ANTIMICROBIAL USE IN AGRICULTURE

To advocate that the Food and Drug Administration (FDA) eliminate future approval of antimicrobials for nontherapeutic uses in agricultural animals that represent a safety risk by contributing to antimicrobial resistance; further,

To encourage efforts to phase out and eliminate the nontherapeutic uses of antimicrobials previously approved by the FDA; further,

To support the therapeutic use of antimicrobials in animals only under the supervision of a veterinarian; further,

To encourage the agricultural industry to report to the appropriate regulatory bodies the specific antimicrobials used, the purpose or indication for their use, and the settings in which they are used; further,

To encourage the FDA, Centers for Disease Control and Prevention, and other stakeholders to monitor and limit, when effective alternatives are available, the therapeutic use of antimicrobials that are essential to the treatment of critically ill human patients; further,

To advocate for the inclusion of pharmacists in antimicrobial surveillance and related public health efforts based on pharmacists’ knowledge of antimicrobial drug products and antimicrobial resistance.

Rationale

The use of antibiotics in animal agriculture represents the majority of antibiotic use worldwide and poses significant public health risks. Approximately 80% of antibiotic consumption in the U.S. is dedicated to agricultural purposes. Despite warnings and risks, antibiotics are still excessively used for growth promotion, feed efficiency, and disease prevention in animal agriculture.

ASHP supports the public health approach to antimicrobial use in agricultural animals outlined in the July 2010 FDA testimony to Congress. The goal of this approach is to minimize the development of antimicrobial resistance, preserving the effectiveness of antimicrobial therapies that are critical in human medicine. According to the FDA, an enhanced action plan would seek to phase out the use of antimicrobials for nontherapeutic purposes (e.g., animal growth promotion, food efficiency) by eliminating future approvals for new nontherapeutic indications. ASHP also supports the FDA’s request for increased statutory authority that would facilitate removal of previously approved nontherapeutic uses of antimicrobials. This two-pronged approach is critical to preserving the effectiveness of existing antimicrobials as well as those in development. ASHP opposes nontherapeutic uses but supports animal use of antimicrobials for therapeutic purposes (e.g., treatment of disease or prevention of disease in animals within a population that has documented disease) when this use occurs under the supervision of a veterinarian. Reporting of the specific antimicrobials used, the purpose or indication for their use, and the settings in which they are used would support achievement of the FDA’s action plan. In addition, ASHP advocates that FDA approval and subsequent use of antimicrobials should take into consideration the public health impact of the drugs’ use. Pharmacists’ knowledge of antimicrobial drugs and antimicrobial resistance will be critical to these efforts, including the identification of antimicrobial classes for which animal treatment use should be minimized in order to retain the effectiveness of these drugs for the treatment of critically ill human patients.