Who's Hogging Our Antibiotics

BACKGROUND:   All uses of antibiotics contribute to drug resistance, and research clearly shows that resistant bacteria from food animals contribute to the problem. A focus on only the human use of antibiotics ignores many other contributors of resistant bacteria.  Antibiotics are available over the counter and are routinely and consciously administered to healthy food animals in the U.S. at levels that are not designed to treat specific pathogens.  The European Union (EU) has attempted to address this problem by limiting antibiotics used in food animal productions.

METHODS:   Descriptive statistics on the limited sales data of antibiotics for food producing animals in the US will be discussed.  More data is available from some EU and other countries and will be contrasted with US data. In Denmark, for example, consumption is measured in grams of active compound and in number of doses. Doses are species specific and defined as “Defined Animal Daily Doses” (ADD); grams of active compound are only used as the measure for the overall consumption. ADDkg is defined as the assumed average maintenance dose per day, for treatment of one kg animal for the main indication in a specified species and is independent of the weight of the animals treated, 

RESULTS:   There were 9.4 million kgs of medically important antibiotics were sold in the US for use in food producing animals, of which 90% were administered in livestock food or water, compared to 3.3 million kgs for treatment uses in humans. That is the greatest level of detail available in the US.  In contrast, in Denmark, consumption by species and for which therapeutic purpose (non-therapeutic uses of antibiotics are not allowed) are available, monitored regularly, and policy developed based on values and trends.   

CONCLUSIONS:  A collaborative effort by all major users of antimicrobials here and abroad is needed to address the growing problem of antibiotic resistant pathogens. The World Health Organization recommends veterinary oversight of antibiotics critical for human medicine that are used in food animals and a national surveillance system to monitor antibiotic use and resistance, but such a system has not been instituted in the U.S.  In order to adequately address the issue of antimicrobial resistance, the US must commit to monitoring the consumption of antimicrobials for both human and animal use. Surveillance systems are in place in some developed nations that could serve as a model in the US.