By Tara Bannow • The Bulletin

It’s no surprise farmers give their animals antibiotics when they’re sick. But many also give herds the medications on a large scale — either in their feed or water — to prevent illness.

The latter is a controversial practice, and a perennial topic of debate at the Oregon Legislature. This year was no exception.

Proponents argue if no animals are sick currently, stressful situations like being shipped long distances or a 50-degree temperature swing can quickly cause illness.

“With these temperature extremes coming on in crowded conditions, I don’t want to wait until 20 animals are sick to begin to treat these animals,” said Chuck Meyer, past president of the Oregon Veterinary Medical Association and a veterinarian in Grants Pass.

For the past few years, health care providers and consumer advocates in Oregon have argued in support of measures that would prohibit the practice, which contributes to the spread of antibiotic-resistant bacteria that kill an estimated 23,000 Americans each year, per the Centers for Disease Control and Prevention.

In each of those years, including this one, the measures fail under fierce opposition from industry groups like the Oregon Farm Bureau and the Oregon Cattlemen’s Association.

Despite the most recent dud, new federal regulations that began in January could potentially decrease antibiotic use in agriculture. Although farmers can still feed their herds antibiotics to prevent illness, they now need approval from a veterinarian to do so when it comes to antibiotics that are used in human medicine. The new rule also prohibits operations from using antibiotics to make their animals bigger.

“It keeps me as a layperson from just going down to the feed store and buying a bunch of stuff and deciding that I want to use it without consulting a veterinarian,” said Troy Downing, animal and rangeland sciences professor with Oregon State University Extension.

Bacteria become resistant to antibiotics when they survive the medications and then become stronger and multiply. People can be exposed to antibiotic-resistant bacteria in animals through eating contaminated meat or crops fertilized using stool from a contaminated animal, drinking or swimming in water that came into contact with a contaminated animal’s stool or simply tending to the animals. A 2015 report commissioned by the U.K. government found that unless action is taken, antibiotic-resistant bacteria could kill up to 10 million people worldwide annually — more than the current number that die of cancer each year.

But some question how much will change under the new rules. A Government Accountability Office report from March found the Food and Drug Administration, which oversees the new rules, does not have performance measures. The report also says the benefit of veterinary oversight will be limited by the fact that some antibiotics don’t have defined durations on their labels.

On top of that, many veterinarians make their living working for large farms, and are thus unlikely to push for changes, said Charlie Fisher, state director for the consumer advocacy group Oregon State Public Interest Research Group. OSPIRG has championed tighter antibiotic rules at the Oregon Legislature since 2015.

“We’re kind of putting vets in a difficult position if we’re expecting individual ones to change the longstanding practices of really large factory farms,” he said, “which is why it really falls upon regulators and the government to step in and make sure that everyone is operating in the right way.”

Fisher said OSPIRG will continue to pursue the issue at the Oregon Legislature.

Changing practices

For his part, Downing said he thinks veterinary oversight could encourage producers to adopt practices that reduce the animals’ stress, and thus the need for antibiotics. For example, the beef industry is working toward ensuring calves are able to spend at least three weeks at home with quality feed and water before being separated from their mothers to be shipped and sold, he said.

“I would say as an industry we’re trying to prevent those animals from getting that shipping stress by doing better care before they go to the sale yard,” Downing said. “Part of it is educating producers.”

Downing expects veterinarians will still allow producers to feed herds antibiotics to prevent illness, but there will be more scrutiny on the dose and how it is being used.

Brad LeaMaster, state veterinarian with the Oregon Department of Agriculture, said he thinks whether or not to give herds antibiotics to prevent disease should be a decision between the farmer and the veterinarian, as they know the operation’s conditions and history. He said he’s confident veterinarians will only approve antibiotic use when it’s appropriate.

“That’s what veterinarians do,” he said. “Why would they do anything else?”

The FDA is directing farmers and veterinarians to keep records of their antibiotic use in the event of future audits by the agency. Veterinarians could lose their state licenses if they’re found to be negligent, LeaMaster said.

Meyer, the Grants Pass veterinarian, said if he thinks there are situations in which the farmer could solve the illness problem by improving operations, he may approve one-time antibiotic use and suggest changes.

Doctors don’t typically treat herds of patients, but a comparison might be large groups of people after natural disasters like Hurricane Katrina in the U.S. or hurricanes and earthquakes in the Dominican Republic, said Dr. Dawn Nolt, associate professor of pediatric infectious diseases at Oregon Health & Science University. People are similarly prone to illness when they’re in stressful situations and living in poor conditions, she said.

“We try to prevent that by quickly giving them relief aid through restoring their sanitation, restoring their housing,” Nolt said. “We do that in lieu of just giving everyone antibiotics against diarrhea. We as human doctors feel that perhaps the animal conditions could be improved in that way.”

Resistance affecting patients

Meyer believes agriculture’s role in antibiotic resistance is overstated, and that the majority of resistance is still the result of antibiotic use in humans, especially when people stop taking their prescriptions before they’re supposed to.

“I think that there is sometimes misunderstanding in the human profession of what the veterinary profession does and how we do it,” he said.

That was a point of contention recently at the Oregon Legislature, where proponents of stricter antibiotic regulation noted that 70 percent of the medically important antibiotics sold in the U.S. are used in agriculture.

The number — widely cited in debates on the issue nationwide — comes from the consumer advocacy group Consumers Union. It was calculated using 2011 data from the health care information company IMS Health on the amount of antibiotics sold for human medicine and FDA data on antibiotic use in agriculture.

The FDA included a class of antibiotics called tetracyclines in its new rule because they’re considered important for human medicine and their use in agriculture is believed to contribute to antibiotic resistance.

Meyer said he doesn’t believe that’s true, because while many farmers feed their herds tetracyclines on a large scale, doctors “tend not to use the tetracyclines at all.”

Not true, Nolt said.

“We use the tetracyclines a lot,” she said.

Specifically, antibiotics called doxycycline and minocycline, which are included in the tetracycline class, are commonly used in the treatment of skin infections and at low doses to control acne, Nolt said.

As a pediatrician, Nolt regularly sees antibiotic-resistant bacteria striking babies who’ve never been given antibiotics themselves. She treated a 4-month-old baby with a urinary tract infection who was resistant to all of the liquid antibiotics usually used. That baby had to stay at OHSU’s Doernbecher Children’s Hospital for at least a week receiving antibiotics through a peripherally inserted central catheter, or PICC line.

In another case, a 17-year-old patient undergoing chemotherapy contracted a bloodstream infection that could only be treated by eight antibiotics, making it difficult to find one that worked for him, Nolt said.

Nolt has also had patients die from antibiotic-resistant bacteria.

The medical community has worked for years to cut down on inappropriate antibiotic use, Nolt said. Medical students have learned about the problem for at least 15 years.

“I wonder if the outreach to agriculture has been delayed because everyone’s focused on human medicine and not necessarily perhaps what the contribution has been from agriculture,” Nolt said.

A local perspective

Linda Anspach, the co-owner of DD Ranch in Terrebonne, said she only uses antibiotics when her animals are so sick they’re at risk of dying. It happens once or twice a year out of the hundreds of animals on her farm, where she and her husband raise pigs, steer, sheep, chickens and other animals.

She never uses antibiotics to prevent illness.

“I’m totally against the practice,” she said.

Anspach said her animals rarely get sick. If they did, she said she’d make changes to her operations rather than give them antibiotics, she said.

However, Anspach said there’s a lot of money at stake. She understands the desperation farmers can feel to keep their animals alive.

“That’s kind of the crux of the issue is dollars at the end of the day,” she said.

— Reporter: 541-383-0304,

tbannow@bendbulletin.com

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