The FDA en­lists vet­eri­nar­i­ans to help bat­tle su­per­bugs

▶ Farm­ers pre­pare for new FDA re­stric­tions on an­i­mal an­tibi­otics ▶ “You’re not go­ing to turn this ship around overnight”

Bloomberg Businessweek (North America) - - Contents - �Alan Bjerga

A ban on the in­dis­crim­i­nate use of an­tibi­otics in live­stock is set to take ef­fect by the end of 2016. For pub­lic-health ad­vo­cates, the pro­hi­bi­tion is po­ten­tially a huge vic­tory in the bat­tle against the spread of an­tibi­otic re­sis­tance in hu­mans. But for the ban to work, the coun­try’s vet­eri­nar­i­ans will have to po­lice the front lines of the $187 bil­lion U.S. meat, dairy, and poul­try in­dus­try.

Dr. Carie Tel­gen, who wran­gles dairy cows for a liv­ing as a large-an­i­mal vet in up­state New York, says she be­lieves the reg­u­la­tions are long over­due. “Con­sumers have lost a lot of faith in the food they’re eat­ing,” says Tel­gen, whose prac­tice is near Green­wich, about 180 miles north of New York City. “It’s good for us to step up and show them we’re do­ing the right thing.”

Di­rec­tives from the U.S. Food and Drug Ad­min­is­tra­tion will make vet­eri­nar­i­ans the watch­dogs against rou­tine use of bac­te­ria-fight­ing drugs, which many farm­ers and ranch­ers add to feed and wa­ter to pro­mote growth and pre­vent dis­ease in an­i­mals. Vets will have to write pre­scrip­tions for drugs that were pre­vi­ously avail­able over the counter; the rules will also make feed- store op­er­a­tors less like sales­peo­ple push­ing a prod­uct and more like phar­ma­cists dis­pens­ing a con­trolled med­i­ca­tion.

Pres­sure on farm­ers to cut back on the drugs has been build­ing for decades, with sci­en­tists draw­ing a link be­tween in­creased use of an­timi­cro­bials for an­i­mals and the emer­gence of an­tibi­otic-re­sis­tant in­fec­tions in hu­mans. The Cen­ters for Dis­ease Con­trol and Preven­tion es­ti­mates th­ese so- called su­per­bugs at­tack more than 2 mil­lion peo­ple in the U.S. an­nu­ally, with about 23,000 dy­ing.

For years, live­stock groups had com­pli­cated the FDA’S ef­forts to en­act a ban, pok­ing holes in the re­search. That po­si­tion has soft­ened, says Dr. Wil­liam Flynn, deputy di­rec­tor for science pol­icy at the FDA’S Cen­ter for Ve­teri­nary Medicine, be­cause the science has im­proved. The de­bate about who or what to blame has been re­placed by a shared un­der­stand­ing that any med­i­cally un­nec­es­sary use of an­tibi­otics, be it for an­i­mals or hu­mans, adds to the over­all cri­sis of re­sis­tance. “We know enough,” Flynn says. “We need to rec­og­nize that we’re all con­tribut­ing.”

Grow­ing con­sumer aware­ness of the is­sue, re­flected in de­ci­sions this past year by Pan­era Bread and Mcdon­ald’s to drop an­tibi­otic-treated meat from their menus, has helped nudge the food in­dus­try along. In Novem­ber a hand­ful of com­pa­nies, in­clud­ing Tyson Foods and Walmart, asked Congress to add more money to pro­grams that com­bat an­tibi­otic re­sis­tance by mon­i­tor­ing drug use on farms. Law­mak­ers did so in the ap­pro­pri­a­tions bill passed in De­cem­ber.

The FDA has es­ti­mated one-time busi­ness com­pli­ance costs of the ban at $1.4 mil­lion. The 26 com­pa­nies that make the an­tibi­otics won’t take much of a hit. Elanco, a unit of Eli Lilly, says it will make up for lost rev­enue by sell­ing al­ter­na­tive prod­ucts.

Still, turn­ing the FDA’S new rules into re­al­ity will make for a chal­leng­ing year. “You’re not go­ing to turn this ship around overnight,” says Will Hue­ston, a pro­fes­sor of ve­teri­nary medicine at the Univer­sity of Min­nesota. “We’re go­ing to have to re­solve a lot of ques­tions across the sup­ply chain.” Vets may face pres­sure from some live­stock farm­ers to write need­less pre­scrip­tions and “will need to say no,” says Michael Ap­ley, a ve­teri­nary medicine pro­fes­sor at Kansas State Univer­sity who serves on a White House ad­vi­sory coun­cil on an­tibi­otic re­sis­tance. “Morally, you’re wrestling with the added value you can pro­vide to the live­stock vs. need­ing to be re­spon­si­ble to­ward a broader pub­lichealth goal.”

The bot­tom line Vets will be on the front line of an ef­fort to curb use of an­i­mal an­tibi­otics that con­trib­ute to the spread of su­per­bugs.

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