Consumer Federation of California

Last year, the FDA released voluntary guidance for the pharmaceutical industry, which sells 80% of all antibiotics in the U.S. to farmers, primarily because they promote growth in animals. That guidance asked drug companies to please stop selling antibiotics for that purpose, but allows them to keep selling just as many drugs for “disease prevention,” even though it’s been proven that continuous, low-dose use of antibiotics renders their medical use less effective and contributes to the development of drug-resistant pathogens. Today, the President’s Council of Advisors on Science and Technology issued a report that some had hoped would recommend the FDA take a harder line on this issue. Those people are probably a bit disappointed.

The PCAST report [PDF] does acknowledge that there is a growing problem with the over-use of antibiotics, not just in agriculture, but also in the medical field, where about half of the antibiotics given every year are unnecessary or prescribed in a way that doesn’t maximize their effectiveness.

It also makes note of the financial costs of infections from drug-resistant bacteria, with direct health care costs of upwards of $35 billion a year, and another $35 billion lost annually in productivity from all the time taken off work, including the 8 million total days spent in hospitals.

“And the problem is worsening,” reads the report. “A number of bacterial diseases are almost or entirely untreatable because the causal agents have acquired resistance to all of the antibiotics that can be deployed against them.”

PCAST makes several recommendations for stemming the tide to antibiotic resistance, from the bureaucratic — appointing a member of the National Security Council staff as White House Director for National Antibiotic Resistance Policy (DNARP) — to the financial — expanding funding for state and local public health departments for programs targeted at the detection of antibiotic resistance, reponse to outbreaks, and “aggressive” prevention activities — to the innovative — supporting research into new antibiotics and alternatives to antibiotics.

But where the recommendations fall short is on agricultural use of antibiotics, even though farm animals consume four times the amount of antibiotics as those prescribed to the entire U.S. population.

PCAST even writes in the report that “it is clear that at least some drug-resistant pathogens have evolved under selective pressure from antibiotic use in agriculture and may have contributed significantly to resistance in clinical settings.”

It also states that any national strategy to reduce the emergence and incidence of antibiotic resistance must include “substantial changes in the use of antibiotics in agricultural settings, in order to preserve antibiotic utility in human medicine.”

And yet, the report takes a wait-and-see approach to this issue, offering its support to the previous FDA guidance (which only came about as the result of a lawsuit filed by the Natural Resources Defense Council and others who wanted the FDA to fulfill the decades-old legal obligation it had been ignoring).

PCAST says the FDA should, rather than actually force farmers to stop using drugs for growth promotion, sit back and assess the progress of its voluntary guidance “by monitoring changes in total sales of antibiotics in animal agriculture and, where possible, in usage of antibiotics; and by developing and undertaking studies to assess whether decreases are observed in antibiotic resistance among farm animals.”

And only if the FDA eventually determines that its guidance is as pointless as it appears to be, does PCAST recommend that it “should take additional measures,” though it offers no recommendations on what those measures might be.

“Waiting for an agency that has failed for over 40 years to take action on the overuse of antibiotics in livestock feed is not a wise strategy,” reads a statement from advocacy group Keep Antibiotics Working. “To make matters worse, the report fails to make a strong call for FDA to put in place a system to collect information on antibiotic use that is needed to determine if FDA’s policies that [PCAST] endorses are actually working.”

Additionally, KAW points out that many farmers will go the cheapest and easiest route, so as long as they are able to get their hands on low-cost antibiotics that are proven to increase animal growth, they have no incentive to look into alternatives.

“Today’s report from the President’s science advisors underscores the crisis we’re facing as bacteria become increasingly resistant to antibiotics,” says Mae Wu, health attorney at the Natural Resources Defense Council. “Unfortunately, much more follow through is needed from the Administration. Just as the administration is taking steps to deal with abuse of antibiotics in humans, it must take steps to curb the overuse of antibiotics in animals, which consume about 80 percent of the antibiotics sold in the United States. Shying away from taking these needed steps will not yield the ‘substantial changes’ that PCAST says are necessary.”

Congresswoman Louise Slaughter from New York, an outspoken critic of over-use of antibiotics and the only microbiologist in the House, says that she appreciates PCAST’s recommendations for greater surveillance of antibiotic use in agriculture, but also takes issue with the report’s failure to recommend stronger actions from the FDA.

“I maintain that voluntarily asking industry to change labels is not enough to protect human health,” said Rep. Slaughter in a statement. “Not only does it give industry two more years to begin complying, it leaves a loophole a mile wide for using antibiotics daily to prevent disease when they are clearly only meant for treatment.”

While some defenders of the use of antibiotics in animal feed claim that farmers do use discretion and primarily use these drugs for disease prevention, a recent investigative report found that many of the nation’s largest chicken farms are providing drugs — some of them belonging to classes of antibiotics that are considered “critically important” to humans — without regard to whether their birds were at risk for illness.

That same report spoke to a farmer who has raised chickens for Perdue for years, including some flocks that were antibiotic free. He claims there was no difference in the mortality rate between those fed the drugs and those who were not, implying that the antibiotics fulfill no medical need and are used solely for growth promotion. But he also says that both types of flocks grew to full size, which makes one wonder if farmers aren’t throwing away money on medically unnecessary drugs that also don’t result in bigger animals.

Tags: Antibiotics, Food Safety