DearU.S. Senator/Member of Congress from Maryland,
As medical doctors and health professionals, we are writing to ask for your help in addressing the serious and growing problem of antibiotic-resistant bacteria (“superbugs”) that increasingly threatens public health. We specifically ask for your help to ensure that the Food and Drug Administration (FDA) acts to reduce the misuse of antibiotics in animal agriculture, and we ask you to support legislation enabling FDA to better track and monitor this issue.We need your leadership on this vital issue.
It is hard to think of a problem that could more directly affect your constituents than a serious illness that does not respond to treatment. Antibiotic resistance is compromising the effectiveness of essential human medicines, leading to longer illnesses, more hospitalizations, and deaths when treatments fail. Incidence data published by the Centers for Disease Control and Prevention (CDC) for 2005 suggest that just one kind of antibiotic resistant pathogens, Methicillin-resistant Staphylococcus aureus (MRSA), killed nearly 19,000 Americans, more than HIV/AIDS in that year. A CDC-funded study estimates that antibiotic resistance in the United Sates results in up to $26 billion a year in excess healthcare costs and up to $35 billion a year in total societal costs.
The overuse of antibiotics in animal agriculture is a critical contributor to the problem of antibiotic resistance. Eighty percent of all antibiotics, and seventy percent of all medically important antibiotics, sold in the United States are for use in livestock. The vast majority are not used to treat any diseases, but are fed regularly to animals to speed growth and compensate for unsanitary and crowded conditions. According to the Centers for Disease Control and Prevention, the scientific literature “establish[es] a clear link between antibiotic use in animals and antibiotic resistance in humans” and “there is a compelling body of evidence to demonstrate this link.” Major medical and public health organizations, such as the American Medical Association, the American Academy of Pediatrics, the Infectious Diseases Society of America, and the American Public Health Association, have called for stronger action to protect life-saving antibiotics in the face of the clear scientific evidence linking the misuse and overuse of antibiotics in food animals and the spread of antibiotic resistance.
While FDA has warned for nearly 40 years that the misuse and overuse of antibiotics in healthy animals is a serious human health concern, the agency has done little to change the status quo and currently either does not collect or publicly report the information necessary to evaluate drug use trends, patterns of use, or high risk practices. FDA issued a draft guidance in the Fall of 2012 that urges reduced use of antibiotics in animal agriculture but relies on voluntary adoption by industry to succeed. Yet it currently lacks the tools it needs to track industry’s progress in reducing use or identify high risk sectors and practices.
We ask you to support other legislative efforts that would address this shortcoming when the Animal Drug User Fee Amendments of 2008 (ADUFA) is reauthorized in 2013. As part of ADUFA reauthorization, Congress should require stronger reporting requirements for livestock antibiotic sales and distribution that can help illustrate current use patterns, explain resistance trends, and monitor progress in assuring responsible livestock antibiotic use. Such reporting would provide critical information to help track progress in reducing the inappropriate use of antibiotics and help target attention where it is needed.
We also ask for your leadership in ensuring that Congress does not undermine FDA’s authority to curb antibiotic use in animal agriculture. In March and again in early June of 2012, a federal court directed FDA to take action to end the use of antibiotics when their use in animals is not proven safe for human health. The court specifically required FDA to withdraw approvals for non-therapeutic uses of penicillin and tetracyclines in animal feed unless drug manufacturers prove that such uses are safe. We ask for your help to ensure that no Congressional action is taken that would limit or undermine FDA’s ability to comply with the court’s order or otherwise curb the misuse of antibiotics in animal agriculture.
As doctors and healthcare professionals on the frontlines of this war against antibiotic resistant pathogens, we see every day how critical antibiotic stewardship is for our patients and communities. We hope you will give this issue the priority it deserves and ensure that FDA takes decisive action to track and curb antibiotic use in the livestock sector.
MedChi, the Maryland State Medical Society
Maryland Hospital Association
American Academy of Pediatricians – Maryland
Maryland Society of Anesthesiologists
Maryland Nurses Association
Alliance of Nurses for a Healthy Environment
Maryland Physicians for a National Health Program
Physicians for Social Responsibility – Chesapeake
Hon. Dr. Dan K. Morhaim, Maryland General Assembly*
Hon. Theodore J. Sophocleus, Maryland General Assembly, American and Maryland Pharmaceutical Associations*
Dr. Ellen Silbergeld, PhD, Professor of Environmental Health, Johns Hopkins University*
Dr. Keeve Nachman, PhD, Johns Hopkins Center for a Livable World*
Dr. Jay Graham, MD, MPH, MBA; GWU School of Public Health and Health Services*
Dr. Linda M. Bock, R.N.; Dimensions Healthcare*
Dr. Brian H. Avin, M.D.; The Neurology Center*
Dr. Amjad Chaudhry, DVM, MPH; Deputy Animal Program Director, DHHS, NIH, NIMH*
Dr. Young Dae Cha, PD; Walter Reed Outpatient Pharmacy*
Dr. Tony Hausner, PhD; Centers for Medicare and Medicaid Services (retired)
Dr. Dana Beyer, MD
Rick Sullivan, MS, LCPC
Dr. Harvey Fernbach, MD, MPH
Michele Maslov Forman
Wendy Rambo Shuford, RN
Dr. Saurabh Singh, MD
Dr. Yousef Zarbalian, MD
Amanda M Pak, RPh
Dr. Cindy L. Parker MD, MPH
Dr. Amjad Riar, MD
Dr. Yvette Butler, MD
*Organizations listed for identification purposes only.
Background and updates on this topic:
Lauren Wilson, MD
I am a pediatrician. Today I treated a young infant with multidrug resistant E. Coli. Stop this craziness!
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