With growing research on how the widespread use of antibiotics in both farm animals and as prescribed in hospitals is rendering them less effective, three legislative proposals are taking aim at both sides of the issue.
Assemblyman Kevin Mullin, D-South San Francisco, and state Sen. Jerry Hill, D-San Mateo, have authored between them three bills they say will help deter antibiotic-resistant bacteria becoming all too common and harder to fight.
Some livestock representatives say they’re supportive of the judicious use of antibiotics with many cattleman and ranchers already complying with recommendations. Yet they fear mandatory restrictions could threaten availability for critical therapeutic purposes and say human misuse needs to be addressed as well.
The Centers for Disease Control and Prevention documented more antibiotic-resistance bacteria deaths each year and last year’s salmonella outbreak sickened 400 Californians, many resistant to multiple types of antibiotics. The two situations spurred Mullin and Hill to action. Hill claims antibiotics are rippling through the food chain. Antibiotics are in the food we eat, it can be found in breast milk and they’re prescribed to children in record numbers, he added.
“I’m trying to solve the problem of overconcentrations of antibiotics in humans which has led to antibiotic-resistant bacteria and is killing 23,000 [Americans] annually and sickening two million [Americans] annually,” Hill said. “And that number is growing. So it’s a two-pronged approach; we have to deal with it in humans, how we ingest and are taking them, and we have to deal with food animals.”
Last December, the Food and Drug Administration issued a request for pharmaceutical companies, livestock and poultry producers to stop using antibiotics to promote faster growth in animals. However, it’s only a request and compulsory laws need to be instated, Mullin said.
“Resistance to antibiotics is an increasingly serious problem. The [FDA’s] voluntary guidance is not enough to stop the inappropriate use of antibiotics in livestock and leaves the public’s health at risk,” Mullin said.
Nearly 80 percent of the nation’s antibiotics are sold for use in livestock and are often routinely given to healthy animals to promote growth. The consequences are dire and appear when antibiotics become less effective for treating infections in humans, according to the legislation.
Mullin’s Assembly Bill 1437 would ban the use in livestock for weight-gain purposes. Antibiotics that threaten public health by increasing the prevalence of antibiotic-resistant bacteria would be barred from animal use as well, according to the legislation.
It does maintain, although with restrictions, the ability for those who raise livestock to disperse antibiotics in cases where there is a known sick animal that has been exposed to others.
Many ranchers already strive to protect both the health of their customers and their livestock, said Billy Gatlin, executive vice president of the California Cattleman’s Association.
The CCA is in support of regulatory legislation, however Mullin’s bill veers from the FDA’s definition of therapeutic uses and could limit one’s ability to care for livestock, Gatlin said.
“For us, it’s an issue of animal welfare and ensuring we provide the best possible care to animals under our watch, and part of that is not only being able to treat diseases when one gets sick … it’s about the prevention of disease and not have the animal contract and needlessly suffer from a disease if we see that it’s likely or the threat is present,” Gatlin said.
Hill is attacking the issue through two bills so as to address both the gratuitous use in livestock and encourage oversight on the use of antibiotics in hospitals. Senate Bill 835 would codify the FDA’s recommendations for use in livestock while forbidding growth enhancement marketing and require veterinary prescription and oversight.
The CCA is in support of Hill’s bill as, Gatlin said, “we believe that it strikes a balance between the safe and judicious use of antibiotics with the need for ranchers to have access to antibiotics to treat and prevent and cure disease.”
But the blame cannot be laid entirely on the livestock industry as human behaviors also play a role such as in the disposal of or by not finishing a prescription as instructed, Gatlin said.
“We all know any time you use an antibiotic, resistance is likely to develop because … if you don’t kill all of it those strains will reproduce and are stronger,” Gatlin said. “So we know that resistance occurs, not just in food animals, but on the human side there are several factors that lead to antibiotic resistance.”
Hill said the issue is multi-faceted and although addressing the use in animals is vital in combating the increasing prevalence of antibiotic-resistant bacteria, it needs to be addressed in hospitals as well.
Hill’s Senate Bill 1311, co-authored by Mullin, would require hospitals to have an antimicrobial stewardship program.
The CDC estimates antibiotic-resistant infections in people results in at least $20 billion in direct health care costs and $35 billion in lost productivity each year.
SB 1311 strengthens existing provisions legislated in 2006 by then-state Sen. Jackie Speier.
Hospitals would be required to establish programs that generate awareness and dissuade the unnecessary use of antibiotics by choosing and following established guidelines from reputable sources such as CDC or Infectious Diseases Society of America. Hospitals would be required to have a physician oversee the programs that could include audits, dose optimization rules, prior authorizations for certain antibiotics or reevaluating use 48 hours after prescribed.
Hill said he’s glad multiple bills are making their way through the Legislature and hopes addressing the problem on all fronts will reduce the propagation of and suffering from antibiotic-resistant bacteria.
“The more we discuss this, the more it raises concerns and the level of interest,” Hill said. “That’s sometimes why we do what we do.”
The Senate Committee on Health will hear SB 1311 Thursday. The Senate Committee on Appropriations will hear SB 835 April 28.
AB 1437 has been referred to the Committee on Agriculture and no hearings are currently scheduled.
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