Maryland Antibiotics Legislation May Have Little Impact

The headlines say that the Keep Antibiotics Effective Act of 2017 will make all chickens raised in Maryland free of antibiotics. While this sounds promising, the legislation has several deficiencies and will not achieve its sponsors’ intent.

A gutted version of the bill has recently passed in the Maryland Senate and House of Delegates and is on its way to reconciliation before being sent to Governor Larry Hogan for his signature. If a reconciled bill is signed into law, we are concerned that Maryland will be setting a regressive precedent for other states considering action.

The proposed legislation does not ensure that any animals will be raised “free from antibiotics” or that the total agricultural use of antibiotics in Maryland will decline. The potential for collection of data describing how these drugs are used has also been compromised. Rather than the initial proposal to require the collection of antibiotic usage data (including Veterinary Feed Directives, or VFDs, and prescriptions), the revised legislation only requires the Maryland Department of Agriculture (MDA)—which opposes the legislation—to collect publicly available data on antibiotics use in Maryland (see below for more detail on this). It also creates a public misperception that the problem of antibiotics misuse in agriculture is resolved and decreases the likelihood that Maryland will adopt meaningful legislation on this issue in coming years.

What’s wrong with the proposed legislation?

• Does not improve knowledge of antibiotic use for disease prevention. It allows medically important antibiotics to be used for disease prevention but does not require the collection of VFDs or prescriptions, which would provide information about instances of drug use for disease prevention.
• Use of vague, undefined term “regular pattern” prevents meaningful restriction of antibiotics misuse. It prohibits the administration of medically important antibiotics in a “regular pattern,” but does not define or describe regular patterns; there is disagreement among non-governmental organizations and governmental agencies about what constitutes routine or regular use of antibiotics.
• Does not require any meaningful data collection. It requires the MDA to collect publicly available information on the use of antibiotics from the U.S. Department of Agriculture, Centers for Disease Prevention and Control, FDA, and national trade associations, even though there is currently only sales data publicly available.
• Redundant of existing FDA guidance. It does not require anything more meaningful or stringent than the changes that have already taken place under FDA guidance. As the MDA argued, this legislation is “duplicative and incomplete compared to the national effort by the Food and Drug Administration’s (FDA) Center for Veterinary Medicine.”
• No meaningful change to veterinarian involvement. A veterinarian does not need to have visited the farm location (the original bill required a vet visit within six months of the prescription).
• Loophole allows use of medically important antimicrobials at any time in animal’s life. A medically important antibiotic could be prescribed by a veterinarian if, in their judgment, it “is necessary for prophylaxis (i.e. prevention) to address an elevated risk of contraction of a particular disease or infection.” Such a broad exception, in practice, would mean a medically important antimicrobial could be prescribed and used at virtually any time in the animal’s life.

How should the legislation be strengthened?

• Strengthen definitions of regular and appropriate use. It should define “regular pattern,” with definitions specific for each animal species. Further, antibiotic use is only appropriate under circumstances where at least one animal within a herd or flock has been diagnosed as sick or an exposure has been documented.
• Collect data that are useful and accessible. It should require the collection of VFDs and veterinary prescriptions so that the agricultural use of antibiotics may be measured and analyzed by species.
• Data should be collected by a health agency. It should require the Maryland Department of Health and Mental Hygiene, which is familiar with collecting and storing sensitive information and may have an interest in reducing antimicrobial resistance, to collect data on antibiotic drug use.

The proposed legislation does not meet the current antibiotic use standards by major poultry integrators and consequently will not result in more responsible antibiotic use in Maryland animal agriculture.