Since 2011, HHS (Health and Human Services) and USDA agencies have taken actions to increase veterinary oversight of medically important antibiotics used in the feed and water of food animals and to collect more detailed antibiotic sales, use and resistance data.
However, these actions do not address long-term and open-ended use of medically important antibiotics because some antibiotics do not have defined durations of use on their labels. Without developing a process to establish appropriate durations of use on labels of all medically important antibiotics, FDA will not know whether it is ensuring judicious use of medically important antibiotics in food animals.
In addition, FDA officials told us the agency is developing a plan that outlines its key activities over the next five years to further support antimicrobial stewardship in veterinary settings, including steps to bring the use of medically important antibiotics administered in other dosage forms (not feed or water) under veterinary oversight.
However, FDA was unable to provide us with this plan or provide specifics about the steps outlined in the plan because it was still under development. …
The Secretary of Health and Human Services should direct the Commissioner of FDA to take the following three actions:
• Develop a process, which may include time frames, to establish appropriate durations of use on labels of all medically important antibiotics used in food animals.
• Establish steps to increase veterinary oversight of medically important antibiotics administered in routes other than feed and water, such as injections and tablets.
• Develop performance measures and targets for actions to manage the use of antibiotics such as revising the veterinary feed directive and developing guidance documents on judicious use.
The Secretary of Agriculture should take the following three actions:
• Direct the Administrator of APHIS to develop performance measures and targets for collecting farm-specific data on antibiotic use in food animals and antibiotic-resistant bacteria in food animals.
• Direct the Administrator of APHIS and the Administrator of FSIS to work with the Director of CDC to develop a framework for deciding when on-farm investigations are warranted during outbreaks. …
The USDA agreed with our recommendations. The department stated that it will develop performance measures and targets for collecting farm-specific data on antibiotic use in farm animals and antibiotic-resistant bacteria.
The USDA also agreed that a decision matrix to support multi-agency cooperation and to determine when on-farm investigations are warranted could be a useful addition, and noted that it has similar matrices that can serve as a model for antimicrobial resistance investigations.
These comments are from a U.S. Government Accountability Office report, which is at http://bit.ly/2p9t4Gd.