On January 4th, the FDA opened the door a crack to mandatory regulation of at least one class of antibiotics, cephalosporins. The announcement explains the FDA’s reason for the action:
The cephalosporin class of drugs is important in treating human diseases, such as pneumonia, skin and tissue infections, pelvic inflammatory disease, and other conditions. It is critical to preserve the effectiveness of these drugs.
FDA is concerned that certain extralabel uses of cephalosporins in cattle, swine, chickens and turkeys are likely to contribute to cephalosporin-resistant strains of certain bacterial pathogens. If cephalosporins are not effective in treating human diseases from these pathogens, doctors may have to use drugs that are not as effective or that have greater side effects.
The Agency is particularly concerned about the extralabel use of cephalosporin drugs that are not approved for use in cattle, swine, chickens and turkeys because little is known about their microbiological or toxicological effects when used in these food-producing animals.
Small But Significant Change?
Writing for Mother Jones, Tom Philpott points out “that cephalosporins make up a tiny—and shrinking—percentage of the antibiotics used in factory farms.” In fact, the FDA’s report on antimicrobials that end up in food-producing animals puts cephalosporins at less than .2% of the total sold and distributed for use in U.S. livestock. That 2010 figure is down 41% from 2009. So the move is hardly a major shift in policy.
The new ruling cuts farmers and veterinarians more slack than the original restriction proposed in 2008. On the good side, cephalosporins will no longer be routinely injected into factory-farmed chicken eggs, and use in cattle and pigs will be more tightly controlled.
That is a move in the right direction, but the new ruling is a small blip on the larger antibiotic screen. Given FDA’s foot dragging for the past 34 years, it hardly merits notice, let alone celebration, particularly in light of the pre-Christmas gift handed to the livestock industry. Whether or not it signals a shift in direction remains to be seen. One thing is certain, though: three groups will be pushing hard against even the smallest progress.
Pharmaceutical, Veterinary and Livestock Groups Wary
Between the December and January announcements by the FDA, the American Veterinary Medical Association sent a letter to Secretary of Agriculture Tom Vilsack that read in part:
To restrict certain uses of antibiotics without careful consideration of the risks and benefits to both humans and animals removes a very valuable tool in the veterinarian’s medical bag for preventing and minimizing animal disease and suffering while also ensuring a safe and wholesome food supply.
From the perspective of pharmaceutical, veterinary and livestock industry groups, 34 years of studying the risks and benefits are not enough. Numerous studies raising red flags are premature or inflammatory. Voluntary compliance is the only fair route.
Never mind that the usefulness of one of medicine’s most important tools is at risk, the threat of superbugs increasing. The FDA still appears to be paying far more attention to economic concerns of those who benefit from the sale and use of antibiotics in livestock than to the very real specter of a pandemic for which there may be no longer be an effective remedy.
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