U.S. Aims to Curb Peril of Antibiotic Resistance

By Sabrina Tavernise, NY Times, Sept. 18, 2014 WASHINGTON—The Obama administration on Thursday announced measures to tackle the growing threat of antibiotic resistance, outlining a national strategy that includes incentives for the development of new drugs, tighter stewardship of existing ones, and improvements in tracking the use of antibiotics and the microbes that are resistant to them. The actions are the first major White House effort to confront a public health crisis that takes at least 23,000 lives a year, and many experts were pleased that a president had finally focused on the issue. But some said the strategy fell short in not recommending tougher measures against the overuse of antibiotics in agriculture, which, they argue, is a big part of the problem. Researchers have been warning for years that antibiotics—miracle drugs that changed the course of human health in the 20th century—are losing their power because of overuse. Some warn that if the trend is not halted, we could return to the time before antibiotics, when it was common for people to die from ordinary infections and for children not to survive strep throat. Americans use more antibiotics than people in other industrialized nations, with rates more than twice those in Germany and the Netherlands, according to the Pew Charitable Trusts, a Washington-based research and advocacy group. The United States also uses far more antibiotics in livestock than many other nations; animals raised for food in America are given about six times as much antibiotics as are animals in Norway and Denmark. “We’ve been like a frog in the pot as the water heats up,” said Allan Coukell, the senior director for drugs and medical devices at Pew, who contributed to the report. “Now the administration is saying we can’t keep going like this, that we have to tackle this crisis.” But many health experts were disappointed with the report, saying it virtually ignored a major source of antibiotic resistance in the United States: the use of the drugs in agriculture. The government has estimated that more than 70 percent of antibiotics in the United States are given to animals, and scientists and industry are at odds over how much that use in industrial-scale farming contributes to problems in people. Companies use antibiotics to prevent sickness when animals are packed together in ways that breed infection. They also use them to make animals grow faster, though the Food and Drug Administration has taken steps that it says will stop that. But many advocates and experts remain skeptical that the agency’s actions will be effective, because the rules contain what they say is a sizable loophole. Experts expressed disappointment that the White House was not calling on the F.D.A. to close it. The section on agricultural use in the council’s report “sounds like it was written by someone from the meat industry,” said Dr. James Johnson, a professor of medicine and an infectious disease expert at the University of Minnesota. “Really disappointing. Actually, depressing.” Lance Price, a microbiologist at George Washington University, said the new efforts seemed to be focused on future supplies—encouraging drug companies to develop new drugs and others to invent diagnostic tests—rather than on overhauling a system that he believes is not working.