ANTIBIOTICS, one of the great medical advances of the 20th century, are being threatened by their careless use in the 21st century. Time and again, disease-causing bacteria in humans become resistant to antibiotics because they are prescribed for the wrong conditions or because patients fail to complete the full course of the prescription. A third, highly avoidable cause of resistance is the use of antibiotics in poultry or livestock.
The Food and Drug Administration has before it now an application to use on cattle an antibiotic from a family of antibiotics crucial to treating humans. The agency should follow the advice of its veterinary advisory committee and turn thumbs down on this bid.
The antibiotic is cefquinome. Intervet, the world's third largest animal health company, wants to sell it for treatment of bovine respiratory disease, or "shipping disease," which occurs frequently when cattle are shipped in trucks or rail cars to feed lots and are then kept in close confinement. Intervet's application says the drug would be sold for therapeutic use in individual cases and not as a preventive, where the danger of resistance developing would be even greater as bacteria mutate and find ways to survive the drug.
But Margaret Mellon, director of the Food and Environment Program of the Union of Concerned Scientists, says that bovine respiratory disease is so endemic in feed lots that cefquinome's use would become routine. She said there are alternative drugs to use with cattle and the disease would be much less common if the industry would change the conditions under which cattle are raised and prepared for slaughter. Critics of cefquinome use for bovine respiratory disease also worry that once it becomes available for that purpose, it would be used for others as well.
Cefquinome belongs to a class of antibiotics known as cephalosporins.
According to the president of the American Academy of Pediatrics, Dr.
Jay E. Berelhamer, this class of drugs is widely used in children, who are particularly dependent on antibiotics in cases of infection because their immune systems are less developed than those of adults . In a letter to the FDA opposing approval of cefquinome for cattle, Berelhamer says a similar antibiotic is often prescribed for children being treated for cancer whose immune systems are weakened. "If widespread use of cefquinome leads to resistance to it . . . , the consequences could be severe for our most vulnerable patients," he wrote.
Other professional organizations that have opposed approval of cefquinome include the American Medical Association, the Infectious Diseases Society of America, and the American Public Health Association.
The FDA should take the advice of the doctors and place the continued effectiveness of antibiotics above the profit margins of cattlemen.Boston Globe
