Regulation Of Antibiotic Resistance In The US
Kansas State University
This paper summarizes and discussed National Research Council, Board on Agriculture and Natural Resources report (NRC, 1999) on the Use of Drugs in Food Animals: Benefits and Risks. In reflection of the report itself, it focuses on issues related to the development of resistance to antimicrobial agents. It emphasizes the need for a more streamlined and enhanced means of developing and approving new agents, the need for greater integration of oversight and policy development efforts, and the necessity of greater availability of better data. It states that antibiotic resistant pathogens have been transmitted from animals to man, causing illness. It also discusses the issue of banning the sub-therapeutic use of these compounds, including the economic implications of such a ban.
Key words: National Research Council; ban; antibiotic resistance; drug resistance; sub-therapeutic administration; animal production; policy.This paper addresses the issue of antibiotic resistance as it pertains to the use of antibiotics in animals. In particular, the recent results and recommendations of a National Research Council (1999) report entitled The Use of Drugs in Food Animals: Benefits and Risks are discussed. This report resulted from the work of a sub-committee appointed at the request of the Center for Veterinarian Medicine in the Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA).
In 1995, the FDA/USDA requested a study of the use of drugs in food animals, and of the associated benefits and risks pertaining to their use. The study was to make recommendations based on available knowledge of the human health effects of these drugs. In addition, the accessibility of drugs, and the accountability and overall adequacy of the United States regulatory process was to be examined. The sub-committee was assembled to represent a broad mix of stakeholders including industry (pharmaceutical companies; beef producers; the National Pork Producer Council); scientists and academics (e.g., dairy specialists, agricultural economists); consumer advocates (e.g., the Consumer's Union); and medical doctors (with an interest in antibiotic use and resistance). The mix of committee members entailed definitively held viewpoints about the use of drugs in food animals. However, the report resulted from a consensus viewpoint based on available evidence.
Conclusions And Recommendations Of The NRC Report
The sub-committee began its work in early 1996. A pre-publication report came out in 1998, while the final report was published in 1999. The committee drew two main conclusions from their research that are as follows.
Table 1. Survey report of microbiological hazards in swine.
Table 2. Survey report of microbiological hazards in cattle.
Table 3. Survey report of microbiological hazards in poultry.
Should Therapeutic Use Of Antibiotics Be Banned?
Although there is an urgent need to find alternatives to the use of antibiotics in animal production, the case for some level of therapeutic administration of antibiotics can still be made. A total ban on the use of antibiotics in animal production comes at a cost. Hayes (1999) has investigated the potential cost of a total ban using a model which estimates the direct cost to consumers.
The model only looked at cost to consumers, not to producers. Depending on the variables and assumptions used, potential costs range from $5 to $10 per year per consumer. This cost is manageable. However, the model did not look at multiplier effects and indirect costs from the imposition of a total ban. Some individual producers might exit the industry during an initial shakeout from the ban. Financial costs of individual producers forced out of business were not considered. Costs from the erosion of export markets due to domestic price increases were also not considered.
Clearly, the question of whether countries would engage in a total ban is likely to come down to a political issue. Nevertheless, scientific risk assessment, impact assessment, and a pragmatic recognition of existing conditions are important inputs in the political process. Despite a relatively low direct impact to consumers, the NRC report did not recommend an outright ban on the therapeutic use of antibiotics in food producing animals. In contrast, the World Health Organization (WHO, 1997) has strongly advocated such a position.
The NRC report did not draw this conclusion for several reasons. Scientific evidence available was not conclusive. In addition, the most important cause of human resistance, in the sub-committee's view, was considered to be the direct administration of antibiotics to humans. Certainly, the physicians that served on the sub-committee took this position. Whether one argues this position strongly or not, there is clear evidence that the direct administration of antibiotics to humans is an important cause of antibiotic resistance. However, probably the most compelling reason for not engaging in an outright ban in animal agriculture is that over-the-counter sales of antibiotics would have to be banned for resistance to be adequately addressed. Prescription use also would have to be heavily restricted. So the report concluded that to ban the sub-therapeutic uses of antibiotics (without banning over the counter use as well) would not really address the issue.
Committee on Drug Use in Food Animals, Panel on Animal Health, Food Safety, and Public Health, National Research Council. (1999). The use of drugs in food animals: Benefits and risks. Washington DC: National Academy Press.
Hayes, J.D. (1999). Costs of eliminating sub-therapeutic use of antibiotics. In Committee on Drug Use in Food Animals, Panel on Animal Health, Food Safety, and Public Health, National Research Council, The Use of Drugs in Food Animals: Benefits and Risks (pp. 179-187). Washington DC: National Academy Press.
Suggested citation: Coffman, J. (2000). Regulation of antibiotic resistance in the US. AgBioForum, 3(2&3), 141-147. Available on the World Wide Web: http://www.agbioforum.org.
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