A Review of the Effectiveness of Current US Policies on Antimicrobial Use in Meat and Poultry Production

Abstract

Purpose: Industrial food animal production accounts for most animal-source protein consumed in the USA. These operations rely on an array of external inputs, which can include antimicrobials of medical importance. The use of these drugs in this context has been the subject of public health debate for decades because their widespread use contributes to the selection for and proliferation of drug-resistant bacteria and their genetic determinants. Here, we describe legislative and regulatory efforts, at different levels of governance in the USA, to curtail food animal consumption of medically important antimicrobials.

Recent findings: The features and relative success of the US efforts are examined alongside those of selected member states (Denmark and the Netherlands) of the European Union. Evaluation of efforts at all levels of US governance was complicated by shortcomings in prescribed data collection; nevertheless, available information suggests deficiencies in policy implementation and enforcement compromise the effectiveness of interventions pursued to date. The political will, robust systems for collecting and integrating data on antimicrobial consumption and use, and cross-sectoral collaboration that have been integral to the success of efforts in Denmark and The Netherlands have been notably absent in the USA, especially at the federal level.

Keywords: Antibiotic resistance; Antimicrobial use, Food animal production; Drug resistance, Microbial; Livestock; One Health; Policy.

Fig. 1

Total US livestock antibiotic sales in kilograms, by class and year. NIR, Antimicrobial drug classes with fewer than three distinct sponsors of approved and actively marketed animal drug products are reported collectively as “Not Independently Reported” (NIR)

Fig. 2

Map of antibiotic use among producers in North America and Europe in mg antibiotic per PCU of livestock. Total consumption of medically important antimicrobials for terrestrial food-producing animals (cattle, dairy, swine, and poultry). Mg/PCU data and methodology for all European countries are from [43] “Sales of veterinary antimicrobial agents in 31 European countries in 2020.” (EMA/24309/2020), Available: https://www.ema.europa.eu/en/documents/report/sales-veterinary-antimicrobial-agents-31-european-countries-2019-2020-trends-2010-2020-eleventh_en.pdf. Canadian mg/PCU data are from 2018, and available from Public Health Canada, Canadian Antimicrobial Resistance Surveillance System, 2020 Update. Available: https://www.canada.ca/content/dam/hc-sc/documents/services/drugs-health-products/canadian-antimicrobial-resistance-surveillance-system-2020-report/CARSS-2020-report-2020-eng.pdf; US antibiotic sales data (in kg/year) are from the 2020 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals. Available: https://www.fda.gov/media/133411/download. A description of the data sources and method for converting these US sales data to mg/PCU is provided in the Supplement

Fig. 3

Total sales of medically important antimicrobials in 1000 kg in North American and European countries. Total sales of medically important antimicrobials for terrestrial food-producing animals (cattle, dairy, swine, and poultry) in 2020, except for Canada (whose data are from 2018)