There are many culprits in the growing problem of microbial resistance to antibiotics that makes these precious drugs advocates ineffective public health but often link to agriculture. Farmers give more than 70% of the antibiotics used in the US to improve health and promote the growth of livestock and poultry. Yesterday, the US Food and Drug Administration (FDA) has announced changes in the agricultural use of antibiotics to protect medical drugs.
The American Society for Microbiology applauded the move in an email, calling it "a major step to address antibiotic resistance globally." But critics worry about what they consider an important gap, and they say that the measures do not go far enough.
Farm animals are often given a steady dose of antibiotics added to their diet in order to stimulate growth and prevent the onset of disease. Unfortunately, the practice increases the risk of microbial resistance evolution and eventually spread to humans. In final guidance published on 11 December, the FDA asked companies that produce drugs for animals to voluntarily change their labels. Should they announce more improved growth and feed efficiency of antibacterial drugs that FDA believes medically important to humans.
If the labels are changing, drugs are not available over the counter. Instead, farmers or food plants would require a prescription from a veterinarian, who may approve the use for the treatment of sick animals or prevention of disease in people considered "at risk." The FDA wants to hear businesses within 3 months about their plans to change the label and will give them 3 years to implement. The agency has preferred a voluntary approach because it says regulatory measures would take longer, cost more, and be more disruptive to the industry. The companies support the plan.
The Johns Hopkins Center for a Sustainable Future (CLF), which recently released a report critical of the use of antibiotics in agriculture, is skeptical that voluntary action sufficient to protect public health . "[T] he guidelines will probably not change the way these medicines are used in food animals," according to a statement released today. "The FDA can take care if companies call the growth promotion or disease prevention, but bacteria are not," said Keeve Nachman, a scientist of Environmental Health at the Johns Hopkins School of Public Health Bloomberg in Baltimore, Maryland, in the statement. "If antibiotics are used in the same way, they will have the same effect."
Christine Hoang, deputy director for scientific affairs at the American Veterinary Medical Association, provides that the change will lead to less use of antibiotics overall. FDA guidelines specify when the drugs are to be used for medical purposes, she noted, for example by providing antibiotics for piglets that are shipped to a facility with outstanding disease. "All veterinarians know that you can not deviate from the label," she says Science Insider. "You could lose your license." Almost all states require a prescribing veterinarian to get acquainted with the keeping and care of animals by a client, even if they do not require a visit for each prescription.
CLF wants FDA to eliminate all uses of antibiotics for disease prevention. Hoang, however, said that such a ban could be a "very serious problem for food security." If animals become ill, she said, the disease can cure their gastrointestinal tissue, which increases the risk of fecal contamination during slaughter, which could add to the spread of resistant microbes. Healthy animals are important for food safety, said Hoang.
Representative Louise Slaughter (D-NY) a longtime proponent in Congress of tighter restrictions on antibiotics in agriculture, in a statement that the FDA is short train. "FDA volunteer orientation is an inadequate response to the overuse of antibiotics to farm without enforcement mechanism and no steps to success," she wrote. "Unfortunately, this orientation is the biggest step the FDA has taken a generation to fight against the overuse of antibiotics in agriculture business, and it unfortunately falls short of what is needed to deal with a crisis public health. "
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