You need data to know if interventions to foster the judicious use of medically important antimicrobial drugs are actually adopted and whether they have the desired effect in terms of both antibiotic use practices (also known as stewardship) and managing antibiotic resistance.
On Wednesday, the federal agencies at the forefront of the resistance fight — the Food and Drug Administration, the Department of Agriculture and the Centers for Disease Control and Prevention — held a public meeting to discuss possible approaches for collecting additional on-farm antimicrobial drug use and resistance data.
“Tracking the use of antibiotics is critical to knowing how we’re doing with stewardship,” said Beth Bell, director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases. “Good information about where, why and how animal antibiotics are used is the basic information needed to know when stewardship is going well.”
William Flynn, deputy director for science policy at the FDA’s Center for Veterinary Medicine, said that several different sources of data are needed to tackle antibiotic resistance. Such sources include sales, on-farm use, resistance trends in foodborne bacteria, animal demographics and health, and FDA inspection activities.
Some of these data are already available. For example, the National Antimicrobial Resistance Monitoring System (NARMS) tracks antimicrobial resistance patterns in bacteria isolated from humans, retail meats and animals at slaughter. And drug companies are required to report basic information about antibiotic sales to FDA under the Animal Drug User Fee Act (ADUFA).
On-farm antibiotics data are collected to a limited extent, but they are not representative or detailed enough to help inform antimicrobial stewardship.
At Wednesday’s meeting, Kathe Bjork gave an overview of some of the surveys USDA is considering to collect use data. These included on-farm longitudinal studies, a veterinary diagnostic laboratory longitudinal study, enhanced or focused surveys through the National Animal Health Monitoring System (NAHMS), or evaluation of data collected by producers.
One idea not mentioned by government officials Wednesday, but advocated by consumer groups during the public comment portion of the meeting, was to obtain use information from feed mills.
The finalized Veterinary Feed Directive rule requires feed mills to keep records of use, so it’s already an aggregation of data and close enough to the farm to allow for species distinction.
“No one single data source is going to answer all of our questions in a meaningful way,” Flynn said. “We need to pull together all these sources of info into an integrated report.”
The agencies outlined what such an integrated report might look like and said that their goal is to publish the first one in 2018.
FDA is collecting public comments until Nov. 30, 2015, on the suggested ways of collecting additional antimicrobial drug use data and other possible approaches.
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