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LETTERS I BOOKS I POLICY FORUM I EDUCATION FORUM I PERSPECTIVES

LETTERS edited by Jennifer Sills

Antibiotics: Discontinue Low-Dose Use IN HIS EDITORIAL “TIME TO DEAL WITH ANTIbiotics” (15 November 2013, p. 777), D. Kennedy correctly calls again (as he did in the 1970s) for curbs on the overuse of antibiotics on industrial farms, where excessive animal crowding has favored the likelihood of disease and the perceived need to rely on low-dose prophylactic antibiotics to stifle outbreaks. It is critical to recognize that veterinarians must continue to have access to effective antibiotics to treat animals that are clinically ill from bacterial infections. Such treatment entails the targeted use of therapeutic doses

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KEEVE E. NACHMAN,* TYLER J. S. SMITH, ROBERT P. MARTIN Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. *Corresponding author. E-mail: [email protected]

References 1. Johns Hopkins Center for a Livable Future, “Industrial Food Animal Production in America: Examining the Impact of the Pew Commission’s Priority Recommendations” (Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2013); www.jhsph.edu/research/ centers-and-institutes/johns-hopkins-center-for-a-livable-future/_pdf/research/clf_reports/ CLF-PEW-for%20Web.pdf. 2. Pew Commission on Industrial Farm Animal Production, “Putting Meat on the Table: Industrial Farm Animal Production in America” (Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2008); www.ncifap.org/_images/PCIFAPFin.pdf. 3. D. C. Love, M. F. Davis, A. Bassett, A. Gunther, K. E. Nachman, Environ. Health Perspect. 119, 279 (2011). 4. P. Loftus, “Zoetis chief leads animal-health firm following split from Pfizer,”Wall Street Journal (2013); http://online.wsj.com/news/articles/SB100014240527023037555045792 07710851450896.

for short periods of time at concentrations that are capable of achieving high bacterial kill rates. However, the practice of routinely administering antibiotics at low-dose concentrations in feed and water for extended periods of time to large populations of animals that lack signs of clinical illness is the surest way to spawn resistant bacteria (1). Even more threatening, and many would say unethical, has been the industry’s use of low-dose antibiotics for purposes of growth promotion in healthy animals. Although the FDA has recently determined the use of antibiotics for growth promotion to be injudicious, it continues to condone the use of low-dose antibiotics in feed and water for disease prevention (2).

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IN HIS EDITORIAL “TIME TO DEAL WITH ANTIBIOTICS” (15 NOVEMBER 2013, p. 777), D. Kennedy mentioned our assessment of the impact of the Pew Commission on Industrial Farm Animal Production (IFAP) (1). We support his call to end the misuse of antibiotics in animal agriculture. We believe, however, that finalization of the U.S. Food and Drug Administration (FDA) guidance documents will not have a meaningful impact on the way these life-saving drugs are administered to animals; thus, they will not slow the contribution of IFAP to our rapid progression toward a postantibiotic era. These guidances—nonbinding pleas for the cooperation of drug companies—do not call for an end to the use of antimicrobials in the absence of a microbial disease or documented disease exposure, as recommended by the Commission (2). Instead, they would effectively rebrand uses currently labeled “growth promotion” as “disease prevention.” Like growth promotion, prophylactic uses entail low, subtherapeutic doses and can span much of the animal’s life span. They apply continuous selective pressure for antibiotic resistance and may even induce new resistance-conferring mutations (3). Furthermore, the FDA’s proposal for veterinary oversight would eliminate the federal requirement that a valid “veterinarian-clientpatient relationship” exist before veterinarians order the use of antibiotics in feed, allowing veterinarians to prescribe antibiotics for use at

operations they have not visited recently for administration to animals they have never seen. The head of a large drug company recently told The Wall Street Journal that the guidances will not substantially affect revenues (4), implying that minimal changes to antibiotic sales are expected. This explains why companies support voluntary limits on their products: The limits will have little practical effect. We share Kennedy’s assessment of the problem, but instead would call for meaningful regulation—comparable to what he attempted as FDA commissioner almost four decades ago—to curb irresponsible antibiotic use. If such efforts fall short, legislative relief is needed.

Kennedy states that the FDA Guidance for Industry #213 “would end antibiotic use for growth promotion” and restrict prophylactic use in feed and water to veterinary prescriptions, but it must first be recognized that this is a guidance document only and has no enforcement authority. Furthermore, if low-dose concentrations of antibiotics continue to be allowed for preventive use (even by prescription), they provide a “back door” through which growth promotion effects can still be exploited under another name, thereby incentivizing industry to secure the needed prescriptions and essentially continue business as usual. In this respect, Kennedy’s enthusiasm for the new FDA guidelines may be overly optimis-

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Antibiotics: Call for Real Change

Don’t blame the Dingo

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tic. Rather, to truly deal with antibiotics, we are going to have to find innovative ways to reconfigure the production environments on animal farms that are grounded in sound husbandry principles and obviate the need for low-dose antibiotics in any form.

Thus, although the SCI or impact factor system has drawbacks, it is still a fair standard. More research is needed to build a system, based on impact factor or SCI, in which cheaters stand to lose more than they gain.

RAYMOND J. TARPLEY

Department of Automation, Tsinghua University, Beijing, 100084, China. E-mail: [email protected]

College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA. E-mail: [email protected]

References 1. M. T. Brewer et al., Am. J. Vet. Res. 74, 1078 (2013). 2. FDA Center for Veterinary Medicine, “Guidance for Industry #209: The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals” (www.fda.gov/downloads/AnimalVeterinary/ GuidanceComplianceEnforcement/GuidanceforIndustry/ UCM216936.pdf).

Science for Sale: Fair Evaluation Standards IN HER NEWS FOCUS STORY “CHINA’S PUBLICAtion bazaar” (29 November 2013, p. 1035), M. Hvistendahl points out that many scientists and organizations are starting to abandon the use of impact factors to evaluate a single researcher. Science leaders in China are considering new standards as well, such as total paper citations. The use of the Science Citation Index (SCI) may have some disadvantages, such as the financial incentives to forgery described in the article. However, in China, it may be the fairest standard to assess scientists. Without the SCI standard, the chance of getting research funding in China would be entirely based on the scientist’s relations with government. Using total paper citations or number of patents awarded would have similar problems, because both of these metrics can be influenced by money.

Letters to the Editor Letters (~300 words) discuss material published in Science in the past 3 months or matters of general interest. Letters are not acknowledged upon receipt. Whether published in full or in part, Letters are subject to editing for clarity and space. Letters submitted, published, or posted elsewhere, in print or online, will be disqualified. To submit a Letter, go to www.submit2science.org.

CAI LUO

Science for Sale: Authorship Confirmed IN HER NEWS FOCUS STORY “CHINA’S PUBlication bazaar” (29 November 2013, p. 1035), M. Hvistendahl highlighted the issue of scientific articles being for sale in China. This problem is not widely known by journal editors outside of China. The article indicated that a meta-analysis published in the Canadian Journal of Neurological Sciences (CJNS) was available for sale on 21 August 2012 on Core Editing’s blog, before submission of the paper to CJNS. At CJNS, we conducted an investigation of the paper in question. The corresponding author was able to provide detailed information of their data analysis, including screen shots of a list of files used for data analysis from the first author’s computer, output from the data analysis program used, copies of handwritten notes used for data analysis, records of discussion between the authors regarding the results, and previous versions of the paper. The authors also provided records of e-mail correspondences from February 2012 between the first author and the author of a paper included in the metaanalysis in which the first author asked and obtained data for the meta-analysis. These e-mail communications were independently verified by the U.S.-based author who provided the additional data. On the basis of this information, we concluded that the paper published in CJNS was the work of the first and the corresponding author of the paper. ROBERT CHEN Department of Medicine (Neurology), Toronto Western Hospital, University of Toronto, Toronto, ON M5T 2S8, Canada and Editor-in-Chief, Canadian Journal of Neurological Sciences. E-mail: [email protected]

www.sciencemag.org SCIENCE VOL 343 Published by AAAS

Science for Sale: Improve Ethics Education WE APPLAUD SCIENCE FOR ITS INVESTIGATIVE journalism on “China’s publication bazaar” (M. Hvistendahl, News Focus, 29 November 2013, p. 1035). This article should stimulate other journals to undertake similar research. Indeed, we would like to suggest that conducting such research become a standard component in the responsible conduct of research courses now required of all National Science Foundation (NSF)– funded students and postdocs. Unfortunately, the NSF requirement is, at many universities, met with minimalist online courses. Even at our own institution, there has been resistance to making ethics education mandatory for all graduate students. We believe that just as true science and engineering education requires original research or experimental designs rather than simply learning the results of others’ work, ethics education should include more than studying classic ethical theory, professional codes, and case studies. This would, however, require turning a one-credit course into a more substantial effort. Such a course would not only enhance ethics education. It could well benefit the fields of science and engineering, as well as the ways in which these fields serve society. Finally, we would recommend that courses in research ethics be required of all graduate students, not solely those who receive support from NSF or National Institutes of Health grants. CARL MITCHAM* AND ROEL SNIEDER Colorado School of Mines, Golden, CO 80401–1887 USA. *Corresponding author. E-mail: [email protected]

CORRECTIONS AND CLARIFICATIONS News Focus: “China’s publication bazaar” by M. Hvistendahl (29 November 2013, p. 1035). Wang Mouyue, managing director of the Chinese Medical Journal, was quoted incorrectly due to an error in transcription from the original Chinese. The article quotes Mr. Wang as saying that “China’s paper-selling market is very large, and there’s every sort of agency imaginable out there.” He actually said: “China’s paper-publishing market is very large, and there’s every sort of agency imaginable out there.” Also, the article stated that the Journal of Zhejiang University-SCIENCE is not indexed in SCI. The three journals under the title Journal of Zhejiang University-SCIENCE are all listed in SCI Expanded. The PDF and HTML versions online have been corrected to reflect these changes. In addition, the article described how Core Editing had advertised authorship for sale on 12 papers listed on its blog. The corresponding author of one of these papers, later published by the Canadian Journal of Neurological Sciences, has since provided documentation to Science and to the editor of the Canadian Journal of Neurological Sciences indicating that none of the authors paid to have their names added to the paper.

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Antibiotics: call for real change.

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