“Although previously unthinkable, the day when antibiotics don’t work is upon us. We are already seeing germs that are stronger than any antibiotics we have to treat them.” These are the words Dr. Arjun Srinivasan of the Centers for Disease Control and Prevention (CDC) used last year to kick off the agency’s educational campaign on antibiotic resistance, “Get Smart About Antibiotics Week 2012.”
In a blog posted at the time, I registered my surprise and disappointment that CDC had failed to include animal settings in its 2012 campaign and urged the agency to expand the focus this year. I’m sorry to report that CDC did not get the message. Get Smart About Antibiotics Week 2013 (November 18-24) again focuses almost exclusively on human medical use.
CDC’s Dr. Tom Chiller explained (in a letter to a colleague) that the agency’s educational site aimed at food animals, Know When Antibiotics Work on the Farm, is not currently funded and doesn’t have any dedicated staff.
Given the urgency of the issue, why, for heaven’s sake, not?
Animal producers have many options
How many swine producers know that routine use of antibiotics doesn’t deliver economic benefits in finisher pigs? Dan Charles of National Public Radio did a great piece highlighting this fact, but it needs to be hammered home across farm country. Swine producers, just like human patients, need to be educated about opportunities to reduce the demand for antibiotics.
There are many avenues animal producers could take to avoid unnecessary use of antibiotics, among them encouraging appropriate weaning times, all-in-all-out animal management systems, and clean, uncrowded facilities. Consumers could be urged to do their part by looking for and purchasing meat produced with fewer antibiotics.
Animal use of antibiotics is still a significant contributer to the crisis
Ignoring the problem of animal antibiotic use has not made it go away. FDA 2010 data reveal that 80 percent of antibiotics sold in the US were intended for use in animals. Many of those drugs–for example, penicillins, tetracyclines and erythromycin–are in the same classes as drugs critical for human medicine.
Feeding enormous quantities of antibiotics in feedlots and poultry and swine houses generates huge populations of bacteria in animal guts that are resistant to human drugs. Resistant bacteria have easy routes to humans: on food, through the environment, and via people who work with and around the animals.
Antibiotic-resistant food-borne illness is becoming all too common. Recently, Costco announced an expanded recall of Foster Farm chicken implicated in an outbreak of antibiotic-resistant Salmonella that has already sickened over 320 people.
Scientists agree that antibiotic use on farms contributes to increasing levels of severe and difficult-to-treat human (and for that matter, animal) disease. Just this month, two former Commissioners of the FDA, Donald Kennedy and David Kessler, wrote to the Executive Office of the President urging “swift action to curb unnecessary use of medically important antibiotics in food animal production.”
In September of this year, CDC itself issued a report, Antibiotic Resistance Threats in the United States, 2013, calling antibiotic use the single most important factor leading to antibiotic resistance and noting that there is more use of antibiotics in food production than human medicine. The report endorsed phasing out the use of antibiotics for growth promotion, saying the drugs should “only be used to treat infections.”
CDC should target overuse and inappropriate use in animals
Just like the CDC’s human campaign, the CDC campaign on animals should be aimed at unnecessary uses: feed efficiency and growth promotion (purely economic uses) and routine disease prevention, which often compensates for stressful conditions in crowded animal facilities.
The best approach is to legally restrict the sale of antibiotics for routine purposes, a goal that would be accomplished with the passage of the Preventing Antibiotic Resistance Act of 2013 introduced by Senator Diane Feinstein (D-CA) and the Preservation of Antibiotics for Medical Treatment Act of 2013 introduced by Representative Louise Slaughter (D-NY). But even with successful legislation, a broad appreciation of the opportunities to reduce antibiotic use in food production would be important.
I applaud the CDC’s campaign to address the overuse and inappropriate use of antibiotics in human medical settings. Such use is an essential driver of antibiotic resistant disease. But the CDC should be campaigning with equal vigor against overuse and inappropriate use in food animal production.
It simply makes no sense to urge the parents of sick children to forgo unneeded antibiotics, while silently standing by as producers of cattle, swine and poultry continue to overuse the same drugs just to avoid the transition to modern management systems.
Expanding CDC’s Get Smart campaign to include animal settings would have been a smart idea last year–and it still will be next year. CDC should find the funds to make it happen.