Dial Down the Rhetoric on Antibiotic Use

When it comes to antibiotics and antibiotic resistance, it’s hard to know who or what to believe.

Opponents of the use of antibiotics in food producing animals cite the fact that 80% of all antibiotic use occurs in agriculture. Supporters of agricultural use counter that the most frequently used antibiotics in agriculture, some 40%, are ionophores that are not used in human medicine and therefore pose little risk.

And even after the Food and Drug Administration’s Feed Directive went into effect, calls for the halt to the use of antibiotics continue. (Recall the Feed Directive precludes the use of medically important antibiotics, and any antibiotics used in feed must have a veterinary prescription with a stated need, dose and duration.)

Many proponents of the continued use of antibiotics in agriculture point to the overuse of drugs in human medicine. Studies show more than 30% of all human prescriptions are inappropriate or unnecessary, and up to 50% of antibiotic use in hospitals is inappropriate or unnecessary.

One need only consider the opioid addiction crisis to know many drugs are over-prescribed.

The tough reality
At the same time, other studies show that more than two million people are infected with antibiotic resistant infections each year, 23,000 people die of complications from those infections and antibiotic resistance is leading to $20 billion in excessive health costs.  

This back and forth between pro and con--antibiotic shaming, if you will--has to stop. The screaming and shouting is not leading to real solutions to the overuse and misuse of drugs or growing bacterial resistance.

In Minnesota, an effort known as the One Health Antibiotic Stewardship Initiative has been established to bring both human and animal agricultural sectors together, says Amanda Beaudoin, director of the One Health Initiative with the Minnesota Department of Health. Beaudoin is a veterinarian and epidemiologist.

The One Health Initiative’s mission is to bring together leaders in human, animal, and environmental health to work together to raise awareness and change behaviors to preserve antibiotics and treat infections effectively.

Working together
“Globally the industry has come together to talk about this issue,” Beaudoin says. “It’s relevant to every country. We need to impress upon each government the importance of putting together a strategy.”

She says there are four key elements to dealing with antibiotic resistance: preventing, tracking, improving how antibiotics are prescribed, and developing new technologies and drugs.

The goal is to create understanding as to why antibiotics are needed, how they are used and how over-use and incorrect use can be stopped.

The reason: We’re all in this together. “Human, animal and environmental health are inseparable,” Beaudoin says. “Antibiotics are a shared resource and optimizing use is beneficial to everyone.”

The hard reality is all antibiotic use can lead to resistance, and every sector is contributing to resistance to some degree, she says. “The lack of ‘proof’ of harm is not an argument for irresponsible use, and greater abuse in other disciplines is not an argument for injudicious use in yours. Behavior change is key.”

Shared concern
The One Health Initiative was started to bring greater understanding and awareness to everyone. More than 40 groups, ranging from the Mayo Clinic to the Minnesota Milk Producers Association, are now involved.

The hope is that shared concern over antibiotic resistance will result in a more productive discussion about antibiotic need and use while maintaining their effectiveness.

You can learn more about the One Health Initiative at www.health.state.mn.us/onehealthabx. This article appeared in the June issue of Farm Journal's PORK, to read more from the issue, click here.