Dive Brief:
- The FDA is taking another step to curb the rise of antimicrobial resistance, this time with a focus on veterinary medicine. The planned five-year blueprint will build on current programs and launch new ones with an overall aim to reduce overuse of antimicrobial drugs.
- The framework includes key goals, objectives and actions for the fiscal years 2019 to 2023, and focus on limiting the use of antibiotics in the food supply.
- Key goals will be to align antimicrobial use with the principles of antimicrobial stewardship; support better stewardship of antimicrobials in veterinary settings; and enhance monitoring of antimicrobial drug use and resistance use in animals.
Dive Insight:
Antibiotics have saved millions of lives, both human and animal. However, antimicrobial resistance has been a challenge pretty much from the beginning of their use, and is becoming a frightening global scourge. According to World Health Organization data from 22 countries, in patients with suspected bloodstream infections, up to 82% carry bacteria resistant to at least one of the most commonly used antibiotics. Penicillin resistance is seen in up to 51%, and between 8% and 65% of E. coli associated with urinary tract infections is resistant to the commonly-used antibiotic ciprofloxacin.
"Some of the world’s most common – and potentially most dangerous – infections are proving drug-resistant," said Marc Sprenger, director of WHO’s Antimicrobial Resistance Secretariat, in a statement.
Much of the drive to reduce and prevent antimicrobial resistance has been at the bench and the bedside. Campaigns to patients and healthcare professionals to cut the use of antibiotics, including work to create drugs and add-on treatments to circumvent resistance, and efforts to contain resistant outbreaks before they fully take hold.
Another front is the veterinary setting.
Low doses of antibiotics have long been used in livestock as growth promotors and to prevent illness, but this use increases the levels of antibiotic resistance, particularly critical when the drugs are related to those used in humans.
To try to curtail this routine use of antibiotics, the FDA issued guidance for industry in 2012 concerning the "Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals," with a follow-up for drug sponsors covering recommendations for "New Animal Drugs and New Animal Drug Combination Products Administered in or on Medicated Feed or Drinking Water of Food-Producing Animals" published in 2013. Implementation of this latter guidance for industry, #213, was completed in January 2017.
"The goal [of GFI #213] was to transition medically important antimicrobials that are used in the feed or drinking water of food-producing animals to veterinary oversight, and to eliminate the use of these products in animals for production purposes, such as for growth promotion," said FDA commissioner Scott Gottlieb in a statement.
The new plan will include: establishing appropriate durations of use of medically-important antimicrobials; bringing medically important antimicrobials under veterinary oversight; and developing and advancing new strategies for promoting antimicrobial stewardship in companion animals.