Public health win: FDA ordered to act to stem antibiotic overuse in farm animals
It’s a hellish and frightening prospect — the chance of acquiring Methicillin-resistant Staphylococcus Aureus (MRSA), a staph bacterial infection that’s resistant to methicillin and common antibiotics like oxacillin, penicillin and amoxicillin.
Most commonly manifesting as ghastly, pus-filled pustules or boils that are red, swollen and painful, MRSA can quickly develop into a severe and life-threatening infection of the bloodstream, lung or heart.
But MRSA is only one of a growing number of “superbugs” or antibiotic resistant infections. These include resistant strains of bacteria that cause tuberculosis, as well as Streptococcus and Enterococcus and Clostridium difficile.
Few people know that this rise of superbug infections was predicted by the United States Food and Drug Administration 35 years ago, when it first became alarmed over the growing use of low doses of antibiotics in healthy livestock.
But in the years that followed, the FDA didn’t take steps to stop the agricultural industry from this now-widespread practice.
Now, a federal judge in New York has ruled that the FDA must address the use of antibiotics in livestock — and public health advocates and environmentalists hope the ruling will lead to a ban on the practice.
The ruling favors a coalition of plaintiffs — which includes the Natural Resources Defense Council, Center for Science in the Public Interest (CSPI), Food Animal Concerns Trust (FACT), Public Citizen, and the Union of Concerned Scientists (UCS) — which filed suit last May in a bid to push the FDA to exert more control over the agricultural use of penicillin and tetracycline.
These two popular antibiotics are mixed in with feed partly to protect chickens, pigs and cattle from getting sick in crowded, unsanitary feedlot areas, but mostly also to speed their growth. According to a recent estimate by the FDA, only 20 percent of all antibiotics sold in the U.S. are given to sick people — the remainder is given to farm animals used in food production.
Way back in 1977, the FDA became alarmed over the use of constant low doses of antibiotics in healthy animals, saying this might trigger the development of antibiotic-resistant killer bacteria that could potentially infect people.
“In the intervening years, the scientific evidence of the risks to human health from the widespread use of antibiotics in livestock has grown,” the court decision noted.
Meanwhile, as the years passed and antibiotic use in livestock rose, public health advocates have been pushing the federal government to put more restrictions on this system. The NRDC antibiotics used in livestock rose dramatically from the previous decade, reaching 29.8 million pounds in 2009.
But the problem is, after constant use some animals develop germs that are immune to antibiotics. These “superbugs” can then pass to farm workers and their families. In other cases, the “superbugs” run off into lakes and rivers during heavy rains, are carried by the winds into neighboring communities or contaminate steaks and chops that end up in meals.
“For over 35 years ago, FDA has sat idly on the sidelines largely letting the livestock industry police itself,” said Avinash Kar, NRDC health attorney, commenting on the ruling, which she praised.
“In that time, the overuse of antibiotics in healthy animals has skyrocketed — contributing to the rise of antibiotic-resistant bacteria that endanger human health,” said Kar. “Today, we take a long overdue step toward ensuring that we preserve these life-saving medicines for those who need them most — people.”
“These drugs are intended to cure disease, not fatten pigs and chickens,” Kar added.
The Union of Concerned Scientists — as well as other environmentalists and public health advocates — cheered the decision. “This ruling is an important victory for public health,” Margaret Mellon, senior scientist with the Union of Concerned Scientists’ Food and Environment Program, said in a statement.
From wonder drugs to overuse
The wonder drugs of the 20th century, antibiotics were key medical discoveries then. Since they were first brought on the market in the 1930s, antibiotics have become a common part of medical practice, and are still used to heal everything from infected wounds to strep throat. But health experts now agree that the overprescribing of the drugs has also played a role in today’s surge of antibiotic resistant germs.
The FDA approved antibiotic use in animals in 1951, before concerns about drug resistance rose. Initially, they were used in animals indiscriminately: impressed by the effects of penicillin and tetracycline on the robustness of cattle, chickens and pigs, farmers began to add the drugs to feed and water, without prescriptions or even sign of sickness in the animals.
By the 1970s, public health officials began to worry that overuse was leading to the development of treatment-resistant infections.
In 1977, the FDA concluded that the overuse of antibiotics in livestock, poultry and other animals weakened the treatment’s effectiveness in humans. The agency then issued an order that would have banned the non-medical use of penicillin and tetracycline in farm animals, unless drugmakers could show the drugs were safe.
But farming groups — who have long argued the drugs are needed to keep animals healthy– vigorously opposed the ban. Together with drugmakers, farmers groups lobbied in Congress. Soon, the House and Senate appropriations committees passed resolutions against the ban — and the FDA retreated.
Long overdue ruling
In a ruling handed down on March 22, Judge Theodore Katz took the side of the four consumer safety groups that brought a lawsuit against the agency, saying that the FDA must begin steps to withdraw approval of the two antibiotics for routine use in animals. The FDA has 60 days to appeal the ruling.
While a praiseworthy first victory for public health, the court ruling will not immediately stop the use of antibiotics on livestock — the FDA must first schedule a public hearing and give drugmakers a chance to respond.
“If, at the hearing, the drug sponsors fail to show that use of the drugs is safe, the FDA commissioner must issue a withdrawal order,” concludes Katz, a judge in the U.S. District Court of Southern New York.
FDA spokeswoman Siobhan DeLancey said Friday the agency is “studying the opinion and considering appropriate next steps.”
The case is Natural Resources Defense Council et al. v. FDA, in the U.S. District Court for the Southern District of New York, no. 11-3562.
The ruling follows a first step taken by the FDA in January, when it ordered farmers to limit the use of cephalosporins — a newer class antibiotics related to penicillins — which are now being given to some cattle, swine, chickens and turkeys. These, however, aren’t as widely used as penicillin and other common antibiotics.
In fairness to the agency, FDA officials had repeatedly said antibiotics in agriculture pose a serious public health threat throughout President Obama’s first term in office. They also said they would act on the issue — and in January they did take that first step.
In May 2011, the NRDC and its co-plaintiffs sued the FDA to compel the agency to act on its 35-year-old order. But the FDA countered then that the 1977 ruling was outdated. It also claimed it had already issued more recent proposals to curb antibiotics. This includes a 2010 recommendation that veterinarians be consulted before antibiotics are given to animals. It said it was expected to finalize those recommendations — which aren’t binding — late in March.
Flesh Eating Virus Blog