December 18, 2020

US FDA reports consecutive rise in livestock antibiotic sales

For the second straight year, the United States Food and Drug Administration (FDA) is reporting an increase in the amount of medically-important antibiotics sold for use in food-producing animals in the country, according to the Center for Infectious Disease Research and Policy.

According to the FDA's summary report for 2019, domestic sales and distribution of medically-important antibiotics for food animals rose 3% from 2018 through 2019, though lower than the 9% increase from 2017 through 2018. The uptrend comes after three years of falling antibiotic sales.

The FDA says the decline shows that efforts to support more appropriate use of antibiotics in food-animal production, including rules implemented in 2017 that banned the use of medically-important antibiotics for growth promotion and required veterinary oversight for using antibiotics in water and feed, are having an effect. They also argue that some rebound in antibiotic sales was to be expected once producers adjusted to the new rules.

Advocates for more appropriate antibiotic use in food-producing animals however say the rising sales numbers indicate the agency needs to do more to protect medically-important antibiotics, which are becoming less effective as antibiotic resistance rises.

"It is appalling to see medically-important antibiotic sales rise for the second year in a row," David Wallinga, MD, senior health advisor at the Natural Resources Defense Council (NRDC), said in a statement. "Clearly, not enough is being done to protect the nation from a future pandemic. The next administration must act with the urgency that this public health threat demands."

According to the data, of the more than 6.1 million kilograms of medically-important antibiotics sold to US farmers in 2019, an estimated 41% were intended for use in cattle, 42% in swine, 10% in turkeys, and 3% in chickens. The amount of antibiotics sold for use in chickens fell by 13% compared with 2018 and those for turkeys declined by 4%. Sales for swine meanwhile rose by 9%. The increase for cattle was less than 1%.

The most frequently sold class of medically-important antibiotics in 2019 were tetracyclines, which accounted for 67% of sales. Penicillins made up 12% and macrolides 8%. Sales of tetracyclines and macrolides rose by 4 and 3% in 2019, respectively, while sales of penicillins fell 2%.

Nearly all antibiotics sold were for use in feed (65%) and water (29%), increasing 4% from 2018.

The continuing decline in chicken antibiotic sales — a 62% reduction since 2016 — likely indicates an ongoing consumer-driven movement that has transformed how poultry producers raise chickens. In recent years, several fast-food chains and large poultry producers have committed to phasing out medically-important antibiotics in poultry production in response to consumer demand for antibiotic-free chicken.

That movement has been slower to take hold in the beef and pork industries. Although antibiotic sales for cattle have fallen 30% since 2016, an NRDC report earlier this year found that, on a weight-adjusted basis, US cattle producers still use three to six times more antibiotics than many of their European counterparts.

Veterinary and public health consultant Gail Hansen, DVM, MPH, noted that even though the US swine population increased by 3 to 4%, the 9% increase in antibiotic sales indicate that swine antibiotic sales are "heading in the wrong direction."

While US meat producers are no longer allowed to use antibiotics for growth promotion, they can still use them to prevent bacterial diseases, a practice the World Health Organization has called on countries to end in order to prevent the emergence of antibiotic resistance. The FDA, however, still allows for preventive use of antibiotics in food-producing animals, and considers the practice necessary for maintaining the animal health.

Wellington and others say much of this preventive antibiotic use, particularly in beef and pork production, is to compensate for poor nutrition and unsanitary and stressful living conditions that contribute to disease.

Hansen and Wallinga say the report is another indication that the FDA needs to start setting goals for reduced antibiotic use in meat production, as had been done in other countries like the United Kingdom.

Wellington adds that another way for the FDA to cut antibiotic use significantly in food animals would be to impose duration limits on their use. He noted that roughly one third of all medically-important antibiotics used in livestock have no duration limit, meaning that farmers can use those antibiotics indefinitely at sub-therapeutic doses.