The recommendations of this committee are as follows:

The judicious and responsible use of antibiotics should continue to be regulated to protect both human and animal health.

Increased financial support is needed for more research on the actual effect of antimicrobial resistance in food animals on human health.

Increased surveillance of microbial resistance is needed to monitor the patterns of microbial resistance.

Increase awareness and education of the public on the issue of antimicrobial resistance through educational programs and propaganda.

This committee has found no significant evidence of a detrimental affect on human health caused by antimicrobial resistance in food animals. Stopping the use of antibiotics entirely has no benefit for human health, and it has not proven to be cost effective in countries where the change has been made, such as Denmark. These decisions must be made based on scientific evidence and an analysis of the risks and benefits to all parties involved.

The Food and Drug Administration, or FDA, states that using antimicrobials in food producing animals is decided from two main reasons: How important this drug/drug class is to human health and if the pathogens from food producing animals are a potential threat.

FDA believes that proposed uses of antimicrobials in food-producing animals can be placed into one of three main categories based on the importance of the drug or drug class in human medicine. these categories would aid the agency in evaluating the potential microbial human health impact of the use of the antimicrobial drug in food-producing animals and determine the long term effects on human and animal health.• Category I Drugs human exposure to resistant bacteria from animals must be avoided or extensively minimized• Category II Drugs level of increased resistance in humans due to use of the drug in food-producing animals could safely occur• Category III Drugs: resistance transfer from animals to humans would have no effect on the availability of effective antimicrobial drugs to treat human diseases.

ABSTRACT

PUBLIC HEALTH & PROTOCOL1

PHYSICIAN PERSPECTIVE5

Microbial Resistance and the Consequences of Pharmaceuticals in Animal Production Agriculture

Microbial Resistance and the Consequences of Pharmaceuticals in Animal Production Agriculture

Jodie Joseph, Lacey White, Sara Reichelt, Jennifer Cook, Alicia Braxton, Aly Worf, Danielle Lindquist,  Michelle Borges, Kira Pruitt, ShinHae Yoon, Brooke Reimer, Hernant Desai

Mentor : Dr. Michael Williams

Jodie Joseph, Lacey White, Sara Reichelt, Jennifer Cook, Alicia Braxton, Aly Worf, Danielle Lindquist,  Michelle Borges, Kira Pruitt, ShinHae Yoon, Brooke Reimer, Hernant Desai

Mentor : Dr. Michael WilliamsNorth Carolina State University College of Agriculture and Life Sciences Honors ProgramNorth Carolina State University College of Agriculture and Life Sciences Honors Program

The use of veterinary pharmaceuticals in food animal production is a controversial and ongoing issue with regard to human and animal health. Antibiotics, also known as antimicrobial drugs, are used in food animal production for disease prevention, therapeutics, overall health, and growth promotion. Bacterial resistance to antimicrobial drugs is an evolutionary mechanism that has been observed prior to the implementation of antimicrobial use in animal agriculture. It  has been argued that the use of antibiotics has expedited this innate characteristic. Overuse of antimicrobial drugs in human and animal therapies has been shown to lead to increased resistance and decreased effectiveness. The purpose of this research committee is to consider the perspectives of the livestock industry, public health organizations, veterinarians, and physicians and subsequently recommend actions that should be taken to determine the proper use of veterinary pharmaceuticals in animal production agriculture. After consulting with various experts in these disciplines and reviewing the peer reviewed scientific literature, the committee’s consensus is that the judicious use of antimicrobial drugs in animal agricultural should continue to be regulated, but more extensive research should be conducted and increased surveillance should be implemented before an absolute regulatory policy can be decided.

Industry advocates limited and responsible use of antibiotics, “only for treating sick and preventing the onset of sickness with proper diagnostic confirmation.” Strictly comply to all FDA regulations and adhere to USDA withdrawal times. To ensure proper health, rely on “enhanced management practices” rather than heavy antibiotic use. Smithfield Farms, the number one swine producer in the nation, does not use antibiotics for growth promotion.

INDUSTRY PERSPECTIVE3

RECOMMENDATIONS

1. FDA Framework Documenthttp://scrapetv.com/News/News%20Pages/Everyone%20Else/images/baby-pig.jpghttp://patervis.com/poultry.jpghttp://www.dennisflood.com/photos/2003/1000/dairy_cows.jpg2.” Murphy Brown’s Commitment to Responsible Use of Antibiotics” http://smithfieldfoods.com/responsibility/smithfield-antibiotic-policy.aspx3. Smithfield Corporate Social Responsibility Report 2009-2010, pages 54-55. 4. Dr. Eric Gonder, DVM, PhD, Veterinarian with Butterball, LLC5. Dr. Christopher A. Ohl, M.D., Associate Professor, Infectious Diseases 6. Dr. Jennifer Koeman DVM, M.S. Public Health, director of producer and public health, National Pork Board7. Dr. Peter Robert Davies, BVS, PhD, MBA, Professor, Swine Health and Production8. Dr. Glen Almond, PhD, DVM, professor of Pig Health and Production9. Dr. Andy McRee, DVM, Diplomate of the American College of Poultry Veterinarians

Many physicians believe that most of the problems associated with antibiotic resistance in humans arise from human errors. Interviews conducted of physicians brought the following ideas:

• The use of antibiotics in food animals prevent food-borne illnesses.• Bacterial resistance is a part of evolution.• The main concern for bacterial resistance is in hospitals where

multiple-drug resistance can develop.

•Measures to prevent further resistance must be taken in hospitals: more isolation, increased hand washing and dress changing, shoe covers, gloves, etc. • A decrease in antibiotics prescribed in private practices and

urgent cares• Research for new antibiotics needs to be done to reduce the risks

associated with the existing and the newly arising strains of antibiotic resistant bacteria.

VETERINARIAN PERSPECTIVE4

A majority of veterinarians in the industry are in support of the use of antibiotics in the food animal industry.  There have been no confirmed cases of human resistance due to the use of these antibiotics.  Veterinarians make it clear that they do not use extravagant amounts of antibiotics in the use of treatment for a whole herd or flock when only one animal has been affected.  Prevention is the main goal of all veterinary medicine in the food animal industry.

Food borne campylobacter continues to show resistance to antibiotics considered critical to Human Medicine. This growth clearly shows that antibiotic resistance continued to grow even after the ban on antimicrobial resistance was set into law in Denmark.

REFERENCES

Unsuccessful Treatment

Development of resistant animal bacterial strain

Survival through food processing/handling

Survival through food preparation

Resistance transfer to human

Colonization in human

Disease

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• In 1998, the Danish government issued a voluntary ban on the use of antibiotic growth promotants (AGPs) during the finishing stage of pork production. • The use of AGPs was banned for all swine in 2000. Known as the

Danish Experience, the cons of this ban have proven to outweigh the benefits as there have been numerous animal health and well-being consequences. • As of now, there is no evidence that a ban such as this would

protect public health or combat antimicrobial resistance.

THE DENMARK EXPERIENCE1

8 STEPS TO MICROBIAL RESISTANCE TRANSFER