I want to introduce a federal group I have worked with for the last four years, the Presidential Advisory Council on Combating Antimicrobial Resistant Bacteria, or PACCARB (bit.ly/paccarb). While I am writing as a voting member of this council, the views expressed herein are my own.
PACCARB advises the Secretary of Health and Human Services (HHS) on antibiotic resistance. This occurs through reports created by 15 voting members and 10 liaison members, which make up respective working groups tasked with answering particular questions identified by the chair or transmitted by the secretary of HHS.
You can find reports and council members on the website. Past members are listed in the reports to which they contributed.
This council was established in 2015, with the first public meeting Sept. 29, 2015. Since then, there have been 13 public meetings, where an amazing group of experts have come to advise and educate the council and the rest of America (and the world). Many more have contributed via public comments — you can, too! And we get to read your comments!
The great thing about these meetings is that you can look through all of them on the website and watch the different segments; you also have access to all of the PowerPoints from the panel experts. Sift through the public meetings and pick out areas of interest to you.
Personally, this experience has been one of the greatest educational opportunities I have had. Not only through the long list of experts who have participated in panels, but also through comments we receive, conversations and relationships established with human health care professionals.
The biggest lesson of all? Everyone I work with on the council just wants to preserve the use of antibiotics for human and veterinary health for future generations. Antibiotic resistance is a real and pressing problem, and everyone needs to pitch in. In my personal opinion, one of the biggest behavioral problems involved in antibiotic resistance is that the problem always seems to be what someone else is doing, and what we are doing is without fault.
I invite you to look on the website for the latest report, Priorities for the National Action Plan on Combating Antibiotic-Resistant Bacteria: 2020-2025, a Report with Recommendations.
The executive summary begins, “The rise of antibiotic-resistant bacteria poses a serious threat to public health and the economy. Antibiotic use in both human and veterinary settings selects for antibiotic resistance, which has a negative effect on both human and animal health.”
Notice that it doesn’t say that veterinary medicine and food animals are the root of the problem, or that all of the human health antibiotic resistance challenges are due to animal use of antibiotics.
If you think that food animal production is the victim of a singular focus on our antibiotic use, in my opinion, you are completely wrong. Across all uses of antibiotics, there are legitimate questions about what is used and why.
How could the uses be optimized? How could the need for the uses be prevented? Uses in food and companion animals are addressed in the report, along with a multitude of uses and challenges in human medicine.
The last time we had a new antibiotic released (the fluoroquinolones) that we use in cattle today, was 1978. My advice? Besides making sure we preserve antibiotics for our friends and family, we need to make sure they are there for our cattle, too.
Work with your veterinarian to do everything possible to prevent disease before it requires an antibiotic. And when one is necessary, make sure you use an appropriate case definition to identify the animals needing therapy and then the right regimen (drug, dose, route, frequency and duration) to get the job done.
Apley, DVM, Ph.D., is a professor in clinical sciences at Kansas State University in Manhattan.