Antibiotic resistance is primary issue that Congress can address

Times & Democrat | Editorial staff | January 23rd, 2012

THE ISSUE: Antibiotic resistance;

OUR OPINION: FDA should be one implementing reforms

The epidemic of antibiotic resistance is worsening, necessitating urgent action to ensure doctors will continue to have antibiotics that work for life-threatening infections. The 2011 outbreak of resistant salmonella that spread through ground turkey - which killed one and caused more than 80 illnesses - highlighted the urgency to address this very real threat.

Every medical and public health organization of note agrees that combating resistance by curbing the overuse of antibiotics in healthy food animals is an important and necessary step.

Unfortunately, in the last few months the Food and Drug Administration has taken one small step forward and two large steps back in this effort.

Earlier in January, the FDA announced new restrictions on how cephalosporin antibiotics - critical for human medicine -could be used in cattle, pigs and poultry. The FDA first proposed such restrictions on cephalosporin use in July 2008 because scientific evidence showed that overuse of these antibiotics in livestock was threatening their effectiveness in treating serious salmonella infections, including in children. Not long after, FDA withdrew the proposed restrictions due to industry pressure.

However, before this month's announcement about cephalosporins, the FDA:

-- Withdrew - quietly, right before Christmas - longstanding proposals to remove approvals for use in livestock feed of two human antibiotics (penicillins and tetracyclines). The FDA initially proposed to remove their approvals in 1977 because the scientific evidence indicated that feeding these antibiotics to animals for purposes other than disease treatment created an unacceptable risk to the public. In 2010, 14 million pounds - more than 250 times the amount of cephalosporins sold - were sold for animals, most of it to be used in feed or water.

-- Denied, in November, a citizens' petition that called on the FDA to "begin withdrawing the approval of the non-therapeutic uses of seven classes of medically important antibiotics because these uses were inconsistent with FDA's standards of safety with respect to antibiotic resistance." These uses account for an estimated half of the 29 million pounds of antibiotics given to food animals annually. In rejecting the petition, FDA called the withdrawal process too expensive and resource intensive.

While the FDA's action on cephalosporins is welcome, the disappointing steps backward indicate the Obama administration's unwillingness to address resistance that is due to antibiotics given to livestock in feed and water for growth promotion and routine disease prevention.

Instead of using its authority under law to restrict the sale of drugs that put the public at risk, the FDA has opted to issue voluntary guidelines that it hopes the pharmaceutical industry will follow in terms of its enormous sale of antibiotics in livestock feed and water.

Keep Antibiotics Working - a coalition of health, consumer, agricultural, environmental, humane and other advocacy groups with more than 11 million supporters - urges the FDA to intervene and stop the squandering of life-saving drugs before they are lost. If this administration will not act, Congress can and should.

Bipartisan legislation introduced in the House and Senate, the Preservation of Antibiotics for Medical Treatment Act (H.R. 965/S. 1211), would reduce antibiotic resistance by phasing out the use of antibiotics in the feed and water of food animals for reasons other than disease treatment if the same or related drugs are also used in human medicine. If a drug company can show that its product is not creating a human health problem due to resistance, it will be exempt from the phase-out.

While the FDA could begin implementing these needed reforms immediately through its mandate to protect public health, for decades the FDA simply has not acted. Congress should not wait for the FDA. Instead, Congress should pass the legislation, which would go a long way to curbing antibiotic resistance.

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