Executive action to combat the rise of drug-resistant bacteria: is agricultural antibiotic use sufficiently addressed?

摘要

On September 18, 2014, President Barack Obama issued an Executive Order titled Combating Antibiotic-Resistant Bacteria. The order demands a ‘strategic, coordinated, and sustained effort' to detect, prevent, and control antibiotic resistance. According to the Centers for Disease Control and Prevention (CDC), antibiotic-resistant infections are a rising health concern that result in at least two million illnesses and 23,000 deaths each year in the United States. The Executive Order and accompanying documents have been criticized for taking a weak stance against the use of antibiotics in agriculture; however, they include goals to promote antibiotic stewardship on farms, better surveillance of antibiotic use, and the development of alternatives to antibiotics. The criticisms are also unwarranted based on the current state of scientific evidence; nevertheless, there remain compelling reasons to limit the use of antibiotics in agriculture, and if fully implemented, the executive action is set to achieve this goal. This paper will explore why the criticisms are unwarranted, present the conflicting evidence on whether antibiotic use in farm animals poses a significant health threat to humans, offer other reasons to limit the use of antibiotics in livestock, and suggest ways that the government can maximize the efficacy of the proposed actions.