Antibiotic Resistance 101

Antibiotics are critical tools in human medicine. Medical authorities are warning that these life-saving drugs are losing their effectiveness, and there are few replacement drugs in the pipeline. Bacteria evolve in response to the use of antibiotics both in humans and in animals. Those bacteria that are resistant to antibiotics prosper as antibiotics kill the non-resistant bacteria. Once they emerge, antibiotic-resistant (AR) bacteria can transfer AR traits to other bacteria in animals and the environment. The development of antibiotic resistance is hastened by the use of low doses of antibiotics at industrial farms. The drugs are used routinely not to treat sick animals, but for growth promotion and disease prevention, a practice known as nontherapeutic use.

Both in the United States and worldwide, agriculture uses vastly more antibiotics than human medicine, and agriculture uses drugs from every major class of antibiotics used in human medicine. The Food and Drug Administration (FDA) reported in 2011 that 80 percent of antibiotics in the United States are sold for agricultural purposes.

Antibiotic-resistant (AR) bacteria can spread from farm animals to humans via food, via animal-to-human transfer on farms and in rural areas, and through contaminated waste entering the environment. The most commonly affected populations are those with under-developed or compromised immune systems: pregnant women, children, the elderly and people with certain health conditions. But increasingly, AR bacteria have the potential to affect anyone.

Antibiotic resistance has become a global problem. People get sicker from these infections, as it takes multiple rounds of increasingly stronger antibiotics to stop the infection, allowing the infection to progress further than it might otherwise. Fewer drug options can make it harder for doctors to treat patients with allergies to some antibiotics and make it more likely for patients to require stronger drugs given intravenously.

The Centers for Disease Control and Prevention (CDC) estimates that at least 2 million Americans each year experience AR infections, leading to at least 23,000 deaths. Approximately 22 percent of those infected originate from foodborne pathogens. Multiple studies have found AR bacteria in retail meat and fish products, including the federal government’s National Antimicrobial Resistance Monitoring System (NARMS), and AR bacteria have cause notable foodborne illness outbreaks.

The livestock industry still minimizes its role in antibiotic resistance, but the evidence is clear. Several DNA analyses of AR bacteria point to livestock as the source. The CDC, American Public Health Association, American Medical Association, American Academy of Pediatrics, Infectious Disease Society of America and World Health Organization all agree that nontherapeutic uses of antibiotics in livestock pose a threat to human health.

Despite the urgency of this growing public health threat, neither Congress nor the FDA has taken sufficient steps to restrict the nontherapeutic use of antibiotics in livestock. The FDA currently insists that voluntary guidance to industry will solve the problem, citing lack of resources as an impediment to withdrawing current drug approvals for nontherapeutic uses, despite having restricted certain uses for particular antibiotics.

Food & Water Watch recommends that:

• Congress should pass the Preservation of Antibiotics for Medical Treatment Act (PAMTA)/Prevention of Antibiotic Resistance Act (PARA), which would ban nontherapeutic uses of antibiotics in livestock, thereby avoiding the cumbersome drug-by-drug process currently required of the FDA to achieve the same goal. City Councils across the country have passed resolutions urging Congress to pass PAMTA, and more are joining their ranks.
• Congress also should pass legislation to greatly improve available public data on antibiotic use in livestock.
• The FDA should assess the impact of its voluntary strategy and start the regulatory process now to withdraw drug approvals for injudicious uses. The FDA also should strongly enforce the existing bans on certain uses of antibiotics.
• The FDA should address the Government Accountability Office (GAO)’s recommendations to improve data collection on the use of antibiotics and the development of antibiotic resistance. NARMS must be broadened to allow the FDA to identify and respond rapidly to emerging resistance.
• Government agencies should collaborate to increase research on antibiotic resistance, including the mechanisms of resistance emergence, spread and remediation as well as alternative means of preventing illness in livestock.
• The U.S. Department of Agriculture (USDA) should provide training and technical assistance to livestock producers that are transitioning away from nontherapeutic antibiotic use. The USDA should address contract stipulations that require livestock producers to use feed with antibiotics already added.