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ARTICLE

Farm to Table: How Antibiotic Use in Agriculture Affects Human Health

NOV 01, 2016 | MICHAEL D. NAILOR, PHARMD, BCPS-AQ ID, AND EMILY L. HEIL, PHARMD, BCPS-AQ ID
Although not all antibiotics used on farms are the same products used in humans, many are close analogs of those used in healthcare clinics and hospitals worldwide. The US Food and Drug Administration's (FDA) Guidance for Industry #152 classifies these antibiotics into risk cat­egories based on their importance to human health. For example, the third-generation cephalosporin ceftiofur, although not marketed for use in humans, is considered critically important to human health based on its struc­tural similarity and shared resistance mechanisms with third-generation cephalosporins used in human med­icine. Additionally, compared with human antibiotic prescribing requirements, there are very few mandatory regulations for the antibiotics used, by the ton, on farms. This is particularly alarming since the use of antibiotics not only affects the animal they were given to, but also disrupts the bacterial ecology within, and on the animal that is then consumed by people in our society.1
 
The FDA has introduced two new regulations to ad­dress the use of antibiotics on farms that will go into full effect on January 1, 2017. FDA Guidance #213 recom­mends the removal of growth promotion from antibiotic product labels. Once manufacturers revise the condi­tions of use on their approved labels by removing growth promotion, food animal producers would not be able to legally use the antibiotic for growth promotion pur­poses.2 This guidance is voluntary; however, all affected companies indicated they intend to comply.
 
Guidance #213 is being introduced in conjunction with the Veterinary Feed Directive (VFD) that outlines a pro­cess to ensure veterinary oversight of drugs available for use in animal feed that will move all medically import­ant antibiotics out of OTC status. Additionally, the VFD requires a valid veterinarian client–patient relationship, including that the veterinarian assumes responsibility for making clinical judgement about the animal’s health and provides any necessary follow-up care.3
 
Although Guidance #213 and the VFD are positive steps in the right direction, they will not solve the prob­lem of antibiotic resistance and do not have the same rigor as standards in some European countries. The FDA regulations will not prevent the use of antibiotics at identical, or near identical, doses for the purposes of disease prevention rather than growth promotion. Nor is there adequate infrastructure in place to measure if the guidance actually reduces the use of antibiotics in agri­cultural production. Luckily, increasingly assertive and health-conscious consumers have begun to demand an­tibiotic-free food. This has led many large corporations to begin to phase out animals given feed mixed with anti­biotics while other corporations have promised to solely distribute antibiotic-free animals in the near future.
 


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