When bacteria develop resistance to front-line antibiotics, health care professionals lose their ability to treat deadly infections, leading to more than 35,000 deaths annually in the U.S. and more than 1.2 million worldwide. For that reason, antibiotic resistance has been held up by the World Health Organization as one of the most pressing threats to global health.
Researchers see the potential overuse of those antibiotics in agriculture as a key driver of antibiotic resistance—but they’ve often struggled to access basic information about how many animals are receiving the drugs, for what purpose, and for how long.
Collecting that farm-level data is a critical missing piece in the Food and Drug Administration’s (FDA) five-year plan, launched in 2019, to improve “antimicrobial stewardship” in animal agriculture, advocates say. Now, the deadline is approaching. And while the agency has made other significant regulatory changes in the years before and since, the FDA is not regularly tracking or reporting how antibiotics are used on farms, nor does it have a plan in place to do so in the short term.
“The data is at the feed mills. If the agency really wanted this information, they could figure out how to get it.”
Instead, the agency funded a few small pilot projects that collected data in 2016 and 2017 and published one-time results in 2020. Then, in 2021, FDA commissioned an 18-month “stakeholder engagement” project run by a partner foundation to explore setting up a voluntary antibiotic use reporting system in collaboration with the animal agriculture industry.
Neither effort has proven very effective. According to multiple experts, however, FDA does have access to some important data that could be a game-changer if the agency chose to use it.
That’s because most antibiotics given to farm animals are mixed into their feed at feed mills, FDA-regulated facilities that are required to keep records on prescriptions and distribution. And although those records could begin to paint a picture of what antibiotic use on American farms looks like and help uncover ways to prevent overuse, FDA is simply not collecting them.
“The data is at the feed mills,” said Laura Rogers, deputy director of the Antibiotic Resistance Action Center at George Washington University. “If the agency really wanted this information, they could figure out how to get it.”
In an email, FDA spokesperson Veronika Pfaeffle emphasized that the agency “is committed to antimicrobial stewardship in veterinary settings,” and pointed to other steps it has taken on the issue.
For instance, since 2017, the agency has made at least three changes experts consider consequential: It outlawed the use of antibiotics solely to promote faster animal growth (although many of the same drugs now used for disease prevention also boost growth), gradually made veterinary prescriptions a requirement for all antibiotics also used in human medicine, and set new limits on how long drugs should be administered.
But efforts to gather basic data on how farms use antibiotics day to day—which Pfaeffle agreed “is important to help us understand what drives antimicrobial resistance in animal agriculture”—has lagged.
Every year, animal drug manufacturers are required to report sales data to the FDA, and the agency releases those numbers broken down by which animal species the drugs were sold for. After a large dip in 2016, when the FDA banned antibiotics used solely for growth promotion, sales in the pork and beef industries have gradually ticked back up. Chicken is the exception, as large swaths of the industry have eliminated medically important antibiotics entirely from their production based on consumer demand.
“Overall, the lack of creativity at FDA on this issue is so disappointing.”
When it reports on the overall quantity of antibiotics sold each year, the agency emphasizes that the sales numbers “are not indicative of how these antimicrobial drugs were actually used in animals.” In other words, the FDA tells the public that just because the drugs were sold, it can’t be assumed that they were administered to animals, because farmers could buy more than they end up needing and store or toss the rest.
That’s in contrast to how the data is reported in Europe, said David Wallinga, a physician who has been doing research and advocacy work on antibiotic resistance at the Natural Resources Defense Council (NRDC) for years. In Europe, it’s standard practice to use overall sales numbers and animal production numbers in calculations to estimate the volume of antibiotic use per animal.
Still, even if the FDA did start making those calculations, those numbers would only reveal the amount of antibiotics used per animal. Data that has more details on what the drugs are used for and for how long is universally understood to be of much higher value in preventing overuse. That’s what the feed mills have.
“The CDC [the federal Centers for Disease Control and Prevention] has really been pushing on this point for the last several years and they’ve beefed up their efforts to track antibiotic use in hospitals and in clinics, figure out how much overuse is happening, and then take steps to address it,” Wallinga said. But CDC only has authority over human medicine, while FDA handles drugs given to animals. “That’s what’s missing on the animal side.”
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Author: Lisa Held