From American RadioWorks®, the documentary project of Minnesota Public Radio and NPR NewsSM. On the Internet at

March 2002

Antibiotics on the Farm

by Daniel Zwerdling

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A New Public Health Threat on the Farm

If Mike Culbreath had gotten sick only five years ago, he probably would have recovered in a few days. That's what his doctors will tell you. The antibiotic he took used to cure people fast. But when Culbreath got a common infection earlier this year and took the pills, he almost died.

"Worst thing I've ever had," he says. "That's for sure."

Culbreath runs his family's horse farm near Nashville. He looks a little like Paul Bunyan. He tells the story as he and his wife give the horses their morning hay. He says it just hit him one evening—wham.

"I could drink a 12-ounce can of Coca-Cola and I would have to go to the bathroom five times within 15 minutes of drinking it," he recalls. "It would go right through you."

So Culbreath went to his family doctor and asked him what he thought was wrong.

"He really didn't say ... he said, 'You might have eaten something that disagreed.' And I said, 'Well, I haven't eaten anything.' He said, 'Well, you know, you'll probably be all right.' He gave me some kind of light antibiotic. He told me, 'Be sure and take them as prescribed, and take all of them,' " Culbreath explains.

That antibiotic was Cipro. It stands for ciprofloxacin. This antibiotic came on the market in the late 1980s and since then has become one of the most important drugs in the world because it can treat all kinds of serious diseases, including anthrax. But Culbreath kept getting worse. He lost almost 20 pounds from diarrhea. By now, he was so scared he went to the hospital.

"And the minute I walked in the room and saw him in clinic, literally hunched over—his eyes are very sunken-looking, his face is sunken-looking—it was pretty clear that this gentleman was very ill," remembers Dr. Stacy Davis, a cardiologist at Vanderbilt Medical Center in Nashville. Culbreath sees her occasionally for a heart condition.

Davis says she could see he was incredibly dehydrated. "But we didn't expect the next thing we found. The next thing we found was he was so dehydrated [that] his kidneys had virtually shut down. He was actually on the verge of kidney failure."

Davis says if he'd waited two more days to come to the hospital, Mike Culbreath might be dead. The lab tests show that he had a whopping infection that people often get from eating chicken. It's caused by a kind of bacteria called campylobacter. You probably know about salmonella, right? Federal researchers say campylobacter infections are actually the most common kind of food poisoning in America. They think roughly two million people get sick from it every year, and until recently, Cipro easily cured it. Not this time.

"I mean, it was very clear to me that what he had been treated with wasn't working and he needed to use something else," says Davis.

And here's one of the most troubling parts of this story: Researchers warned years ago that this might happen, and the farm industry used the drug anyway.

The case of Mike Culbreath symbolizes a national problem. Ever since farmers started giving a form of Cipro to chickens around five years ago, thousands of people have gotten camplobacter infections that are resistant to the drug. That's according to a government survey.

The Miracle of Antibiotics

It's easy to take antibiotics for granted. Stuart Levy knows that. He runs one of the most respected laboratories that study them, at Tufts University in Boston. He says we tend to forget that scientists developed the drugs barely 70 years ago.

"What makes an antibiotic a miracle is first that this group of drugs has reversed deaths from pneumonias, septic events in surgery, cured urinary tract infections, skin infections, diseases of the brain—any tissue of the body. There has been antibiotics that could literally, in their heyday, have cured most, if not all, infections," Levy explains.

And back in the 1940s, farmers started using them to cure sick animals. Then researchers accidentally discovered that the drugs can work other miracles, too. If you feed them to pigs and chickens and cattle, they make the animals grow faster. Scientists still don't really know why, although they have theories. In any case, America's drug and meat companies have convinced farmers that you have to feed antibiotics to your animals almost every day if you're going to compete in this age of factory farming.

As Little Feed as Possible

To see why antibiotics have become so important, we've come to a chicken house in the hills of Cornelia, Georgia. A vet named John Smith leads us through a flock of 17,000 chickens. The birds are so densely packed that it looks like Moses parting the sea.

"As you can see, they're not pets," he tells us, "but they're not, you know, overly frightened, obviously."

Smith works for a poultry company named Fieldale. They sell more than three million chickens every week in supermarkets on the East Coast. His company calculates its costs and profits based on something they call feed conversion. They know exactly how many ounces of feed they need to give every chicken so the chickens reach the perfect weight in precisely 46 days.

And Smith says if the chickens munch antibiotics almost every day like vitamins, they gain the same amount of weight in the same amount of time, but on a tiny bit less feed.

"We have a target market weight. These birds we want to weigh about 5.4 pounds when they go to market. Feed conversion is important, because we need to use as little feed as possible to get that 5.4-pound bird. And the cost of feed and the cost of all the other inputs is very important to us to remain competitive and to be a profitable company," he explains.

Creating Super Bugs

But almost ever since farmers began using antibiotics in animals, researchers like Stuart Levy have been warning that they can threaten your health. The problem is bacteria are amazing creatures.

"As a young investigator," Levy recalls, "I was fascinated by bacterial ingenuity, so to speak. They had this facility to resist, to find a way to get around these powerful antibiotics."

Levy started studying this problem back in the 1960s. He'd seen bacteria get resistant to penicillin. He'd seen bacteria shrug off tetracycline. Levy and his colleagues discovered that the more you douse bacteria with antibiotics, the more some of those bacteria transformed themselves like creatures from outer space, so drugs become powerless to kill them. Levy started wondering, how are doctors hurting the public's health when they prescribe too many antibiotics in their clinics? And then it hit him.

"What's happening on the farm if we're throwing at the animals these drugs?" he questions.

Drugs at the Dinner Table

Levy raised a bunch of chickens to find out, and sure enough, the bacteria in the birds that munched antibiotics got resistant almost overnight. Now Levy pictured a scenario: You sit down for dinner. You eat a chicken breast that's still got some resistant bacteria on it. Then you get sick and go to the doctor, but the antibiotics won't work.

Levy did this study back in the 1970s, and officials at the Food and Drug Administration got so alarmed that they decided to banish some of the main antibiotics from farms. But the meat industry went straight to Capitol Hill, and congressmen ordered FDA to back off.

Now here it is decades later. The nation's farms are using more drugs than ever. Doctors are seeing patients with infections like salmonella that half a dozen antibiotics can't treat. Levy says the problem could be affecting your family.

"I'd be amazed if a large proportion ... 20, 30 percent ... has not had, has not confronted an antibiotic resistance problem," says Levy. "Many, many people in the United States are suffering in one way or another, some worse. Some have untreatable infections; some have died in the United States."

Levy says doctors who prescribe too many drugs are still the biggest cause of the problem, but, he warns, "Farms are definitely part of the problem."

Agribusiness executives say there is no problem with antibiotics on farms.

Richard Carnevale speaks for the country's leading drug companies, like Bayer, Pfizer, Monsanto. They have a coalition called the Animal Health Institute. . . Carnevale says if the government cracks down on antibiotics, it could hurt the food supply.

"If you take growth promoters out of the food supply , then animals are not as productive as they were before. They don't resist disease, so there's going to be more animals getting sick. The price of food is going to go up…or animals that are unhealthier are going to get into the food supply."

Denmark Vows to Kick the Habit

If you get on a plane and cross the Atlantic, you'll find a whole country of farmers that seem to be proving that American industry executives are wrong.

"Actually, most chickens now would be raised entirely without antibiotics," explains Henrik Wegener.

Wegener works for the Ministry of Agriculture, and he takes us to the meat section in a supermarket in Copenhagen. And meat's cheap. Chickens are around a dollar a pound. But then Wegener reads the label and it says it tells America and the rest of the world a better way to farm.

"It's standard labeling. You can see, now that you recognize the Danish, produced without antibiotic growth promoters. This one says, 'Produced without antibiotic growth promoters.' You cannot find any one that doesn't say that," says Wegener.

Five years ago, says Wegener, he could not have dreamed that this day would come so soon in Denmark. "No, not at all. Not at all."

One of the most surprising parts of this story is not just that Danish farmers have pretty much kicked the chemical habit; it's the fact that executives and their food industry pushed them to do it. Executives saw studies that antibiotics in farms were causing health problems. They worried that consumers might stop buying meat. So a few years ago, they banned most uses of antibiotics on farms.

Cleaning Up After the Chickens

To see how Danish farmers are coping, we drive down a country road past wheat fields and cattle and farmhouses with thatched roofs.

"My name is Biara. I hope you will enjoy your stay here, and just ask me if you want to know something about my way of raising broilers."

Biara has got an impish smile, silver hair, and really blue eyes. He says when the meat industry suddenly told him to stop using antibiotics, he was scared he'd go out of business.

But Biara says he's learned the secret of how to raise animals a more natural way. You have to take great care of them. For instance, it's harder to visit Biara's chicken house than the intensive care ward in a hospital. He raises his chickens, 45,000 chickens, in a huge brick shed that's longer than a football field. No windows. Before we step foot across the threshold, we have to put on disposable body suits with hoods. Then we have to lift each foot in the air and balance as we pull on a long, plastic boot, and then we carefully place that foot inside the doorway without ever brushing the ground outside. Biara's not protecting us; he's protecting his birds.

"I'm afraid you have some bacteria on you," he says. "Perhaps on your clothes. At least we don't want to take any risk that you'll bring bacteria inside my house."

At this point, we still can't get next to the chickens. He'll only let us view them through a sealed window. Some researchers in Europe and the U.S. say that antibiotics are like a crutch. They basically cover up a farmer's mistakes and they work best in animals that aren't perfectly healthy.

So Biara says he has to be meticulous. "First of all, we have the computer taking care of everything. It's connecting the feed barrel to the water."

Biara's computer sends his chickens just the right amount of feed, and he has to give them better feed now than he used to. The computer creates a soothing climate with perfect temperature and humidity. And Danish farmers say there's one more key to raising chickens without antibiotics. When you hear this, you might think it sounds so obvious that it's silly to even mention it. After farmers send each flock of chickens to market, they clean up.

On the day we visit Biara's farm, his birds are only halfway grown, so let's go down the road to another farm where they've just sent the flock to the slaughterhouse. Here's a quiz for you. When you take tens of thousands of chickens out of your chicken house, what have you got left? Answer: You have a chicken house full of feces and chicken litter and viruses and bacteria that can make your animals sick. And if you're a typical American farmer, you clean up all this stuff only once every two or three years. Danish farmers scour the chicken house every several weeks with high-pressure hoses and disinfectants.

Farmers here say they can't believe that American farmers don't do this. And now you know the Danish secrets of how to kick the drug habit. Biara says he's so determined to make it work that he goes to bed with his chickens, in a way. He's hooked up a video camera and microphone in his chicken house so he can monitor his flocks on his bedroom TV.

"On my TV I can have a look at my broilers inside the broiler house," he explains. "That's a part of my family, and I want to say good night. In the evening, I turn on my television, yes, that's why."

Can American Farmers Kick the Drug Habit?

Since Denmark began its crusade, farmers haven't totally stopped using drugs, but they've cut way back, by almost two-thirds. Government researchers are studying the effects. Some farmers say their pigs tend to get sick more often, although it hasn't caused major problems, and studies show that chickens have to eat a tiny bit more food to gain the same amount of weight. They figure it costs two cents more now to raise each chicken, but the farmers are selling their chickens for two cents more, so they're making as much money as ever. Of course, the main reason Denmark went after drugs was to protect the public's health. The latest government survey shows that most of the main kinds of bacteria on the farms the doctors worry about are already less resistant, which raises a question: Could American farmers kick the drug habit, too? Ask the government scientist who helped prod his country to change, Henrik Wegener.

"It is not rocket science," says Wegener. "If it can be done here, of course it can be done in the States. Whether they do it or the consumers do it for them, sooner or later they'll have to do it. And, of course, the advice they get may be 'Better not listen too much to those crazy Danes.' But I think they should try and listen to us. I think we've set a good example."

And the officials who run FDA now say they want to go after antibiotics again. And that brings us back to Cipro. Remember Mike Culbreath in Tennessee? Remember how he got a campylobacter infection and the best-selling Cipro didn't cure it? The FDA has started the long legal process to ban Cipro from American chicken farmers. And they say they may take on other best selling drugs next.

Meanwhile some food companies say they're not going to wait. McDonalds and other fast food chains recently announced that they won't serve chicken anymore that's been treated with Cipro. And a few big companies that raise chicken say they've decided to yank antibiotics off the farm, so consumers can feel safer. But there is no way yet to confirm if they've really done it.