Spreading AMR misinformation irresponsible

The issue is far too complex and far too serious to be misrepresented in the arena of public opinion.

Dr. Nevil Speer

July 3, 2018

5 Min Read
Spreading AMR misinformation irresponsible

There is a long list of things I want to write about. I'll never be able tackle all of them, especially given that some subjects require repeated coverage. That's where I am this month.

Antimicrobial resistance (AMR) is probably the most pressing — and complex — topic within human and animal health. It's also the issue that most often gets misrepresented in mainstream media. Because of that, AMR needs to be addressed over and over.

In late-May, the New York Times ran an opinion piece dealing with antibiotics and animal agriculture. The author, William Cohan, an accomplished business writer, decided he'd try influencing the American public about agriculture.

Unfortunately, Cohan's journalistic research training failed him. The column merely rehashes run-of-the-mill assertions about antibiotics and animal agriculture. Given the potential influence, those false claims leave a void that's in need of correction. Let's take them point by point.

First, Cohan highlights the Food & Drug Administration's Veterinary Feed Directive. He then carefully indicts animal agriculture by tying it to Centers for Disease Control & Prevention data, saying that "growing resistance to antibiotics causes some 23,000 American deaths a year." Cohan, like all others with an agenda, doesn't tell you the rest of the story, of course.

CDC explains that more than 60% of those deaths are directly attributable to Clostridium difficile, which is "directly related to antibiotic use [in human medicine, not veterinary medicine] and resistance." The other two major threats outlined by CDC include: (1) carbapenem-resistant Enterobacteriaceae — carbapenems are NOT approved for use in livestock production anywhere in the world, and (2) drug-resistant gonorrhoeae — clearly not a livestock concern, so no further explanation necessary.

Second, the editorial predictably leans on antibiotic sales, so Cohan quotes Avinash Kar, attorney for the Natural Resources Defense Council. By the way, Kar's previous work was in California, where the council said he "concentrated on air pollution from factory-farm (emphasis mine) emissions with a focus on California's Central Valley."

It adds that Kar said "of all the 'medically important' antibiotics sold in the United States — that is, those used to treat human disease — about 70% goes into the feed and water of animals, indicating to him that overuse on the farm is still rampant."

That's wrong. Just do that math: Assume that 80% of all antibiotic sales are designated for use in animals (including companion animals). FDA designates 60% of those sales as medically important. That means 60% of the category that comprises 80% of sales is medically important. Overall, that works out to 48% — not "70%."

Third, Cohan then uses Kar to promote Denmark's animal antibiotic usage model, writing that Kar says "Denmark uses about 30% less antibiotics a year on a per kilogram of meat basis than American farms do" — the implication being a subsequent decline in AMR. That's not the case.

Let's back up and look at broader trends in the European Union. According to European Medicines Agency, sales of antibiotics for animal use in the EU declined 13% between 2011 and 2015.

However, at the same time, the European Centre for Disease Prevention & Control shows rising resistance to broad-spectrum antibiotics that varies widely by geographic region, explaining, "These differences are most likely related to differences [in humans] in antimicrobial use, infection prevention, infection control practices and health care utilization patterns in the countries."

Last, and most important, Cohan's opinion piece is titled, "Antibiotics in Meat Could be Damaging Our Guts." Antibiotics in meat? Stop right there.

Cohan explains, "Beyond the threat of drug-resistant illness, there is evidence of another risk from antibiotic overuse in pigs, poultry and cattle: the possibility that people who consume antibiotic-laced meat (emphasis mine) will get some of the drugs, as well as resistant bacteria, into their own digestive tracts — with potentially harmful results."

There's really no such thing as antibiotic-laced meat. As evidence, the most recent (2016) publicly available quarterly sampling report tells a different story. The Food Safety & Inspection Service reported that from January to March 2016, "998 in-plant screen positive values were identified from about 45,000 in-plant tests. Of these positive samples, 242 were lab-confirmed violative samples in 202 violative carcasses. Several of the violative samples were associated with the same carcass."

In other words, 202 carcasses out of 46,156 in-plant tests proved to be in violation — a rate of 0.4%. It's not zero, but to proclaim "antibiotics in meat" in the headline is unfounded, at best, and intentionally misleading, at worst.

The motivation for Cohan's column starts with his friend, Sandy Lewis, an organic cattle producer. He begins telling Lewis's story of loss of animals due to anaplasmosis, which led Lewis on a quest to find out: "Are pig, cattle and poultry farmers misusing antibiotics, allowing too much of the drug to get into our food?"

Of course, the article doesn't tell us anything about Lewis's management practices and whether his failures potentially exacerbated the problem. Ironically enough, the most effective means to prevent anaplasmosis is through inclusion of CTC in the mineral (clearly, that wasn't happening on Lewis's farm).

Recently, Dennis Erpelding published a column in Feedstuffs stating, "Antimicrobial resistance is a public health concern for which action is needed. Based upon current scientific understanding, the most prudent path forward is to incorporate a science-based antimicrobial resistance risk analysis into governmental regulatory approval processes." Right on!

To that end, it's hard to explain why the New York Times would publish such an opinion. It's the wrong approach to say livestock are the sole culprit responsible for AMR, so just remove antibiotics from animal agriculture, and problem solved. Whether that's failure to understand the science or the need to advance an anti-agriculture agenda, either way, the piece is irresponsible.

The issue is far too complex and far too serious to be misrepresented in the arena of public opinion. Because of that, we can't simply be bystanders and let it slide.

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