Why A More Stringent Policy on Antibiotic Use in Agriculture is Needed - Scientific Alliance
WASHINGTON - Antibiotic use in agriculture contributes to increasing antibiotic resistance in bacteria carried by humans, says a panel of scientific experts tasked with evaluating the transfer of antibiotic-resistant bacteria from farm animals and the ecosystem.
14 May 2002
6 minute read
In a new report initiated by the Alliance for the Prudent Use of Antibiotics (APUA), and published in the medical journal Clinical Infectious Diseases released on-line today on the APUA web site (www.APUA.org), the panel calls for immediate action by government and the agriculture industry to reduce the human health risks identified in the report.
The panel recommends elimination of antibiotic use for growth promotion and limiting farm use of critically important drugs needed for hard-to-treat human infections, such as fluoroquinolones and third generation cephalosporins. Furthermore, the panel suggested, regulatory agencies should provide for rapid review of alternatives to antibiotics, and, where possible, changes in management, use of probiotics or competitive exclusion products, and vaccines should be encouraged.
The APUA report, called 'The Need to Improve Antimicrobial Use in Agriculture,' is the first to provide a detailed review of both the environmental and human health impacts of antibiotic use on the farm. A multidisciplinary panel of national scientific experts met over an 18-month period and assessed approximately 500 published studies.
"Based on the panel's extensive evaluation of the evidence, we have found that the use of antibiotics in food animals is contributing to the growing problem of antibiotic resistance in human infections and must be addressed on an urgent basis," said Sherwood Gorbach, MD, co-chair of the panel and a nationally known infectious disease physician based at the New England Medical Center.
Both pathogenic and commensal resistant bacteria can pass through animal waste to other animals, into the production environment and, in some instances, into waterways and other nearby ecosystems. Further agricultural uses of antibiotics, including those in aquaculture and plant production (as well as sustained human use) also contribute to the development and spread of resistant pathogenic and commensal bacteria. Thus, there is exposure risk not just from consumption of food products that may harbor resistant bacteria but also from environmental sources such as recreational waters contaminated with resistant bacteria.
In the United States, the veterinary community, public health officials and the farming industry began confronting the problem in the early 1990's to address the agriculture-based spread of antibiotic resistance, and recent data indicate that these initial efforts have helped.
However, even though efforts are continuing, resistant bacteria are resourceful survivors and will not be overcome by the measures currently in place. To enhance the effectiveness of current control measures, the panel recommends stopping over-the-counter sale of certain antibiotics in agriculture and requiring a veterinary prescription when antibiotics are to be administered to food animals.
"There is a critical need for more timely action to ensure that antibiotics remain effective," noted Stuart B. Levy, MD, President of APUA, which sponsored the study. "Once the resistance in a bacterial population reaches a certain level, reversal becomes extremely difficult."
The U.S. Centers for Disease Control and Prevention, the American Public Health Association, and the American Medical Association have echoed the studies' concerns. The U.S. Food and Drug Administration is instituting reforms by developing a risk-based approach for approval of new veterinary antibiotics and by limiting the use of fluoroquinolones in food animal production. The APUA report comes at a critical time when the U.S. Congress is considering whether to debate the issue of antibiotic use in agriculture.
"The European Union already has taken bold steps to eliminate all use of antibiotics for growth promotion in animal husbandry," said John Bailar, MD, PhD, Professor and biostatistician from the University of Chicago, who served on the panel.
Regardless of the debate and current practice, all uses of antibiotics in animals, agriculture and humans, on a global scale, contribute to the development of resistant bacteria. It is incumbent upon relevant professional societies and all concerned individuals to foster more appropriate use of antibiotics in order to preserve their effectiveness.
Source: Alliance for the Prudent Use of Antibiotics (APUA) - May 9th 2002
The panel recommends elimination of antibiotic use for growth promotion and limiting farm use of critically important drugs needed for hard-to-treat human infections, such as fluoroquinolones and third generation cephalosporins. Furthermore, the panel suggested, regulatory agencies should provide for rapid review of alternatives to antibiotics, and, where possible, changes in management, use of probiotics or competitive exclusion products, and vaccines should be encouraged.
The APUA report, called 'The Need to Improve Antimicrobial Use in Agriculture,' is the first to provide a detailed review of both the environmental and human health impacts of antibiotic use on the farm. A multidisciplinary panel of national scientific experts met over an 18-month period and assessed approximately 500 published studies.
"Based on the panel's extensive evaluation of the evidence, we have found that the use of antibiotics in food animals is contributing to the growing problem of antibiotic resistance in human infections and must be addressed on an urgent basis," said Sherwood Gorbach, MD, co-chair of the panel and a nationally known infectious disease physician based at the New England Medical Center.
Findings Show Health Risk from Environmental Dissemination
The report states that the long-standing practice of using antibiotics for growth promotion in food animals is a strong contributor to the development of antibiotic-resistant bacteria in the environment because it involves feeding low doses of antibiotics to large numbers of food animals for long periods of time in production, a practice which selects for antibiotic-resistant bacteria. These resistant bacteria may be either pathogenic and cause disease, or may be common, harmless bacteria known as commensals.Both pathogenic and commensal resistant bacteria can pass through animal waste to other animals, into the production environment and, in some instances, into waterways and other nearby ecosystems. Further agricultural uses of antibiotics, including those in aquaculture and plant production (as well as sustained human use) also contribute to the development and spread of resistant pathogenic and commensal bacteria. Thus, there is exposure risk not just from consumption of food products that may harbor resistant bacteria but also from environmental sources such as recreational waters contaminated with resistant bacteria.
In the United States, the veterinary community, public health officials and the farming industry began confronting the problem in the early 1990's to address the agriculture-based spread of antibiotic resistance, and recent data indicate that these initial efforts have helped.
However, even though efforts are continuing, resistant bacteria are resourceful survivors and will not be overcome by the measures currently in place. To enhance the effectiveness of current control measures, the panel recommends stopping over-the-counter sale of certain antibiotics in agriculture and requiring a veterinary prescription when antibiotics are to be administered to food animals.
"There is a critical need for more timely action to ensure that antibiotics remain effective," noted Stuart B. Levy, MD, President of APUA, which sponsored the study. "Once the resistance in a bacterial population reaches a certain level, reversal becomes extremely difficult."
Medical and Agricultural Overuse - A Risky Combination
"The effectiveness of antibiotics is being steadily eroded by their indiscriminate use both in humans and animals," said Michael Barza, MD, Director of Medicine at Carney Hospital in Boston and co-chair of the panel. The APUA report is the first to assess the transfer of antibiotic resistance through the food chain, as well as the spread of bacteria from farm waste in the environment.Powerful New Scientific Techniques Provide New Evidence
Concern about the use of antibiotics on the farm has been growing steadily, as has our understanding of the molecular basis for the spread of resistance. New scientific technology has facilitated studies that indicate that antibiotic-resistant bacteria from food animals can be found in humans, which contributes to increased risk of antibiotic-resistant infections.The U.S. Centers for Disease Control and Prevention, the American Public Health Association, and the American Medical Association have echoed the studies' concerns. The U.S. Food and Drug Administration is instituting reforms by developing a risk-based approach for approval of new veterinary antibiotics and by limiting the use of fluoroquinolones in food animal production. The APUA report comes at a critical time when the U.S. Congress is considering whether to debate the issue of antibiotic use in agriculture.
"The European Union already has taken bold steps to eliminate all use of antibiotics for growth promotion in animal husbandry," said John Bailar, MD, PhD, Professor and biostatistician from the University of Chicago, who served on the panel.
Regardless of the debate and current practice, all uses of antibiotics in animals, agriculture and humans, on a global scale, contribute to the development of resistant bacteria. It is incumbent upon relevant professional societies and all concerned individuals to foster more appropriate use of antibiotics in order to preserve their effectiveness.
About the Alliance for the Prudent Use of Antibiotics
APUA is a non-profit scientific organization whose mission is to improve control of infectious diseases worldwide through promoting appropriate use of antibiotics and reduction of antibiotic resistance. The APUA report is available today at www.apua.org.Interviews With Panel Members
To schedule an interview with panel members, please contact Barbara Souder, PhD, MPH, at APUA, 617-636-0966.Science Contact
Stuart B. Levy, MD, 617-636-6764; President, Alliance for the Prudent Use of Antibiotics; Professor of Medicine and of Molecular Biology and Microbiology, Tufts University School of Medicine; Director, Center for Adaptation Genetics and Drug Resistance.Source: Alliance for the Prudent Use of Antibiotics (APUA) - May 9th 2002
