KNOW THE FACTS ABOUT

Antibiotic Resistance and

Animal Agriculture

“A post-antibiotic era means, in effect, an

end to modern medicine as we know it.
Things as common as strep throat or a child’s
scratched knee could once again kill.”
— Margaret Chan, WHO Director General1
The Problem:
For millions of people each
year, antibiotics are the
miracle drugs that save their
lives. We stand at the brink of
an era where that may no
longer be the case.2
The culprit is the spread of
antibiotic resistance. An
estimated 900,000 resistant
infections occur in hospitals
each year,3 killing 63,000
patients,4 which amounts to
roughly 173 patients per day.
Bacteria resistant to treatment
with antibiotics
cause
more
infections
and more severe infections
than do bacteria susceptible
to antibiotics.5
Each year, antibiotic resistance
results in 8 million more
hospitalization days for sick
patients, adding more than
$20 billion to U.S. healthcare
costs.6
As older drugs become inef-
fective, we face a future in
which few new antibiotics are
on the horizon.7
The Cause: Antibiotic Overuse
Overuse of antibiotics is common in both for unhealthy conditions on livestock farms).
agriculture and in human medicine. To reduce the total antibiotics used in animal
Exposing bacteria to antibiotics selects for agriculture, it is essential to restrict these
the bacteria most resistant to these drugs, non-therapeutic antibiotics in food animals.
which then survive and reproduce. Antibiotics
are important to treat disease. But since Leading health experts and scientific bodies
their use creates stronger, more resistant concur: Using antibiotics in animal agriculture
strains of bacteria over time, antibiotics must leads to antibiotic-resistant infections in
be used only when absolutely necessary. humans. An expert panel convened by the
Livestock Institute of Medicine (IOM) concluded
Overuse in humans: Livestock injection antibiotic use in animal agricul-
other
Patients request—and doctors 3% ture “has been linked to the
often prescribe—antibiotics 5% 13% establishment and spread
Livestock
for colds and other viral water of drug-resistant infec-
infections for which they 20% tions in humans.”11
Human
do not work. Even when
prescribed correctly for Meat is routinely con-
bacterial infections, a 59% taminated with antibiotic
Livestock feed
patient’s failure to com- resistant bacteria. In fact,
plete the full course of medi- FDA data show that on
cine can promote the survival of average you need to buy 100
antibiotic-resistant bacteria. U.S. Antibiotic Use packages of chicken breast to
36 million pounds9,10
find one that is not contami-
Overuse in animals: U.S. Food & nated with resistant bacteria.12
Drug Administration (FDA) data show
almost 80 percent of all antibiotics in The human diseases most strongly linked to
the U.S. are sold for use in animal agri- agricultural overuse of antibiotics include
culture — most identical or nearly so to food poisoning caused by resistant
human drugs.8 The vast majority of these Salmonella and Campylobacter.13 More
antibiotics (over 70 percent) are given to recently, animal agriculture also has been
groups of animals in their feed or water9,10 — identified as a source of other resistant
often for reasons other than to treat disease, human infections including resistant E. coli
(i.e. to promote slightly faster growth or for infections14 and Methicillin-resistant
routine disease prevention to compensate Staphylococcus aureus (MRSA) infections.15
via animal waste to fish, fruits, and
to soil and water vegetables sold as food
Antibiotics
routinely given to via farm workers
farm animals kill and food processors
susceptible bacteria,
but resistant
bacteria survive in
the animals and can
be transmitted… via contaminated
meat products to the general
population, in
whom antibiotic-
resistant infections
may develop
to other animals
on the farm
Source: GAO Report Antibiotic Resistance, 2011
The Solution: Reduce Antibiotic Use
Reduce use in humans:
The Centers for Disease Control and Prevention
(CDC), along with hospitals and leading med-
ical organizations, are implementing extensive
programs to educate both patients and physi-
cians about reducing antibiotic overuse.16
Reduce use in animal agriculture:
In 2003, the Institute of Medicine concluded,
“[a] decrease in antimicrobial use in
human medicine alone will have little
effect on the current situation. Substantial
efforts must be made to decrease inappro-
priate overuse in animals and agriculture
as well.”17
FDA or Congress should cancel existing
approvals of antibiotics important in
human medicine that are given to animals
for non-therapeutic uses.
The FDA can cancel drug approvals when there
is new information challenging the safety of
the drugs, but the FDA has only rarely taken
this step.18 Ten important classes of antibiotics
are currently used both in human medicine and
non-therapeutically in animals.19
In 2003, the FDA began requiring all new ani-
mal antibiotic drugs seeking approval to be
evaluated for safety related to antibiotic resist-
ance,20 but the agency has made no commit-
ment to review the safety of drugs already on
the market.
The FDA approved most non-therapeutic
antibiotics used in animal agriculture decades
ago, at a time when the issue of resistance was
not well recognized.
Congress needs to pass new legislation to
curb antibiotic resistance because the FDA
has failed to fulfill its mandate to protect
the public health.
For more information, visit www.keepantibioticsworking.com
It Can Be Done
The Preservation of Antibiotics for Many important trading
Medical Treatment Act (PAMTA): partners have already limited
non-therapeutic antibiotic use
“ Phases out non-therapeutic feed and in animal agriculture, including
water use of classes of antibiotics that
most European countries,
are also used in human medicine over a
South Korea, and New Zealand.23
two-year period, unless FDA concludes
that continued use of a drug will not
Large companies such as
contribute to resistance affecting
Applegate Farms, Chipotle
humans.
Mexican Grill, McDonald’s, and
Bon Appétit Management
“ Is endorsed by more than 375 groups Company have already taken
including the American Medical
steps to reduce antibiotic use
Association, the American Public Health
in animal agriculture by their
Association, and 160 other health-relat-
producers.24
ed organizations.21
Many farms around the country,
“ Does not prevent the use of antibiotics both large and small, are
to treat sick animals.
raising animals without non-
therapeutic antibiotic use. In
“ Covers only antibiotics that are used fact, over 40% of farms raising
both in human medicine and in animal
chicken for meat do not use
agriculture.
antibiotics in this way.25
“ Would have a negligible effect on con-
sumer prices.22
“ Would save tax dollars.
The bill’s provisions for
canceling existing
approvals for non-
therapeutic use
would occur far
more quickly and
cost-effectively
than would
FDA proce-
dures.
Endnotes Over 375 public health, agriculture, and consumer
groups have signed on as endorsers of the
1 M. Chan. 2012. Keynote address by WHO Director-General at the Conference on Preservation of Antibiotics for Medical Treatment
Combating Antimicrobial Resistance: Time for Action, Copenhagen, Denmark, March 14,
Act (PAMTA), including:
2012. Antimicrobial resistance in the European Union and the world. [LINK]
2 M. Chan. 2011. Statement of WHO Director-General at World Health Day 2011. Combat American Academy of Family Physicians
drug resistance: no action today means no cure tomorrow. [LINK] American Academy of Neurology Professional
3 Alliance for the Prudent Use of Antibiotics. 2009. Antibiotic-resistant infections cost the Association
U.S. healthcare system in excess of $20 billion annually [Press release]. [LINK] American Academy of Pediatrics
4 Infectious Diseases Society of America. 2004. Bad bugs, no drugs. As antibiotic discovery American Medical Association
stagnates... a public health crisis brews. [LINK]
American Nurses Association
5 World Health Organization. 2003. 1st Joint FAO/OIE/WHO Expert Workshop on Non-
American Public Health Association
Human Antimicrobial Usage and Antimicrobial Resistance: Scientific Assessment. [LINK]
6 JM Hughes. 2011. Preserving the lifesaving power of antimicrobial agents American Society for the Prevention of Cruelty to
Animals
[Commentary]. JAMA 305(10):1027-1-28. [LINK]
Breast Cancer Fund
7 HW Boucher et al. 2009. Bad bugs, no drugs: No ESKAPE! An update from the Infectious
Diseases Society of America. Clin Infect Dis. 48 (1): 1-12. [LINK] Cancer Prevention Institute
8 Center for a Livable Future. 2010. New FDA numbers reveal food animals consume lion’s Center for Science in the Public Interest
share of antibiotics [Blog]. [LINK] Consumer Federation of America
9 U.S. Food and Drug Administration. 2010, 2009. Summary Report on Antimicrobials Sold Family Farm Defenders
or Distributed for Use in Food-Producing Animals. [LINK]
Food Animal Concerns Trust
10 U.S. Food and Drug Administration. 2011. Letter from FDA to Representative Slaughter.
April 19, 2011. [LINK]
Health Care Without Harm

11 Institute of Medicine. 2010. Antibiotic resistance: Implications for global health and Humane Society of the United States
novel intervention strategies: Workshop Summary. Washington, DC: The National Humane Society Veterinary Medical Association
Academies Press. [LINK] Infectious Diseases Society of America
12 U.S. Food and Drug Administration. 2012. National Antimicrobial Resistance Monitoring Institute for Agriculture and Trade Policy
System Retail Meat Annual Report, 2010. [LINK]
The Leukemia and Lymphoma Society
13 MN Swartz. 2002. Human diseases caused by foodborne pathogens of animal origin.
Clin Infect Dis 1;34 Suppl 3:S111-22. [LINK] National Association of County and City Health Officials
14 AR Vieira et al. 2011. Association between antimicrobial resistance in Escherichia coli National Association of Local Boards of Health
isolates from food animals and blood stream isolates from humans in Europe: an eco- National Latino Farmers & Ranchers Trade Association
logical study. Foodborne Pathogens and Disease 8(12):1295-301. [LINK] National Sustainable Agriculture Coalition
15 W. Vanderhaeghen et al. 2010. Methicillin-resistant Staphylococcus aureus (MRSA) in Natural Resources Defense Council
food production animals. Epidemiology and Infection. 138(5):606-25. [LINK]
Pew Campaign on Human Health & Industrial Farming
16 Centers for Disease Control and Prevention campaigns to prevent antimicrobial resist-
ance. [LINK] Physicians for Social Responsibility
17 MS Smolinski et al., eds. 2003. Microbial Threats to Health: Emergence, Detection, and Sierra Club
Response. Washington, DC: The National Academies Press, p. 207. [LINK] The Society of Infectious Diseases Pharmacists
18 U.S. Food and Drug Administration. 2011. Denial of 2005 Citizen Petition. [LINK] STOP Foodborne Illness
19 Antibiotics used both in human medicine and non-therapeutically in food animals are Union of Concerned Scientists
aminoglycosides, diaminopyrimidines, lincosamides, macrolides, penicillins, pleuro-
motilins, polypeptides, streptogramins, sulfonamide, and tetracyclines. Plus hundreds of other public health, agriculture, and
20 U.S. Food and Drug Administration. 2003. Guidance for Industry #152. Evaluating the consumer groups. To see the full list of groups that
Safety of Antimicrobial New Animal Drugs with Regard to Their Microbiological Effects support congressional action to end the overuse of
on Bacteria of Human Health Concern. [LINK]
antibiotics in animal agriculture, please visit:
21 A full list is available at http://www.ucsusa.org/PAMTAendorsers. www.ucsusa.org/PAMTAendorsers
22 In 1999, the National Research Council estimated that banning all antibiotic feed addi-
tives—not just the eight medically important antibiotics targeted by S. 1460/H.R.
For more information:
2932—would increase consumer meat costs by $4.84-$9.72 per person annually.
National Research Council. 1999. The Use of Drugs in Food Animals: Benefits and Risks. www.keepantibioticsworking.com
Washington, DC: National Academies Press, p. 184. [LINK]
or email info@keepantibioticsworking.com
23 R. Johnson. 2011. Potential Trade Implications of Restrictions on Antimicrobial Use in
Animal Production. Congressional Research Service, R41047. [LINK]
24 McDonald’s policy on restricting antibiotics use is at Keep Antibiotics Working: The Campaign to
http://www.aboutmcdonalds.com/mcd/sustainability/library/policies_programs/sustainable End Antibiotic Overuse is a coalition of health,
_supply_chain/product_safety/antibiotics.html; Bon Appétit’s policy on antibiotics use in consumer, agricultural, environmental, humane, and
food animals is at http://www.bamco.com/sustainable-food-service/antibiotic-reduction.
other advocacy groups with more than eleven million
Both accessed on May 16, 2012.
supporters dedicated to eliminating a major cause
25 JM MacDonald, SL Wang. 2011. Foregoing sub-therapeutic antibiotics: the impact on
broiler grow-out operations. Applied Economic Perspectives and Policy 33(1):79–98. of antibiotic resistance: the inappropriate use of
[LINK] antibiotics in food animals.