Growing concerns about antibiotic-resistant bacteria are outlined in a recent report by the President’s Council of Advisors on Science and Technology (PCAST), in a White House National Strategy on Combating Antibiotic Bacteria, and in a Presidential Executive Order. All aim at directing national and international attention toward correction action, including changes in antibiotic use in food production.
The PCAST report notes the “alarming rate” in the evolution of antibiotic resistance in bacteria. The report calls for the establishment of a national capability for microbial surveillance, including efforts related to agriculture.
The FDA and USDA are charged with continuing to take steps to eliminate the use of medically important classes of antibiotics for growth promotion purposes in food-producing animals. One test of the success of these efforts will be whether there is a decrease in the overall sales of medically important antibiotics in animal agriculture corresponding to the elimination of their use in growth production, according to the PCAST report. The government agencies are urged to work with industry to monitor and report on changes in antibiotic use in agriculture and their impact on the environment.
The White House National Strategy notes the substantial evidence that antibiotic use in animal agriculture promotes development of antibiotic-resistant microbes in animals and that retail meat can be a source of microbes, including antibiotic-resistant microbes. According to the report, “it is clear that at least some drug-resistant pathogens have evolved under selective pressure from antibiotic use in agriculture and may have contributed significantly to resistance in clinical settings.”
Goals of the National Strategy include slowing the emergence and preventing the spread of resistant bacteria, as well as improving capacities for antibiotic-resistance prevention. The Presidential Executive Order states that detecting, preventing, and controlling antibiotic resistance will depend not only on healthcare providers but also on industry to develop alternatives to antibiotics for agricultural purposes.
Jesse Goodman, MD, MPH, a professor of medicine and director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University Hospital, says these actions are a “great step forward” to elevate a global public health threat. Dr. Goodman cautions that success with these efforts will require a “sea of change. Doctors, farmers and agribusiness, health systems, and the public need to think totally differently about antibiotics. They are precious resources, and we must reduce their inappropriate use.”