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Public Health Consequences of Macrolide Use in Food Animals:
A Deterministic Risk Assessment
 Authors: H.
Scott Hurd, Stephanie Doores, Dermot Hayes, Alan Mathew, John Maurer, Peter
Silley, Randall S. Singer, & Ronald N. Jones
Abstract:
The potential impact on human health from antibiotic-resistant bacteria selected
by use of antibiotics in food animals has resulted in many reports and recommended
actions. The U.S. Food and Drug Administration Center for Veterinary Medicine
has issued Guidance Document 152, which advises veterinary drug sponsors of
one potential process for conducting a qualitative risk assessment of drug
use in food animals. Using this guideline, we developed a deterministic model
to assess the risk from two macrolide antibiotics, tylosin and tilmicosin.
The scope of modeling included all label claim uses of both macrolides in poultry,
swine, and beef cattle. The Guidance Document was followed to define the hazard,
which is illness (i) caused by foodborne bacteria with a resistance determinant,
(ii) attributed to a specified animal-derived meat commodity, and (iii) treated
with a human use drug of the same class. Risk was defined as the probability
of this hazard combined with the consequence of treatment failure due to resistant
Campylobacter spp. or Enterococcus faecium. A binomial event
model was applied to estimate the annual risk for the U.S. general population.
Parameters were
derived from industry drug use surveys, scientific literature, medical guidelines,
and government documents. This unique farm-to-patient risk assessment demonstrated
that use of tylosin and tilmicosin in food animals presents a very low risk
of human treatment failure, with an approximate annual probability of less
than 1 in 10 million Campylobacter-derived and approximately 1 in
3 billion E. faecium-derived risk.
Journal of Food Protection, 67(5), 980-992.
(Copies of the article are available through Ingenta [http://www.ingenta.com],
a paid subscription service).
Letters to the Editor regarding above publication. Journal of Food Protection,
67(11), 2368-2374. (Copies of the article
are available through Ingenta [http://www.ingenta.com],
a paid subscription service).
For more information about this report, contact:
H. Scott Hurd, D.V.M., Ph.D.
Associate Professor
Analytical Epidemiology & Risk Assessment
Department of Veterinary
Diagnostic and Production Animal Medicine
College of Veterinary Medicine
Iowa State University
1710 Veterinary Medicine Building
Ames, IA 50011-1250
515-294-7905, fax 1072
shurd@iastate.edu
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