Drug & Chicken Giants Poisoning the Public with Antibiotics in Meat

Drug & Chicken Giants Poisoning
the Public with Antibiotics in Meat

Bayer Refuses to Withdraw Animal Antibiotic That Causes Drug Resistance in Humans

Risky Chickens
by Sharon Lerner

Because the vast majority of the roughly 30,000 people who took Cipro
in the anthrax scare were treating fear rather than exposure, the
effectiveness of the bestselling drug was undermined even as its sales
were skyrocketing. The more people who don't have bacterial infections
take antibiotics, the less effective the drugs are when treating real
problems, including TB, pneumonia, and bad colds.

Strangely enough, being partner to human overuse is not the only way
Cipro-maker Bayer is at once reaping benefits from antibiotics and
eroding their power. Bayer's drug Baytril-a super-antibiotic virtually
identical to Cipro that is fed to more than 128 million chickens each
year-is so clearly responsible for hundreds of Cipro-resistant
infections in humans that the Food and Drug Administration has begun
the process of withdrawing its approval.

Shortly after the FDA started its effort to ban potent, Cipro-like
poultry pharmaceuticals last year, Abbott Laboratories voluntarily
withdrew SaraFlox, Baytril's only competitor. Bayer instead appealed
the agency's move, fighting to keep selling a drug that treats chicken
respiratory infections-and pulls in an estimated $150 million
worldwide each year. Cipro dominates the human antibiotic market, but
Baytril is the market for chicken super-antibiotics. (In 1999 alone,
38,000 pounds of such super-antibiotics were fed to animals, according
to the Animal Health Institute.) The FDA is expected to decide by the
end of December whether to ban Baytril outright or to allow Bayer a
hearing to defend it.

The agency bases its own case against Baytril on rising antibiotic
resistance in human cases of food poisoning from a bacteria called
campylobacter, which causes vomiting, diarrhea, and-in about 1 percent
of cases-death. When such cases are extreme, Cipro is often the
treatment of choice. Though people have had access to such powerful
antibiotics since 1987, when Cipro was approved, resistance to them
"did not increase among campylobacter organisms until 1996 and 1997,
soon after the approval and use of these drugs in poultry," according
to an FDA entry in the federal register.

When confronted with Baytril, bacteria in chicken experience a sort of
quick, mini-evolution; while most die from the drugs, those with
genetic differences that make them invulnerable go on to reproduce-and
pass the mutations on. People can pick up these bacterial infections
from eating undercooked chicken or juice from uncooked chicken.

When Baytril was approved in 1995, farmers began feeding it to entire
flocks, even if only one bird was sick. Since then, the percentage of
drug-resistant campylobacter infections in humans has shot up from
about 1 percent to almost 20 percent, with more than 9000
Cipro-resistant cases reported in 1999 alone, according to a national
database of food-borne infections.

While Baytril is used only on sick chickens and turkeys-and the other
birds in their flocks-less powerful antibiotics are routinely also fed
to healthy animals. Indeed, 70 percent of all antibiotics in this
country are used to fatten up the profits by making commercially
raised animals bigger, according to estimates by the Union of
Concerned Scientists. Today, virtually all of the 8 billion chickens
slaughtered each year are exposed to antibiotics at some point in
their lives. (The roughly 36,000 antibiotic-free, certified-organic
chickens provide the only exception.)

The dangers of the resulting antibiotic resistance are obvious. Take
the case of Baytril: Most people with chicken-borne food poisoning
won't require treatment, but for those who do, Cipro is less and less
likely to work. As a result, experts say, the number of drug-resistant
cases of campylobacter and salmonella, another chicken-borne bacteria,
are shooting into the hundreds of thousands, while about 700 people
now die each year from these bugs.

Even as the direct casualties are increasing, Tamar Barlam, a
physician and infectious-disease specialist who directs the
antibiotic-resistance project at the Washington-based Center for
Science in the Public Interest calls them "just the tip of the
iceberg." She worries about infections that may develop unnoticed as
other bacteria-including some that aren't the intended target of the
antibiotic-develop drug resistance.

An article in the October 4 New England Journal of Medicine points to
just that sort of silent epidemic. The study traced drug-resistant,
urinary tract infections in women to a single strain of E. coli the
authors think was passed through infected meat. After finding the
drug-resistant infection in California, the researchers looked for it
in Minnesota and Michigan. "They found it in each of the states they
investigated," says Barlam. "And I truly believe the more we look the
more we're going to find."

Nevertheless, agricultural trade groups defend the widespread use of
antibiotics in healthy chickens. "It improves the gut health of the
bird and its conversion of feed, what we call the feed efficiency
ratio," says Richard L. Lobb, spokesperson for the National Chicken
Council. Without drugs, poultry producers say, chicken prices would go
up. As for Baytril, Lobb argues that a connection between the drug and
antibiotic-resistant infections in humans hasn't yet been proven. Lobb
also supports the industrywide practice of putting Baytril in an
entire flock's food and water, saying, "It's useless to try to treat a
single bird."

Bayer did not comment, but its press release about Baytril states that
the number of campylobacter infections attributed to eating chicken
has been overestimated and that "there is no evidence that withdrawal
of the product would . . . have a meaningful impact on resistant
campylobacter infections in humans."

As Lobb sees it, antibiotics make chickens and turkeys healthier all
around. "And if we are what we eat, we're healthier if they're
healthier."

Many advocates are arguing just the opposite, of course, decrying the
drugs that permeate the entire meat industry. In a recent study by the
federal Center for Veterinary Medicine, researchers found that one in
five packages of supermarket meat and poultry was infected with
microbes, and 84 percent of the bugs were resistant to at least one
antibiotic. Most were resistant to several.

The recent threats of bioterrorism have turned this wave of ever
bolder microbes from a scientific curiosity into a real public health
threat. Anthrax has yet to become resistant to Cipro, but other
bacteria have been foiling antibiotics for decades. These drugs, which
have vastly increased the safety of everything from surgery to
childbirth, may no longer work the way we want them to. And in the
wake of September 11, there are untold ways we really may need them.

The Centers for Disease Control and Prevention has renewed its focus
on sloppy medicine-like using antibiotics, which kill bacteria, to
treat viral infections-which it says accounts for fully one-third of
the 150 million prescriptions written for antibiotics each year. And
big, mainstream groups including the American Medical Association and
the World Health Organization have joined in the call to stop the use
of antibiotics in healthy farm animals.

If Baytril is forced off the market, the ban could mark the end of the
shortsightedness that's made antibiotics a staple of chicken at the
expense of people. "Why the hell aren't we giving a lot more careful
thought to using critical human drugs in animals in the first place?"
asks David Wallinga, a physician who directs the antibiotic-resistance
project for the Institute for Agriculture and Trade Policy, an
advocacy group based in Minneapolis. "We know that once these drugs
lose their effectiveness, we're out of luck."

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