Opinion: Keep Antibiotics Working

Sometimes the spirit and effectiveness of health-protective legislation can be lost in the process of regulatory translation and implementation. Such was the case with the Keep Antibiotics Effective Act of 2017, legislation sponsored by Sen. Paul Pinsky and Del. Shane Robinson to restrict the routine use of antibiotics in livestock that are not sick. The goal of this law, and other similar laws from across the country, is to prevent the rise of “superbug” bacteria that become resistant to all antibiotics, making infections more difficult to treat. This is a very serious public health issue; at least two million people fall sick every year from antibiotic-resistant bacteria, and at least 23,000 people die from these infections, according to the Centers for Disease Control and Prevention. No doubt this is why Gov. Larry Hogan allowed the bipartisan legislation to become law (albeit without the public affirmation of his signature). It took more than a full year after the bill became law to get the Maryland Department of Agriculture to promulgate regulations that define what it specifically means to administer antibiotics to livestock in a “routine” pattern.   During that time, advocates prodded MDA to take action and provided expertise on what the proposed regulations should look like. It wasn’t until a public information request was filed with the agency asking for their internal communications regarding the regulations that we finally saw progress. When advocates from the public health and environmental community — some of whom have worked on the issue of antibiotic resistance for many years — read the draft regulations, they were not found to be based in the science available. Even more disappointing, they did not even achieve the basic intent of the law: to prevent the routine, low-dose use of antibiotics in agriculture. To simplify the issue, think of it this way — would you give your kid a low dose of antibiotics for several weeks in their sandwich just in case they got sick? No. The same principle should apply to livestock. If a farm animal isn’t sick, or headed into surgery, then that animal shouldn’t need antibiotics. But the regulations drafted by the Hogan administration do not make this clear. Unfortunately, as much as 70 peercent of antibiotics developed to treat humans are sold for use in feed and water for farm animals. Historically, a large proportion of that is to speed up weight gain in animals or to compensate for stressful living conditions. The public health crisis from this inappropriate usage is too big to ignore. From salmonella and staph infections to gonorrhea and tuberculosis, we are seeing more resistant bacteria requiring longer courses of antibiotic treatment and multiple types of antibiotics. A new study from George Washington University’s Antibiotic Resistance Action Center found that a strain of E. coli originating in poultry could be causing 30,000 to 40,000 urinary tract infections in the U.S. every year.
Two years ago, a woman in Nevada died of an incurable carbapenem-resistant Enterobacteriaceae infection, resistant to all 26 antibiotics available in the U.S. to treat infection. Drug-resistant cases are increasing with astronomical costs, both human and financial. According to a study by researchers from Emory University and Saint Louis University published this year in Health Affairs, antibiotic resistance adds nearly $1,400 to the bill for treating a bacterial infection and costs the nation more than $2 billion annually.
 The medical community is working aggressively to prevent antibiotic overuse in hospitals and other treatment centers, but the agricultural community needs to do its part. Some companies, like Maryland-based Perdue Farms, have led the way on phasing out routine antibiotic use. Other companies prefer to call chicken raised without antibiotics a “marketing gimmick,” a frustrating obfuscation of the crisis at hand. The General Assembly passed the Keep Antibiotics Effective Act for a compelling reason. The committee with jurisdiction over the regulations has placed a “hold” on them pending further review. It’s up to the Hogan administration to ensure the intent of the law is fulfilled. ALICIA LAPORTE AND RAIMEE ECK
The writers are, respectively, campaign manager with Fair Farms Maryland and president of the Maryland Public Health Association.

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