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When I was commissioner of the U.S. Food and Drug Administration (FDA), the agency’s national advisory committee recommended in 1977 that we eliminate an agricultural practice that threatened human health. Routinely feeding low doses of antibiotics to healthy livestock, our scientific advisory committee warned, was breeding drug-resistant bacteria that could infect people. We scheduled hearings to begin the process of curtailing the use of penicillin and other antibiotics for this purpose, but Congress halted the effort before it started.

Today, the science is even clearer that antibiotic overuse in agriculture is dangerous – yet the same risks persist. Fortunately, the FDA appears poised to act by instituting a measure known as Guidance 213. This voluntary policy instructs pharmaceutical companies to stop marketing certain antibiotics for animal production purposes. Some public health advocates want the agency to make the restrictions mandatory, but voluntary guidance can work – if it is finalized. The agency issued a draft version of its policy in April 2012 and received public comments, as required, but the comment period closed about a year ago. Drugmakers have been left awaiting further instruction.

The new guidelines cannot come soon enough. More antibiotics were sold for use in food animal production in 2011, the last year for which complete data are available, than in any prior year. The FDA annually examines bacteria on retail meat and poultry, and each year the bugs show more resistance to antibiotics. Moreover, several new studies using genetic analysis demonstrate with great precision the evolution and transmission of resistant pathogens not traditionally linked to food. Methicillin-resistant Staphylococcus is a troublesome new source of livestock-associated infections, and the E. coli that cause drug-resistant urinary tract infections can also be transmitted to people via food.