March 13, 2012
As a panel of scientific experts spoke at Thursday’s Congressional briefings on the misuse of antibiotics in food animal production, a theme emerged: There is no longer any debate.
With evidence that is now irrefutable, the panelists addressed more than 120 Congressional staff and others in the Rayburn House Office Building and the Senate Visitor Center. Each echoed a plain and simple message: The science is clear on two points. First, by inappropriately giving antibiotics to livestock*, we promote the growth of new strains of bacteria that are resistant to existing antibiotics and can infect humans. And, second, that those antibiotic-resistant bacteria pose a serious, expensive, and sometimes fatal, risk for humans. The humans at risk, by the way, are not only the humans who eat meat or work with livestock. All humans are at increased risk for infection by antibiotic-resistant bacteria, including vegetarians and those who never have and never will set foot near a chicken, turkey, pig, or cow.
Representative Louise Slaughter (D–NY) opened the House session in her typically plainspoken manner. “To tell you the truth,” she said, “I’m pretty angry about this whole subject. We’ve taken the greatest breakthrough in medical science [antibiotics] and ruined it. It’s absolute nonsense that we’ve done that.” Referring to FDA’s lack of strong action on this issue, and to her struggle to pass PAMTA [Preservation of Antibiotics for Medical Treatment Act], she said, “This fight is probably the fight of a lifetime… I feel as if I’ve been in a fight with FDA since I took office.” Her parting words were, “Let’s fix this while we can.”
The only outstanding question is whether politicians can summon the political will to address the irresponsible use of these lifesaving drugs.
“The science is clear,” was the message that reverberated throughout the presentations from panelists, and CLF director Robert Lawrence, MD, and Caroline Smith DeWaal, JD (Center for Science in the Public Interest), who provided introductory remarks. Panelists included James Johnson, MD (University of Minnesota School of Medicine), Stuart Levy, MD (Tufts University School of Medicine), Lance Price, PhD (Translational Genomics Research Institute), and Tara Smith, PhD (University of Iowa College of Public Health). For more than 60 years, the livestock industries have used antibiotics in animal feed to make animals grow faster and prevent infections, and it has insisted that discontinuing this practice would result in the death of livestock animals and untenable financial duress. The scientists in the briefing provided solid evidence to the contrary.
“We’re okay with therapeutic use [of antibiotics],” said Dr. Levy, to underscore that the physicians and scientists in the room do not want to eliminate completely the use of antibiotics in food animal production—rather, they want to see the inappropriate use of antibiotics stopped. Dr. Lawrence called for the removal from the lexicon of the phrase “judicious use” of antibiotics. The industry has proven, over decades, that it is unable to regulate “judicious use,” he said. He also urged the passing of PAMTA.
Dr. Price, a former CLF doctoral fellow, underscored the prevalence and risks of drug-resistant strains of Staphylococcus and E. coli, especially extraintestinal pathogenic E. coli (ExPEC), as well of the possible emergence of pan-resistant Salmonella—Salmonella resistant to all current antibiotics. His slides are available here: ABR-Briefing-LPrice.
Dr. Smith briefed the audience on a strain of methicillin-resistant Staphylococcus aureus (MRSA) known as ST398. This strain originated in humans and was susceptible to methicillin; it then made the jump to pigs, became resistant to antibiotics while it evolved in the pigs, and has now made the jump back to humans as a methicillin-resistant strain. Her slides are available here: ABR-Briefing-TSmith.
Dr. Levy stressed the “one health” paradigm in which the health of humans and the health of animals are intertwined: the misuse of antibiotics in animals eventually will have consequences for humans, both here and around the globe. “Whatever’s done in one sphere will come back to haunt you,” he said. “Antibiotics are societal drugs.” His slides are available here: ABR-Briefing-SLevy.
Dr. Johnson briefed the audience on the clinical realities of treating patients with resistant infections. The rise of drug-resistant infections and the “dwindling pharmacopeia” of available and safe antibiotics, he said, result in a very precarious position for human patients. His slides are available here: ABR-Briefing-JJohnson.
*The term “livestock” in this blogpost includes cattle, swine, and poultry.