KANSAS CITY, Mo. -- For decades, factory farms have used antibiotics even in healthy animals to promote faster growth and prevent disease that could sicken livestock held in confined quarters.
The benefit: cheaper, more plentiful meat for consumers.
But a firestorm has erupted over a federal proposal recommending antibiotics only when animals are actually sick.
Medical and public health experts in recent years say overuse and misuse of antibiotics pose a serious public health threat by creating new strains of bacteria that are difficult to treat -- both in animals and humans.
"Over time, we have created some monster bugs," said Russ Kremer, a Bonnots Mill, Mo., farmer who speaks nationally about the threat to the food supply.
"It is truly harmful to everyone to feed antibiotics to animals just for growth promotion and economic gain."
But the meat industry argues that the draft guidelines from the Food and Drug Administration are premature. There is not enough evidence to show a clear link between the use of antibiotics in livestock and health problems in humans.
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"What FDA is doing, trying to restrict the use of antibiotics and require additional veterinary oversight, goes beyond where the science, their own science, has gone," said Kelli Ludlum, congressional relations director for the American Farm Bureau.
This summer the FDA issued draft guidelines, which recommend using antibiotics only in acute medical situations and under the supervision of a veterinarian.
The guidelines, which say there is a clear risk to human health, are only recommendations but are a first step toward possible regulations to limit the use of antibiotics in the United States.
Despite meat industry protests, the medical community is unhappy that the FDA recommendations don't go far enough.
They are weak and voluntary, and after decades of study the FDA should just issue regulations, the medical industry says.
"These are guidelines, not regulations, which means no enforcement," said Gail R. Hansen, a veterinarian and senior officer of the Pew Charitable Trusts, which has campaigned for new limits on farm antibiotics.
"We don't see that it is going to move things along very efficiently."
Medical and public health experts say the antibiotic issue has been studied in the United States, Canada, Europe and other countries for 40 years. Those studies led to the European Union issuing rules more than 10 years ago limiting the use of antibiotics in livestock. Even more stringent rules were issued in 2006.
The FDA is expected to issue the final guidance possibly early next year. An FDA spokeswoman said the agency wanted to move quickly to begin phasing in its guideline principles, but first it is studying an overwhelming number of comments the agency received from the public.
For many years doctors have worried that the overuse of antibiotics are creating bacteria that have grown resistant to those antibiotics, which leave people vulnerable to the bacteria.
Ultimately, they fear, a super strain of bacteria could develop that would be devastating to humans.
As a result, medical experts have conducted campaigns to prevent overprescribing of antibiotics for patients.
Now, many have turned their attention to bacteria that could be developing on the farms for the same reason -- overuse of antibiotics -- and then infecting humans.
Already some difficult-to-treat strains of E. coli and salmonella have evolved.
Most of the arguments over the FDA guidelines swirl around whether there is enough scientific evidence to prove a link between farms and humans.
In a letter to Congress last spring, CDC Director Thomas R. Frieden wrote that there is "compelling evidence of a clear link between antibiotic use in animals and antibiotic resistance in humans."
Tom Chiller, a CDC medical director, laid out the evidence:
Scientists have documented studies and data that show when you use antibiotics in animals, it creates resistant bacteria.
Studies also show that the resistant bacteria survive on retail meats consumers buy.
Scientists know people get disease from some of the same hardy strains of bacteria that are found on farms.
"It is hard to do a study, document that antibody A, used in cow A, caused infection Z in human Z," Chiller said. "But we know along the continuum of all those lines that antibiotic-resistant bacteria from animals is getting into the food supply.
The best evidence for the link between animals and humans is a study from Denmark, Chiller said.
In that study, a growth-promoting antibiotic was used only in animals and not humans. The animals developed a resistant bacteria that went through the meat supply and showed up causing human infection.
"We have worked for years with the meat industry," Chiller said. "We need to continue to work together to figure out the right thing in this situation."
But the meat industry remains highly skeptical of such studies, which it says do not clearly identify animals as the source of antibiotic resistance in humans.
Howard Hill, an Iowa veterinarian for Iowa Select Farms, said he doesn't think antibiotic use in livestock production is the likely cause for an increase in antibiotic resistance in humans. Producers say human overuse of antibiotics may be to blame.
Hill also doesn't think antibiotics are being given excessively to livestock, and pigs that do receive scheduled low levels of antibiotics are healthier.
"A healthier pig results in better quality meat and safer meat," Hill said.
Livestock producers criticized several aspects of the FDA recommendations.
For one, the guidelines require that a veterinarian oversee the use of antibiotics. But there is a severe shortage of large-animal veterinarians and that must be recognized by the FDA before possible changes are made, producers say.
The guidance's language is vague, farmers say, and it's unknown how much use of antibiotics would be allowed. They also don't account for what could be a costly increase in meat prices, they say.
Matt Teagarden, industry relations director for the Kansas Livestock Association, said the beef association has had guidelines for years regarding the use of antibiotics in cattle and said most cattlemen feed their animals in a "judicious" way to prevent antibiotic resistance.
Seventy percent of antibacterial medication in the United States is used in livestock production, according to the Union of Concerned Scientists. But the meat industry says that number is lower, and the government doesn't track that number.
The USDA is considering tracking it after being approached by several congressmen, including Rep. Louise Slaughter, a New York Democrat.
Slaughter has more than 100 co-sponsors on a bill that would ban the use of antibiotic use in healthy animals.
Slaughter was disappointed when she saw the draft guidelines because she thinks there is plenty of science to prove the seriousness of the problem, said Vincent Morris, her spokesman. She believed FDA should have proposed regulations, which would be tougher than guidelines.
"(The guideline) doesn't commit any farms to any change," Morris said.
Kremer said farmers have a real option.
Twenty years ago in Missouri, Kremer was a big promoter of antibiotic livestock therapy and a president of the Missouri Pork Producers Association.
But that changed soon after he got gored in the leg by a hog. Strep infection caused his leg to swell to twice its size, he said, and the penicillin wasn't working.
It turned out Kremer's hog had been fed low doses of penicillin for some time, causing a hardier strain of strep to develop, and the strep was passed on to Kremer.
"That was enough to raise my awareness," said Kremer, who now speaks about the dangers of antibiotic resistance.
He started a cooperative of farmers who sell antibiotic-free meat to places like Whole Foods and Chipotle and also now to conventional grocery stores.
There's no doubt that the number of shops selling meat from animals that have seldom or never been treated with antibacterial medications is growing.
But that number is still low, Teagarden says.
"Some consumers place value on purchasing that animal that was never treated with antibiotics," Teagarden said. "But obviously as we look at the meat product, the majority of consumers don't have that as a criteria."
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