White House Makes Push For Private Sector To Help Curb Dangerous Overuse Of Antibiotics

Image courtesy of Bernard Walker

Today at the White House, representatives for some 150 organizations, including Consumer Reports, and private companies gathered for a forum on how to rein in the rampant, and potentially deadly, overuse of antibiotics in everything from hospitals to farm animals.

Overuse of antibiotics, whether by consumers who take them unnecessarily or by farmers who use them on animals solely for their growth-promoting effects, results in the development of drug-resistant bacteria that render the antibiotics less effective and sometimes useless.

According to the Centers for Disease Control and Prevention, antibiotic-resistant pathogens infect more than two million people in the U.S. each year, with at least 23,000 deaths resulting from these infections.

CDC director Thomas Frieden says antibiotic resistance “may be the single most important infectious disease threat of our time.”

Antibiotics have helped prolong human life both through treatment of previously fatal infections but also by making life-saving surgeries and transplants possible.

“If we lose antibiotics, the medicine chest will be empty and it will not only undermine our ability to treat routine infections, but it will undermine much of modern medicine,” explained Frieden in advance of this morning’s forum. “We risk turning back the clock to a world where simple infections can be fatal just as they were a century ago.”

Sylvia Burwell, Director of the Dept. of Health and Human Services, put it even more bluntly in her remarks to the White House forum.

“We’re not entering the post-antibiotic world,” she explained. “We’re in it.”

The greatest threat isn’t bacteria’s ability to adapt, but “our own inaction,” according to Burwell.

Speaking of inaction, the FDA spent decades doing virtually nothing on the issue of antibiotic overuse in farm animals, but has gradually taken the matter to heart in recent years. And because the wheels of regulation turn slowly, much of the focus of today’s forum was on what private companies can do to address the looming threat of drug-resistant super bugs.

As we’ve previously reported, a number of poultry giants, like Tyson, Perdue, and now Foster Farms (the company whose salmonella-tainted chicken sickened more than 600 people in 2013), have each pledged — to varying degrees and on different timelines — to reduce or eliminate the use of antibiotics deemed medically important to human beings. McDonald’s, Panera and other restaurants chains have also committed to sourcing only chickens raised without antibiotics.

Antibiotic overuse is certainly not relegated to the farm. Both patients and doctors share a responsibility for the abuse of these drugs. Even though it’s long been known to the medical community that antibiotics are ineffective in treating acute bronchitis (a viral infection), a 2014 study found that 70% of physicians are still prescribing antibiotics for affected patients.

Meanwhile, a 2014 Consumer Reports survey of physicians found that an overwhelming majority of doctors in the U.S. had recently treated patients with drug-resistant infections.

This chart from the CDC shows common cases in which antibiotics are and aren't effective for treatment.

This chart from the CDC shows common cases in which antibiotics are and aren’t effective for treatment.

Later this summer, Consumer Reports will publish a multi-part investigative series on antibiotic resistance. The first part, “How to Stop a Superbug,” will appear in the August 2015 issue of CR.

“Antibiotic-resistant infection is the health crisis of our generation,” explains Consumer Reports President and CEO Marta Tellado. “The only way we are going to make progress is by taking bold steps, and we welcome the White House Forum as one of those steps.”

Though much of the focus this morning was on the immediate impact that the private sector could have on antibiotic overuse, there were two relevant announcements from the federal government.

First, it was announced that President Obama will sign a memorandum intended to get more drug-free meat in federal cafeterias. Given the sheer number of people the federal government feeds on a daily basis, this could have a significant impact on convincing farmers to increase production of antibiotic-free beef, poultry, and pork.

Second, the FDA released its final rule [PDF] on Veterinary Feed Directive drugs, which make it clear that close veterinary oversight is intended for antibiotics placed in animal feed.

This is the latest in the FDA’s very slow-moving regulatory approach to antibiotics in farm animals.

In 2013, the FDA asked drug companies to withdraw non-medical uses of veterinary antibiotics so that these drugs could no longer be sold expressly for growth promotion.

This move was roundly criticized by public health advocates — and praised by some in the meat and drug industries — for merely compelling farmers to change their reasons for purchasing and using these antibiotics, which account for some 80% of all antibiotics sold in the U.S. Farmers could now just claim that the drugs were for prophylactic disease prevention (a practice that is widely considered to only encourage the development of drug-resistant bacteria) instead of growth promotion.

More recently, the agency proposed a new rule that would add some transparency by showing how much of each drug was going into the different type of farm animal. Again, while this data is helpful, it’s not sufficient to determine whether farmers are actually reducing the amount of unnecessary antibiotics they feed to their animals.