U.S. moves to address antibiotic resistant bacterial diseases
the effectiveness of these drugs as therapies for humans and animals. Although FDA applauds the efforts to date by various veterinary and animal producer organizations to institute guidelines for the judicious use of antimicrobial drugs, the agency believes additional steps are needed.”
At both the federal and state level, legislation has been introduced to curtail the use of antibiotics in livestock to prevent the rise of antibiotic resistant bacteria. On 17 March 2009 Rep. Louise M. Slaughter introduced HR 1549 or the Preservation of Antibiotics for Medical Treatment Act (PAMTA) that would make it illegal to distribute antibiotics to livestock for non-therapeutic reasons.
Additionally in both Pennsylvania and New York, legislation has been proposed that would limit the use of antibiotics in cattle and poultry to only when they are sick. In New York the proposed legislation would make the use of antibiotics to promote growth in farm animals that are not sick illegal and violators of the law could be punished with fines or even jail time.
American efforts still lag far behind Europe, where laws prohibiting farmers from administering animals antibiotics used to treat humans as well as a ban on all drugs used for growth purposes have been in existence since 1998. These laws have proven effective, according to CBS, with a Danish study confirming that the removal of antibiotics in farms dramatically reduced antibiotic resistant bacteria in animals and food.
This still remains a controversial issue in the United States, despite the widening evidence that supports the movement to decrease the use of antibiotics in farm animals. Members of the pharmaceutical industry, livestock and poultry producers, and the American Veterinary Medical Association (AVMA) actively oppose the introduction of legislation that would ban the use of antibiotics in livestock, arguing that their use is critical to maintaining the health of animals and that there is no proven correlation between antibiotic use in livestock and superbacteria.
In 2008 Dr. Lyle P. Vogel, the AVMA’s Assistant Executive Vice President, testified before the Senate Committee on Health, Education, Labor and Pensions stating that, “Risk assessments demonstrate a very low risk to human health from the use of antimicrobials in food animals, and some models predict an increased human health burden if the use is withdrawn.”
As evidence Dr. Vogel examined the Danish example, the same that many organizations use to justify curtailing the use of antibiotics, citing the fact that “when livestock are not given antimicrobials as prevention for disease — as has happened in Denmark since the 1990s — an increase in illnesses is likely to occur.” Dr. Vogel went on to claim that antibiotic resistance in some instances is ten times greater in Denmark than in the United States despite the Danish ban.
Dr. Vogel’s claims run contrary to more thorough studies conducted in recent years by the Danish Integrated Antimicrobial Resistance Monitoring and Research Program (DANMAP). Their studies have shown that imported meat in Denmark is significantly more likely to contain antibiotic resistant bacteria than domestically raised meat that have not been fed antibiotics. For instance domestic Danish pork had no bacteria resistant to ciprofloxacin compared to 22 percent of imported pork.
Based on the same study, Dr. Khan testified that the ban in fact has had a positive impact on human health with data “[showing] a decline in resistance of enterococci isolated from healthy people in the community in Denmark following the ban on antimicrobial growth promoters.”
There is some truth in Dr. Vogel’s claims in that reducing antibiotic use in farm animals alone is insufficient to preventing the increase of super bacteria. In Denmark, despite the ban on antibiotics in farm animals, outbreaks of disease resistant bacteria in humans have continued to occur.
In 2008 there were several large outbreaks disease resistant infections of Salmonella Typhimurium, a type of infectious bacteria, in humans. DANMAP found that 76 percent of all Salmonella Typhimurium infections involved a strain that was resistant to existing antibiotic treatments. Of the 76 percent, it was found that the majority of infections had been acquired when people had traveled abroad, highlighting the fact that combating disease resistant bacteria will prove more difficult than simply limiting the use of antibiotics in farm animals.
In a move to address this growing threat to public health, in November of 2009, the Obama administration established the Transatlantic Task Force on Antimicrobial Resistance, a joint task force with the European Union. The task force will focus on proper therapeutic use of antibiotics in humans and animals, strategies for encouraging the development of new antibiotics, and the prevention of healthcare and community contracted drug resistant infections.
With disease resistant bacteria assaulting the efficacy of antibiotics, one of modern medicine’s greatest assets in curing diseases, the task force has a critical role in helping to address one of public health’s greatest challenges.