Antibiotic use in the United States poultry farming industry is the controversial prophylactic use of antibiotics in the country's poultry farming industry. It differs from the common practice in Europe, where antibiotics for growth promotion were disallowed in the 1950s.

Since their approval by the Food and Drug Administration (FDA) in 1951, antibiotics have been extensively used in large quantities.Castonon, J.R. History of the Use of Antibiotics [Poultry Science, 2011]. Three years prior to their approval, scientists were investigating a phenomenon in which chickens that were exposed to bacteria-rich manure displayed signs of better health compared to those that were not. Testing revealed that chickens fed with a variety of vitamin B12 produced with the residue of a specific antibiotic grew 50% faster than chickens fed with B12 from a different source.Ogle, Maureen. "Riots, Rage, and Resistance: A Brief History of How Antibiotics Arrived on the Farm". Scientific American. Sep 3, 2013. Retrieved 28 October 2016. Further research confirmed that antibiotic use improved chicken health, resulting in increased egg production, lower mortality rates, and reduced illness. Consequently, farmers shifted from expensive animal proteins to comparatively inexpensive antibiotics and B12, as it enabled chickens to reach market weight faster and at a lower cost. With a growing population and increased demand, antibiotics seemed to be an ideal and cost-effective way to boost poultry output. However, in recent times, antibiotic use in poultry production has become a subject of debate because of concerns about bacterial antibiotic resistance.Roth, Natalia. "How to reduce antibiotic resistance on poultry farms." July 27, 2016. Retrieved 28 October 2016. Emerging threats: antibiotic resistance

The Centers for Disease Control and Prevention (CDC) has identified the emergence of antibiotic resistance as a national threat.CDC. "Antibiotic Resistant Threats in the United States" CDC 2013. The concern over antibiotic use in livestock arises from the necessity antibiotics have in keeping populations disease-free. As of 2016, over 70% of FDA approved antibiotics were utilized in modern, high production poultry farms to prevent, control, and treat disease.O’Niel, Jim. “Antimicrobials in the agriculture and the environment: Reducing the unnecessary use and waste” The Review on Antimicrobial Resistance. 2016. The FDA released a report in 2009 estimating that of antibiotics had been used in livestock in that year alone.O’Niel, Jim. “Review on Antimicrobial Resistance” December 2015. However, surveillance of consumer exposure to antibiotics through poultry consumption is limited. More specifically in 2012, the FDA speculated the most significant public health threat in regard to antimicrobial use in animals is the exposure of antimicrobial-resistant bacteria to humans.Federal Register. “Rules and Regulations” 2012. These statements have been challenged by the American meat industry lobbyists, who posit that antibiotics are used responsibly and judiciously in order to ensure effectiveness.American Meat Institute. “The Facts About Antibiotics in Livestock & Poultry Production”.

Consumer health effects

Consumers are exposed to antibiotic resistance through consumption of poultry products that have prior exposure to resistant strains. In poultry husbandry, the practice of using medically important antibiotics can select for resistant strains of bacteria, which are then transferred to consumers through poultry meat and eggs. The CDC acknowledges this transferral pathway in their 2013 report of Antibiotic Resistant Threats in the United States.CDC. "Antibiotic Resistance Threats in the United States 2013", April 23, 2013. Retrieved on 28 October 2016. The annual rate of foodborne illness in America is one in six. For the 48 million individuals affected, antibiotics play a critical role in thwarting mortality rates.CDC. “Estimates of foodborne illness in the United States” 2011. In a literature review conducted by the Review of Antimicrobial Resistance 100 out of 139 studies found evidence of a link between antibiotic use in animals and antibiotic resistance in consumers.

When a gram-negative bacterial infection is suspected in a patient, one of the first-line options for treatment is in the fluoroquinolone family. This, along with penicillin, is one of the first families of antibiotics utilized in the broiler industry. If this first-line treatment is not successful, a stronger class of antibiotics is typically used, however, there is a limitation on how many classes are available, as well as which medications are available on hospital formularies. There is also more drug toxicity affiliated with second and third line antibiotic options. This is one example why it is critical to keep as many first-line antibiotic options available for human use.Lautenbach, et al. "Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae: Risk Factors for Infection and Impact of Resistance on Outcomes", Clinical Infectious Disease, 2001. Retrieved on 28 October 2016.

Other issues are associated with duration and complexity of infection. On average, treatment for non-resistant bacteria is administered 11.5 hours after diagnosis, and treatment for resistant bacteria is administered 72 hours after diagnosis. This is a reflection of the additional threat of prolonged incubation, leading to greater potential for systemic disease, with higher morbidity and mortality associated with opportunities for complications, and prolonged treatment time. For example, of the two million people affected by resistant infections a year, 23,000 will die.CDC. "Antibiotic Resistance Threats in the United States 2013", April 23, 2013. Retrieved on 28 October 2016. Severity in mortality is coupled when exposed to high risk populations such as immunocompromised and elderly individuals in hospital and nursing home settings.CDC. “Antibiotic Resistant Threats in the United States” 2013.

History of federal policy on antibiotic use in livestock 1940s – Beginning of utilization of antibiotics in livestock feed} 1951 – Antibiotics first FDA approved for use in poultry. Approved uses included production (growth enhancement), treatment, control, or prevention of animal disease. Antibiotics were also available for purchase over the counter at that time. 1970 – FDA task force publication proposes limitations of utilizing antibiotics in livestock feed that are also used in humans. 1975 – Secondary to this publication, drug sponsors are required to submit studies demonstrating the antibiotics did not harm human health 1976 – Stuart Levy study demonstrating tetracycline resistant E. coli moving to consumers 1977 – FDA proposal to remove penicillin and tetracycline in subtherapeutic doses, however, request by Congress for further studies to be conducted. 1980 – National Academy of Science recruited by the FDA to conduct further studies, specifically for penicillins and tetracyclines. Conclusion from these studies indicated no sufficient evidence to ban these antibiotics. 1980s-early 2000s – Further studies continued, supported by the FDA 2003 – FDA issued guidance to pharmaceuticals for an approval process utilizing new antibiotics in animal feed. For antibiotics already in use, the FDA would have to withdraw approval for each individual medication. 2005 – Enrofloxacin, an already utilized antibiotic, was removed from poultry production. This took 5 years to accomplish. 2010 – FDA first draft of “voluntary” limitations of medically important antibiotics in livestock, and requirement of veterinarian oversight, which would later become "Guidance for Industry #209". 2011 – FDA removed original request from 1977 to remove penicillins and tetracyclines in feed. 2012 – FDA finalized "Guidance for Industry #209", which was implemented under the Veterinary Feed Directives. These guidelines were issued to pharmaceuticals.U.S. FDA. "Phasing out certain antibiotics use in farm animals", Dec 11, 2013. Updated Feb 25, 2015. Retrieved on 28 October 2016. 2013 – FDA issues “Guidance for Industry #213,” which provided additional information to pharmaceuticals for recommendations from #209. 2014 – All 26 pharmaceutical companies producing antibiotics used in livestock feed agreed to the FDA guidelines in #213. Given total of 3 years to make all recommended changes.Sneeringer, et al. "Economics of Antibiotic Use in U.S. Livestock production" , USDA, November 2015. Retrieved on 28 October 2016.

Current U.S. federal regulators

National Antimicrobial Resistance Monitoring System's (NARMS) Enteric Bacteria program – Established in 1996, and represents a collaboration between the USDA, FDA, and CDC. Its purpose is to organize these organizations into a drug monitoring program for antibiotics utilized in animal feed with the goal of maintaining their medical efficacy. There are three branches which oversee humans, retail meat, and food animals. USDA – Operating under the Food Safety and Inspection Service (FSIS). Main role is in charge of testing imported and domestic meat for antimicrobial resistant bacteria. If a "residue violation" found, they may condemn the product. Regardless, funding and resources are not available for outbreak investigations at farms or ranches. USDA – Operating under The National Organic Program (NOP) uniform national standards are used to create rules & regulations for the production, handling, labeling, and enforcement of all USDA organic products. Since at least 1990 use of any usage growth promoters, hormones, antibiotics and synthetic trace elements used to stimulate growth have been strictly forbidden in all USDA certified organic poultry and other livestock animals. The prohibition applies even in the case the dose is low enough to be considered "sub therapeutic" and applies regardless of how the substances route of administration. This also effects egg products as they must come from animals raised in full compliance to NOP guidelines in order to receive USDA Organic certification. FDA – Operating under the Center for Veterinary Medicine (CVM). Works with CDC to monitor retail meat. CDC – Monitors human samples.

Vertical integration

This is the current business structure utilized almost universally in the broiler, or chicken bred for meat, industry. This also began in the 1940s when antibiotics began to be utilized in livestock feed. Perdue is credited as the pioneer of this structure.Pelton, Tom. "New Book Explains How Perdue's "Chickenizing" Changed the World", 'WYPR', Sep 8, 2016. Retrieved on 28 October 2016. The basis is centralization of production. "Integrators" control cost, policy, and are the decision makers of production. They decide feed formulations, choice of antibiotic administration, and cover those costs in addition to veterinary services. They also own the poultry that is grown. Farmers are labeled as "growers" or "operators." They own the land and buildings where the poultry is grown, and are essentially caretakers for the poultry growth to the integrators. The benefit for growers in this business structure is they are guaranteed payment from the Integrators, which is compensated in weight gained by each flock."Vertical Integration", National Chicken Council, 2012. Retrieved on 28 October 2016. Due to this structure, about 90% of broilers are raised within 60 miles of the processing plant. Integrators are large poultry companies such as Perdue, Tyson, Pilgrim's Pride, and Koch Foods. As of 2011, there were about 20 of these companies in the U.S. that controlled 96% of all broilers produced that year.

Regulatory surveys

There are two main surveys distributed to farmers by the federal government to aid in various regulations of the agricultural industry. They are the Agricultural and Resource Management Survey (ARMS) and the National Animal Health Monitoring Survey (NAHMS).