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Does adding routine antibiotics to animal feed pose a serious risk to human health?

BMJ 2013; 347 doi: (Published 10 July 2013) Cite this as: BMJ 2013;347:f4214
  1. David Wallinga, physician member of steering committee1,
  2. David G S Burch, veterinarian2
  1. 1Keep Antibiotics Working: the Campaign to End Antibiotic Overuse in Animal Agriculture, 305 Brimhall Street, St Paul, MN 55105, USA
  2. 2Octagon Services, Old Windsor, Berkshire SL4 2NR, UK
  1. Correspondence to: D Wallinga dwallinga{at}, D G S Burch d.burch{at}

As fears rise over resistance, some countries have banned routine use of antibiotics in animal feed. David Wallinga says a ban is possible without damaging food productivity, but David G S Burch argues that the drugs used in agriculture are not those causing problems with resistance in humans

Yes—David Wallinga

You cannot dispute the warning of England’s chief medical officer, Sally Davies, that antibiotic resistance is one of modern health’s greatest threats. Also beyond dispute is her analysis of its causes—the lack of new drugs combined with massive overuse of existing antibiotics. What physicians and policy makers generally overlook, however, is the critical role played by the ongoing overuse of antibiotics in livestock and poultry production. Enforceable measures to reduce this overuse must be core to any effort to avert the coming catastrophe. Because meat production is global in nature, these measures must be implemented nationally and supranationally.

Cost of resistance

Resistant infections generally cause more morbidity, mortality, and longer periods in hospital. In the United States alone, associated treatment costs add as much as $26bn (£17bn; €20bn) to the nation’s annual hospital bill; in 2012 dollars, the figure could be nearly $35bn, closer to $70bn if lost work and other societal costs are included.1 2

It will get worse. Ten times more cases of meticillin resistant Staphylococcus aureus occurred in US children’s hospitals in 2008 than a decade earlier.3 From 2000 to 2009, admissions to hospital associated with Clostridium difficile doubled to 336 000,4 while deaths have tripled. Infections by deadly extended spectrum β-lactamase producing Enterobacteriaceae (especially Escherichia coli) are on the rise, in hospital and in communities.5 The World Health Organization states that bacteria – including antimicrobial resistant bacteria—commonly transferring from food animals to people comprise Salmonella, Campylobacter, E coli, and Enterococcus species. Emerging evidence shows that S aureas, …

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