Last chance to save our antibiotics?

pigs in the mud-crop

November 13, 2013

by: David Wallinga, MD

If we’re going to stop the rapid march of antibiotic resistance, we have to up our game as health professionals. In coming weeks, there are two important ways you can help change this picture:

1. Ask the FDA to give us better information on livestock antibiotics (by November 25th)
2. Urge the White House to “green light” FDA proposals to reduce livestock use of antibiotics (the sooner the better)

In its landmark September report, “Antibiotic Resistance Threats” the CDC states, “Up to half of antibiotic use in humans and much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe”[1]. In fact, we know from data that Big Pharma supplies to the FDA that more than 80% of all antibiotics sold in the U.S. – nearly 30 million lbs. annually – are for use in livestock and poultry. This includes penicillins, tetracyclines, erythromycins and other important human drugs.

Using antibiotics repeatedly to speed animal growth or prevent disease in crowded, unsanitary feedlots or barns spurs bacteria to become drug resistant and then spread – on our meat and to the human population. No one thinks this is a good idea, including the FDA. But that Agency has done very little to stem the overuse of antibiotics in agriculture, except to very politely ask Big Pharma to please-oh-please stop selling so many of its antibiotics to pig, chicken, turkey and cattle producers.

Only since Congress passed legislation in 2008 has FDA reported on the total amount of antimicrobials sold for use on farms. That’s where the shocking numbers above come from. They are the pharmaceutical industry’s own figures. But to protect public health, these reports are far from adequate. And FDA knows it. FDA collects much more information from Big Pharma than it forwards to health professionals, or the public. The FDA has proposed some changes to how it reports data on antibiotics used in animals. Good. This is where you come in. Let FDA know how it can further improve these reports, the deadline for comments is November 25th,.

Particulars about which animals (turkeys, chickens, pigs and beef cattle) antibiotics are most used in is desperately needed. Right now the FDA lumps antibiotic use in all animal species together. We also need FDA to definitively break down the dosages and methods of antibiotics distribution. We have very little information on how often antibiotics are injected (commonly done for treating sick animals) versus added to feed for entire flocks or herds of animals (done for promoting growth). Only with this information can we ascertain which uses of antibiotics can be avoided, lessening the “selection pressure” driving bacteria to become resistant in the first place.

Tell the FDA now: Give us better information on antibiotics used on livestock.

The White House also needs to move more quickly. As noted, the FDA has developed a modest proposal asking Big Pharma to voluntarily reduce sales of its antibiotic products for animal feed. We don’t think the proposal’s particularly strong. But it’s something. And unless the White House gives it the green light, and fast, even that modest step may fail before the next Administration comes into office.

So write the President now. Urge him to move the FDA proposal forward. You’ll be in good company. The Academy of Pediatrics, March of Dimes, the American Public Health Association, American Osteopathic Association, the Infectious Diseases Society of America and Pediatric Infectious Diseases Society, among other professional groups, have made similar asks of the White House.

Time is of the essence. The sooner the FDA gets started, the sooner those of us in medicine and public health can determine whether a voluntary approach will work to reduce antibiotic overuse.

Two ways you can take action to safeguard antibiotics from resistance.

Ask FDA to give us better information on livestock antibiotics (by November 25th)
Urge the White House to “green light” FDA proposals to reduce livestock use of antibiotics  (the sooner the better)

[1] Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States, 2013, p. 31

Photo CC USDAgov on Flickr