regulatory uncertainty. So the focus is going to be more
on non-medically important antibiotics and non-antibiotics,
and trying to find ways to treat the disease without using
traditional antibiotics. And some focus as well on vaccines,
trying to develop novel vaccines for treatment and preven-
tion purposes. I think all of this though also points to the
importance of protecting what we have and protecting
the antibiotics from a judicious use standpoint to prevent
resistance. And also protecting the indications that we
have, so that the poultry industry does not lose the impor-
tant indications that they have for existing antimicrobials
for prevention, control and treatment.
; Tracking antibiotic use
Gary Thornton – When researchers and others
talk about getting a handle on antimicrobial
resistance, there is often a lot of emphasis on
the volume of antimicrobials. Are there other
factors of potentially a greater significance?
Dr. Singer – The volume of antimicrobial is an easy number
to state. It’s not easy to calculate but it sounds dramatic.
But yet it is incredibly misleading. In fact, there are many
who have talked about needing an alternative metric for
usage, because you can’t compare how much antibiotic is
given to an animal like a cow versus how much is given
to a human versus a chicken. They have very different
metabolisms; they have very different weight etc. And on
top of that the antibiotics being used are very different.
If you go back to judicious use, what you’re trying to do is
minimize the impact that this antibiotic use is going to have on
the emergence and the spread of resistance. So even though
you may use a lot of antibiotic, if you’re using it judiciously
you may have little impact on resistance. Whereas, a small
application used inappropriately may end up having a much
greater impact on resistance. So strict volume comparisons to
me are sort of nonsensical and we need to have better ways
of assessing what the impacts are of our uses on resistance.
Gary Thornton – Is the CVM looking to the poultry
company or the pharmaceutical company to
track and report antibiotic usage?
Dr. Flynn – There are requirements in place now for
pharmaceutical companies to report to us on an annual
basis the total quantity of any antibiotic that’s intended
for a food animal that they’ve sold or distributed. It
doesn’t necessarily represent what is sort of going out
by the end user or doesn’t necessarily equate to actual
quantity used. So it does have some limits in terms of
what conclusions you can draw from that.
At this point we’ve actually put out a public announcement
asking for general input on this very question: is there
anything we can do to enhance the sales and distribution
information that we’re getting already. We’ve also asked
for a comment on what’s the best way for us to present
that in a meaningful way in an annual summary to the
public. But we’ve also more importantly asked for other
sources of information that would be helpful to inform us.
We’ve got a fairly good response in terms of comments
and we’re in the process of looking at that now and we’re
really trying to put all the ideas on the table.
Dr. Sutherland – And the other thing is many products
have multiple species on the label, so you may sell the
product and it’s used exclusively for cattle and yet it says
swine and chickens on the label. It’s very problematic from
a pharmaceutical company perspective to track usage.
Dr. Ritter – The poultry companies have not participated
in reporting antibiotic usage to date. We don’t know
how the information is going to be used; we don’t know
how it’s going to be presented. You know, it’s got to be
everybody or nobody. We don’t want it to be used for