Reducing Antibiotic Use for Growth Promotion Purposes

Emily Heil, PharmD, BCPS-AQ ID, assistant professor at the University of Maryland School of Pharmacy, explains how the FDA Guidance 213 and the Veterinary Feed Directive will change the use of antibiotics for growth promotion purposes in the United States.

Interview Transcript (slightly modified for readability)

“We have two things coming down the pike that will officially be live on January 1, 2017; one is [US Food and Drug Administration] FDA Guidance 213 and the other is something called the Veterinary Feed Directive [VFD]. Both of these are really important strides to curb the use of antibiotics for the purposes of growth promotion in the United States.

They’re certainly not perfect because they are guidance, and so there is a chance that they may not fully work the way we hope they will but all of the effected pharmaceutical companies so far, have stated that they agree to comply. What will happen then is antibiotics will be relabeled and whatever the label says becomes binding as what the legal use is. It will remove growth promotion from the labels of antibiotics and that will then make using antibiotics for the purpose of growth promotion in agriculture illegal. The hope is that all of the companies will comply; they will remove those growth promotion claims from their labels and then we will see hopefully drastic cuts in the amount of antibiotics being used for this purpose.

I think [one] of the big concerns we have is [the question of] what’s to keep this from just shifting use from growth promotion to disease prevention where you’re still using sub-therapeutic doses to treat big populations. That’s where the Veterinary Feed Directive comes in. That part of the guidance really tries to make sure that there’s an appropriate veterinary client-patient relationship and requires veterinary oversight of the use of antibiotics. Previously, you could buy feed that was laced with antibiotics over the counter. The VFD is going to move that [feed] behind the counter, require veterinary oversight, and hopefully between that and Guidance 213, which removes the growth promotion label, the amount of antibiotics we’re seeing used in agriculture for growth promotion purposes [will drastically decrease].

One of the areas where we really need a little bit more information is in how antibiotics are actually used. There is something called a ADUFA which is how the FDA must report out data on antibiotic sales for the use in agriculture. Unfortunately, we don’t have data on the actual use, [regarding] indications, doses, and duration; all of the data that we have now [are] just on sales. There’s a little bit of room to improve in understanding how these new initiatives that are being implemented by the FDA are actually working [and] a lot of room for improvement in the data we have, but certainly [these are] important steps in the right direction to optimize [antibiotic] use in this population.”