By Pat McLaine and Robyn Gilden
Maryland’s residents including its farmers have lots to lose if we reach a future where there simply aren’t any antibiotics left to treat our sickest patients. Unfortunately, we all seem headed in that direction.
That’s why we, as professional nurses, feel so strongly the time has come for the Keep Antibiotics Effective Act, SB 422/HB 602. Each bill has passed the chamber where it was introduced, but must be enacted by the other house.
Even when used prudently, the use of antibiotics carries some risk that bacterial resistance to them will develop and spread. That’s just as true for antibiotics used in poultry and livestock, as for antibiotics used in clinics and hospitals.
The more we use them, the worse the problem gets. We simply have to address all of our unnecessary uses, or we will sow the seeds for an unhappy future to arrive that much sooner. That’s why we have antibiotic stewardship programs in hospitals, headed by teams of nurses, physicians, and pharmacists to ensure effective oversight of antibiotic use.
A third of antibiotics unnecessary
Experts estimate around a third of antibiotics prescribed to patients outside of hospitals are unnecessary. That’s a problem, and health care providers, the Centers for Disease Control and National Action Plan devised two years ago have taken concrete steps to address it with specific numeric goals for reduction of use. Unfortunately, similar action has not been forthcoming to address livestock use of antibiotics.
There’s good reason to believe that a large proportion of the current use of antibiotics in livestock is unnecessary as well. About 95% of antibiotics for livestock are added to their food and water, methods associated with mass administration to large groups of animals. Many of these routine feed or water antibiotics are believed to be given routinely for prevention in the absence of any disease.
Right now, sales data from the pharmaceutical industry shows us that 70% of all the antibiotics important to human medicine are used in food animal production, not in people. To its credit, the FDA just ended the use of these human drugs to speed up faster growth in healthy pigs, chickens, turkeys and cattle.
FDA action falls short
The steps taken by the FDA fall short. The agency created a big loophole that allows many of these same human drugs to continue to be mass administered to flocks or herds in their feed or water, at virtually the same doses and for long periods of time for prevention of disease.
This bill is so important because it would close that loophole and make sure that antibiotics are only used to when there are sick animals or the antibiotic is necessary for surgeries or medical procedures and that they are not used regularly.
We are disappointed that the data collection provisions in the act essentially amount to no meaningful collection of information of antibiotic use on the farm. But this bill is a step in the right direction.
We expect this bill to be enacted this week. Please call Governor Hogan and urge him to sign the Keep Antibiotics Effective Act into law. Our patients and your families deserve no less.
We all have a stake in a future where antibiotics will still work when our loved ones are sickest. Without SB 422/HB 602, we continue to put that future at risk.
Pat McLaine, DrPH, MPH, RN and Robyn Gilden, PhD, RN are faculty members of the University of Maryland School of Nursing in Baltimore.