A significant decline in the usage of medically important antibiotics in food production came as no surprise Tuesday in the Food and Drug Administration’s report, says Liz Wagstrom, chief veterinarian for the National Pork Producers Council.
Sales and distribution of medically important antimicrobials intended for use in food-producing animals dropped 33% between 2016 and 2017, and a 43% decline since 2015, the peak year for usage.
The 2017 summary report is the first issued since the FDA's new rules on the use of medically important antibiotics in food-animal production were fully implemented. Under Guidance for Industry #213, which went into effect Jan 1, 2017, antibiotics that are important for human medicine can no longer be used for growth promotion or feed efficiency in food animals.
In addition, 95% of the medically important antibiotics used in animal water and feed for therapeutic purposes now require veterinary oversight and can no longer be purchased over the counter.
A bright spot for the livestock industry
FDA Commissioner Scott Gottlieb says he's encouraged by the sales trends reflected in the report.
"These reductions are an indication that our ongoing efforts to support antimicrobial stewardship are having a significant impact," Gottlieb says. “While it’s impossible to completely outrace antimicrobial resistance, we can take important steps now to slow its pace and reduce its impact on both human and animal health.”
In light of the growing U.S. swine herd, Wagstrom says the 28% overall decrease since 2009 is significant.
“As our numbers of animals increase, it makes it much harder to decrease use just because we’ve got more animals that are at risk of disease,” she says.
The pork industry has been working to decrease the need to use antibiotics for decades dating back to the mid-1980s when the Pork Quality Assurance program “really got it’s legs,” Wagstrom says. The program was modeled after the Hazard Analysis Critical Control Point (HACCP) programs used by food manufacturers to ensure the safety of food products but was customized for on-farm use.
Over the years, this program has expanded and improved based on scientific advancements and the recommendations of technology and animal agriculture experts. In 2007, the program’s name changed to PQA Plus®, a program focused on food safety and animal well-being with new features that include on-farm site assessments, detailed animal care components and environmental protection and worker safety.
In addition to PQA Plus®, Wagstrom also credits the decrease in antibiotic use to improved health programs such as vaccinations and production system changes.
A culture of stewardship
Wagstrom says stewardship of antibiotics isn’t just about volume.
“It’s really nice to see volume decreases and we think it shows the importance of veterinary oversight and our stewardship programs,” Wagstrom says. “But it’s just one piece of the puzzle.”
More important is the culture of stewardship, including the decisionmaking for when antibiotics are used, for what purposes and for how long. And then, when antibiotics are needed, considering what changes can be implemented to avoid needing them in future groups, she says.
Wagstrom believes the overall decrease discredits concerns posed by advocacy groups.
“If you look at the 2012 National Animal Health Monitoring System (NAHMs) study, you could glean that around a third of the antibiotics being used at that time were probably used for growth promotion. The drop we’re seeing in 2017 with the implementation of Guidance #213 correlates nicely with that estimate from NAHMS,” she says.
The pork industry has also united with other agricultural commodity groups, meat packers, farm organizations, and companies to develop the “Framework for Antibiotic Stewardship in Food Animal Production” that calls for improvement in areas like disease prevention, veterinary guidance and record keeping following a two-year dialogue moderated by the Farm Foundation and the Pew Charitable Trusts.
“We’ve moved away from talking only about how to measure antibiotic use to how can we become antimicrobial stewards,” Wagstrom says. “We’re focused on working with our customers now to make sure we’re delivering on this framework.”
Tetracycline use is trending down
It’s important to note that the FDA report relies upon sales data provided by drug manufacturers and does not track actual use of the products. Some drugs may be purchased and never administered, while others may be purchased and administered in later years depending upon the shelf life.
Tetracyclines remain the most widely used class of antibiotics in animals that is also important in human medicine, but it has also shown the steepest decline, with usage falling by 40% in 2017. Some types of tetracyclines were used for growth promotion, which is now prohibited.
Still, tetracyclines accounted for 64% of the sales of medically important antibiotics for food production in 2017 – 45% for use in hogs, 44% for use in cattle.
Industry needs to reduce duration of use
The world’s largest beef buyer, McDonald’s, issued a statement last week on their plan to establish reduction targets for medically important antibiotics. Wagstrom believes that the long-term use of medically important antibiotics will continue be a focus in the years ahead.
“McDonald’s understands the need for therapeutic uses of antibiotics – whether it’s treatment, prevention, or control,” Wagstrom says. “But it’s the long-term use without a defined duration that remains a concern to them and others. I think that we will see more efforts to tighten up duration of use so that long-term continuous uses of certain antibiotics would be would become more difficult to utilize.”