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U.S. Department of Health and Human Services

Animal & Veterinary

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Jeremy Mathers, M.S., Ph.D., Alpharma Animal Health

DR. MATHERS: I didn’t know I was the only one who made a written contribution. That is interesting. I just wanted to recap some of the written comments that we did make. So after 11 to 13 years and thousands of isolates in the NARMS program for testing for resistance and being reported, there is time for more detailed review and overview of what trends there are, you know, if any.

A lot of this has been presented at this meeting and going into more detail on the specifics. Our company has a particular interest in the product classes that are considered older drugs used in feed and water. The human Salmonella resistance trends for the older drugs were tetracyclines, ampicillin, sulfa, and streptomycin have declined. Pansusceptibilty has increased and it is over 11 to 13 years. Multidrug resistance and the pentaresistance has declined in the human sector. So whatever feed and water uses that there have been for these older drugs, there has not really been any evidence, at least from the NARMS data that it has driven any increase in the human clinical isolates.

These observations are important when considering precautionary bans of approved products. I am referring to the slide that is still up here.

Other observations for our analysis, if you look at the Salmonella, streptomycin resistance is in second place. Streptomycin is not even approved for feed and water use in the United States. If you look at aminoglycosides as a class, they amount to one percent or less of the total amount sold in the U.S. That is from the AHI data website page.

There has been a lot of exaggeration regarding approved feed and water uses being a direct public health threat. If you look at in vitro for older drugs, they show really no unique resistance patterns or evolution due to lower level or longer use terms. They are more bacteriostatic drugs. If you look at older textbooks and things, you will be able to look at the mechanisms of some of these things. They are just not as well known nowadays. But there have been a lot of studies to show that they are effective at lower levels.

In vivo likewise shows at most there has been some selection effect. I am referring to the Alexander paper that was mentioned before. There is not much evidence that this carries over to the human sector however.

NARMS in our view for 11 years shows evidence that not much really is happening due to feed and water uses of older bacteriostatic classes of antimicrobials. Thank you.

DR. McDERMOTT: Thank you very much. I am inclined to wrap it up. I think I see some people are getting a little bit tired and unless Dr. White, would you like to make a comment?