming more and more prevalent.”

In discussing what could be done to curb antibiotics overuse in humans, the researchers pointed to the importance of improved sanitation and clean water in lower-income countries, as this can significantly reduce diarrheal diseases that prompt many people to seek out antibiotics.

The study’s lead author, Eili Klein, explained to PBS, “If you look at the history of the high-income countries in the 20th century, the primary driver that reduced infectious diseases was improvement in infrastructure, reducing — eliminating bacteria and other diseases from the water.”13