In human medicine, antibiotic use is generally confined to treatment of illness. In contrast, antibiotics and other antimicrobials (drugs that kill microorganisms like bacteria) often are routinely given to food animals in the U.S. in order to grow animals faster and to compensate for unsanitary conditions on many industrial farms. Bacteria exposed to antibiotics at low doses for prolonged periods can develop antibiotic-resistance—a dangerous trait enabling bacteria to survive and grow instead of being inhibited or destroyed by therapeutic doses of a drug.1 Since many of the classes of antibiotics used in food animal production also are important in human medicine, resistance that begins on the farm can lead to a serious public health problem.
Recognizing the potential for a health crisis, Denmark stopped the administration of antibiotics used for growth promotion (i.e., non-medical uses) in broiler chickens and adult swine (finishers) in 1998, and in young swine (weaners) in 1999. Today in Denmark, all uses of antibiotics in food animals must be accompanied by a prescription in a valid veterinarian-client-patient relationship, and veterinarians cannot profit from the sale of antibiotics. In addition, farmers, veterinarians and pharmacies must report the use and sale of antibiotics, and farm inspections are conducted regularly. Although the U.S. food animal production and animal drug industries often claim that the ban was costly and ineffective, the World Health Organization (WHO) found that the Danish ban reduced human health risk without significantly harming animal health or farmers’ incomes.2 In fact, Danish government and industry data show that livestock and poultry production has increased since the ban, while antibiotic resistance has declined on farms and in meat.3
1 World Health Organization, 2000. “Report on Infectious Diseases,” Chapter 3, available here.
2 World Health Organization, 2003. “Impacts of antimicrobial growth promoter termination in Denmark: The WHO international review panel’s evaluation of the termination of the use of antimicrobial growth promoters in Denmark,” available here.
3 Letter from Dr. Jan Mousing, Chief Veterinary Officer of Denmark, to Congress, August 12, 2009, and “FACT sheet – Effects of Danish restrictions on non-therapeutic use of antibiotics,” available here. ; letter to House Speaker Nancy Pelosi from Dr. Frank Aarestrup, Denmark Technical University, including copy of presentation given to congressional delegation, September, 2009, available at: available here. ; Niels J. Kjeldsen, “Consequences of the removal of antibiotic growth promoters in the Danish pig industry,” Danish Pig Production; and Danish Integrated Antimicrobial Resistance Monitoring and Research Program (DANMAP) 2007 report, pp. 81-83, available here.
4 Ibid.
5 See www.danmap.org for a list of reports. See also: F. Bager, H.D. Emborg, F.M. Aarestrup, and H.C. Wegener. 2007. “DANMAP: The Danish experience following the ban on antimicrobial growth promoters: trends in microbial resistance and antimicrobial use,” Danish Veterinary Institute, available here.
6 See, for example: F.M. Aarestrup, A.M. Seyfarth, H.D. Emborg, K. Pedersen, R.S. Hendriksen, and F. Bager, 2001. “Effect of Abolishment of the Use of Antimicrobial Agents for Growth Promotion on Occurrence of Antimicrobial Resistance in Fecal Enterococci from Food Animals in Denmark,” Antimicrobial Agents and Chemotherapy 45(7): 2054-2059; and M.C. Evans and H.C. Wegener. 2003. “Antimicrobial Growth Promoters and Salmonella spp., Campylobacter spp. in Poultry and Swine, Denmark,” Emerging Infectious Diseases 9(4): 489-492, available here.
7 See, for example: B. Bengtsson and M. Wierup. 2006. “Antimicrobial Resistance in Scandinavia after Ban of Antimicrobial Growth Promoters,” Animal Biotechnology 17(2): 147-156, available here; and K. Gravea, V.F. Jensen, K. Odensvik, M. Wierup, and M. Bangen. 2006. “Usage of veterinary therapeutic antimicrobials in Denmark, Norway and Sweden following termination of antimicrobial growth promoter use,” Preventive Veterinary Medicine 75(1-2): 123-132. More on Sweden’s ban in: M. Wierup. 2001. “The Swedish experience of the 1986 year ban of antimicrobial growth promoters, with special reference to animal health, disease prevention, productivity, and usage of antimicrobials,” Microbial Drug Resistance 7(2): 183-90, available here.
8 Aarestrup letter, Op. cit. See also: Mousing letter, Op. cit. These letters summarize trends through 2008 from the DANMAP reports, available at www.danmap.org.
9 See also: Aarestrup letter, Op. cit.
10 Danish Agriculture and Food Council, meeting with Pew staff, Copenhagen, Denmark, September 14, 2009.
11 Fasser, MD, Susan L., “Enterococcal Infections,” emedicine from WebMD, 25 Aug. 2008, available here.
12 DANMAP 2007, see, for example, pp. 81-83, available here.
13 Fact sheet accompanying Mousing letter, op. cit.
14 Mousing letter, Op. cit.
15 Ibid.
16 Kjeldsen, Op. cit.
17 See WHO 2003, op. cit., page 39: Some farmers “altered production systems with such changes as adoption of other feed ingredients, tightening biosecurity, improving sanitation, increasing weaning weights, adopting all-in-all-out pig flow, reducing stocking density, or others. Such changes in production systems would be especially important to producers because many of the changes would require capital investment that in some cases could be substantial.”
18 McBride, William D. and Nigel Key, “Characteristics and Production Costs of U.S. Hog Farms, 2004,” United States Department of Agriculture, Bulletin No. 32, Dec. 2007, 15.
19 Schaffer, H. D., Koonnathamdee, P., & Ray, D. E. (2008). An economic analysis of the social costs of the industrialized production of pork in the United States. Institute of Agriculture, Agricultural Policy Analysis Center, Department of Agricultural Economics. Knoxville: University of Tennessee, available here.
20 Graham, J.P., Boland, J.J. and Silbergeld, E. (2007). “Growth promoting antibiotics in food animal production: an economic analysis.” Public Health Report 2007; 122(1): 79-87.
21 Mousing Letter, Op. cit.
Senator Dianne Feinstein (D-CA) today introduced the Preventing Antibiotic Resistance Act, a bipartisan bill that would eliminate certain antibiotic-related practices that contribute to the rise of drug-resistant bacteria and endanger human health. The legislation is co-sponsored by Senators Susan Collins (R-ME), Kirsten Gillibrand (D-NY), Jack Reed (D-RI), Barbara Boxer (D-CA) and Maria Cantwell (D-WA).
More infoThis bibliography lists the latest published scientific and economic literature concerning the contribution of routine antibiotic use in food animals to the growing public health crisis of human antibiotic resistance. Research on how antibiotic use in food animal production contributes to the growing health crisis of antibiotic resistance dates back more than 30 years.
More infoPew Charitable Trusts today applauded Senators Kirsten Gillibrand (D-NY), Dianne Feinstein (D-CA), and Susan Collins (R-ME), for introducing the Antimicrobial Data Collection Act, which would require the U.S. Food and Drug Administration, or FDA, to report more information on the annual sales of antibiotics used among industrial farm animals. The bipartisan bill would also give the agency a deadline to finalize policies proposed last year to eliminate the use of antibiotics for growth promotion purposes in meat production.
More info"As a nation, we need to exercise greater care with our use of antibiotics, in both humans and animals, so that these medications remain effective in treating serious bacterial infections."
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