New FDA Controls Don't Go Far Enough to Prevent Antibiotic Resistance, GAO Says

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New EPA Regulations Don't Go Far Enough to Curb Antibiotic Resistance

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A federal report released by the Government Accountability Office last week says that the FDA’s new controls on the agricultural use of antibiotics fall short of expectations, especially as far as the prevention of antibiotic resistance is concerned.

The new controls, which were finally implemented in January three years after they were first announced, were intended to make it impossible for livestock producers to use routine, subtherapeutic levels of antibiotics as growth promoters, a technique that has been used since the 1940s to get animals up to slaughtering weight in shorter time frames. The new controls were made up of two documents that would “protect public health” and “help phase out the use of medically important antimicrobials in food animals for productive purposes,” according to the FDA.

The new report, however, says that despite GAO recommendations dating back to 2004, FDA is not collecting enough data to be sure of the guidances' effectiveness, relying chiefly on sales information given by manufacturers instead of direct access to farms. In addition, while veterinary involvement is now required for agricultural antibiotic use, it is unclear what this involvement will look like.

"The agencies haven't put in place a plan for what they are going to do, and they can't provide one when asked," Dr. David Wallinga, a senior health officer at the Natural Resources Defense Council, told The Salt. "They have no target for where they want to go, and they have no metrics for how they will measure progress toward a goal they haven't even articulated."

The GAO also notes that the FDA has not anticipated livestock producers switching to a preventative use of low-dose antibiotics, though estimates from the Animal Health Institute show that growth promotion accounts for less than 15 percent of medically important antibiotic use in food animals.

"My big worry is that we're going to stop calling it growth promotion and we're going to start calling it disease prevention," Keeve Nachman, PhD, MHS, a scientist with the Johns Hopkins Center for a Livable Future, told the Center for Infectious Disease Research and Policy at the University of Minnesota. He notes that as a result, "use, in practice, might not change all that much."

The same day the report was released, a group of members of Congress who had been pushing for the reforms wrote a letter to USDA and the Department of Health and Human Services, parent of the FDA, saying, "The rise of antibiotic resistance is one of the greatest threats to global health, and the misuse and overuse of antibiotics has been linked to the emergence and spread of antibiotic resistant bacteria.”

Research has shown that low-level antibiotic treatments can promote the growth of antibiotic-resistant bacteria that kill 23,000 Americans every year, according to the Centers for Disease Control and Prevention, and 700,000 worldwide, according to the Food and Agriculture Organization.

“We’re reaching a postantibiotic era where we have patients with infections that we can’t treat,” Kurt Stevenson, a physician and medical director at Ohio State University, shared at the Antibiotic Use Symposium hosted by the National Institute for Animal Agriculture last fall. “Antibiotics are unlike any other drug, in that use of the agent in one patient can compromise its efficacy in another.”

Some experts, such as Timothy Johnson, DVM, a professor of veterinary medicine at the University of Minnesota, believe that the guidance will, however, have an impact given the existing consumer pressures on companies to move away from antibiotics. Some large chicken producers, such as Tyson, as well as restaurants, including Burger King, Wendy's, and McDonald's, are already moving away from antibiotic use given consumer demand.

In 2015, American sales of antibiotics for agricultural use totaled 34.3 million pounds, approximately three times as much as for human use, according to Pew Charitable Trusts.

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