Dr. Leah Dorman, Dr. Richard Raymond, and Christopher Doering - Antibiotic Use in Animal Agriculture: Changing the Narrative

Information about Dr. Leah Dorman, Dr. Richard Raymond, and Christopher Doering -...

Published on June 13, 2016

Author: trufflemedia

Source: slideshare.net

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1. Antibiotic Use in Animal Agriculture: Changing the Narrative Arlington, VA May 5, 2016 Richard Raymond, M.D.  Food and Drug Administration (FDA):  Regulates antimicrobial use and collects data on sales. Has authority to remove a product from use for food producing animals if a danger is felt to be present in human health, as it did in 2005 when it announced that enrofloxacin could no longer be used in poultry and banned all off label use in food animals and in 2012 when it took similar action for some cephalosporins. Has also limited or prohibited use of Methicillin, Vancomycin, Cipro, and aminoglycosides to protect human health.  Establishes Maximum Residue Limits (MRLs) for antibiotics in meat and poultry

2.  1. We do not have the scientific knowledge regarding antibiotic resistance to know what, if any, changes are needed to protect human health  2. There is very little cross-over in antibiotics used in both animals and humans, and those antibiotics are seeing decreasing use in animals.  3. The FDA has responded appropriately based on the information available to protect public health by bans of fluoroquinolones and cephalosporins for use in food animals and the new Guidances.

3.  Or better yet, what do we not know?  “If you think you understand antibiotic resistance, then it has not been properly explained to you”  Guy Loneragan, BVSC, PhD Veterinary Epidemiologist and Professor of Food Safety and Public Health at Texas Tech University  Penicillin still the drug of choice for strep throat and syphilis but no longer useful for Staph infections. WHY?

4.  First ever report on antimicrobial resistance released April, 2014  232 pages, just 4 on antibiotic use in animal agriculture  “The magnitude of transmission from animal reservoirs to humans remains unknown.”  “More data are needed to identify priority areas for intervention.”

5.  FDA report on all “antimicrobials sold or distributed for use in food-producing animals” in 2014:  Ionophores 31%(not used in human medicine at all) are antiparasitics  Not Individually Reported (NIR) 8.0% (None of the 8%used in human medicine)  Tetracyclines 43% (70% of antibiotics used in animal ag that are also used in human medicine but less than 3% of total antibiotics sold for use in human medicine in the US)

6.  Of the total weight of antibiotics sold for possible use in animals, 82% of that total is either not approved for use in human medicine (the ionophores and NIRs for example) or are rarely prescribed for use in human medicine as a poor second or third choice drug (chlor- and oxy-tetracycline for example)  It is my firm belief that it is the 18% where there is overlap that we should focus our attention and discussions on. The rest is just a distraction and muddies the water.

7.  1. Penicillin (Augmentin) Kg share = 44.0%  2. Cephalosporins (Keflex) Kg share = 15.1%  3. Sulfa and TMP (Bactrim) Kg share = 14.2%  4. Quinolones (Cipro) Kg share = 9.2%  5. Macrolides (Z-Pak) Kg share = 5.3%  These top five classes represent 88 % of all antibiotics sold for use in human medicine.  Source: FDA letter to Congresswoman Slaughter

8.  Two of the top four classes of antibiotics of critical importance in human health are restricted by the FDA from most uses in animals:  2. Cephalosporins: less than 0.1% of all sales for use in animals  4. Fluoroquinolones: Less than 0.1% of all sales for use in animals  These two comprise 25% of human abx

9.  Over all sales up 1 % and according to animal rights groups and politicians, the sky is falling, BUT:  Macrolides Down 9%  Penicillin Down 14%  Sulfa Down 22%  Tetracyclines Up 9%

10.  Overall sales: Up 6%  Sulfa: Down 9%  Penicillin: Down 9%  Macrolides: Flat  Tetracyclines: Up 11%  Ionophores: Up 3%  We are moving in the right direction but no one seems to know that or say that.

11.  From 2002-2012 third-generation cephalosporin resistance in chicken rose from 10% to 28%: Often the drug of choice to treat children with Salmonellosis  Reality: “no flouroquinolone resistance in Salmonella from any source. This is the drug of choice for treating adults with Salmonellosis.” (FDA)

12.  Food and Drug Administration (FDA):  Has authority to remove a product from use for food producing animals if a danger is felt to be present in human health, as it did in 2005 when it announced that fluoroquinolones (FDA approved in 1998) could no longer be used in poultry and banned all off label use in food animals and again in 2012 when it took similar action for some cephalosporins.

13.  1. We do not have the scientific knowledge regarding antibiotic resistance to know what, if any, changes are needed to protect human health  2. There is very little cross-over in antibiotics used in both animals and humans, and those antibiotics are seeing decreasing use in animals.  3. The FDA has responded appropriately based on the information available to protect public health by bans of fluoroquinolones and cephalosporins for use in food animals and the new Guidances.

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