The Centers for Disease Control this week unveiled a new report detailing the use of antibiotics in the U.S., finding that the most common place for antibiotic misuse is in hospitals.
The report counters speculation among critics of antibiotics in agriculture that farms using antibiotics to prevent or treat bacterial infections in animals are the primary driver behind the developing "superbug" epidemic.
Instead, Tom Frieden, CDC director, said healthcare centers are the source of many of the most resistant organisms.
"Right now the really most acute problem is in hospitals," Frieden noted in a press call. "And the most resistant organisms in hospitals are emerging in those settings, because of poor antimicrobial stewardship among humans."
The CDC has categorized the most dangerous drug-resistant infections into three groups – urgent, serious and concerning. Frieden noted that the most urgent bacteria include carbapenem-resistant Enterobacteriaceae, drug-resistant gonorrhea and Clostridium difficile.
These infections often result in hospitalizations and added cost, CDC's report said, estimating that antibiotic resistance adds $20 billion in excess direct health care costs, with additional costs to society for lost productivity as high as $35 billion a year.
To combat the rising costs, Frieden introduced the CDC's four core actions to control and limit antibiotic resistance: preventing infections and the spread of resistance; tracking resistance patterns; improving use of today's antibiotics and antibiotic stewardship; and developing new antibiotics and diagnostic tests.
"These are important. They're not easy. We're taking some actions on them. But one of the reasons we're raising the alarm now is to accelerate the pace of implementation of those actions," Frieden said.
Despite the concern that antibiotic resistance is growing, Frieden reiterated the CDC's position on antibiotics in agriculture.
"USDA and FDA are the lead on this issue, but we continue to promote the concept that if an animal is sick using antibiotics to treat that animal is obviously important. We want to increase the rational use of antibiotics and improve antimicrobial stewardship so we can preserve antibiotics and not increase the unnecessary use of antibiotics," Frieden said.
Antibiotics in ag critics The Center for Science in the Public Interest, however, said the report did not go far enough.
"CDC found that 22% of the resistant illnesses are linked to foodborne hazards, so the overuse of antibiotics in the animal sector can no longer be ignored." said Caroline Smith DeWaal, director of food safety at CSPI. "The volume of antibiotics sold for use in animals dwarfs those used in human medicine. While attention to both sectors is vital, action is urgently needed to manage the food safety risks posed by the non-therapeutic use of antibiotics in food animals."