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Antimicrobial resistance will surge unless use of antibiotics in animal feed is reduced

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6050 (Published 07 October 2013) Cite this as: BMJ 2013;347:f6050
  1. Anne Gulland
  1. 1London

The use of antibiotics in agriculture must be curbed in a bid to stop the growing threat of antimicrobial resistance, England’s chief medical officer, Sally Davies, has said.

Davies told a meeting on antimicrobial resistance at the Royal Institute of International Affairs (Chatham House) in London that 70% of the antibiotics dispensed in the United States were used in animals, particularly in agriculture, where they were used to encourage growth in livestock destined for human consumption.

“One of the things that worries me is the massive use of antibiotics in animals. I think we have this the wrong way round. The vets need to prove why they need so many antibiotics, and it’s not up to [human health experts] to prove they are unsafe,” she said.

One delegate at the conference, the majority of which was held under the Chatham House rule that states that those attending should not be identified by name in the media, to enable them to speak freely, said that vets were “drug dealers,” as it was in their financial interest to sell drugs to their customers.

Davies added that if farming and other agricultural sectors improved their hygiene they would not need so many antibiotics.

Didier Pittet, director of the infection control programme and the WHO Collaborating Centre on Patient Safety at University of Geneva Hospitals, told the BMJ that the global nature of the food industry added to the complexity of the problem, with food produced in one country and packaged in another.

The UK and the Nordic countries were examples of good practice on antimicrobial resistance policies, but there had to be a global approach to the problem, said Pittet. “It makes no sense to have one country being perfect about the use of antibiotics in human and animals but the next door country is not good. We live in a complex world, and the rules and regulations are different in every country.”

Davies said that WHO would come up with a resolution on antimicrobial resistance at its 2014 executive board meeting in January, which would “raise the issue up the agenda.”

One speaker said that there were large gaps in surveillance of the threat of antimicrobial resistance, with a lack of population based data to show its effects on morbidity and mortality.

The conference heard about inappropriate use of antibiotics in developing countries, with such drugs often being available over the counter. One conference delegate compared the private pharmaceutical sector in the developing world to a “failed state.” Another said that in India antibiotics were doing the “heavy lifting of reducing the burden of infectious disease” in the absence of improved hygiene and sanitation.

Jennifer Cohn, medical coordinator at the charity Médecins Sans Frontières, said that the developing world was seeing “alarming rates” of antibiotic resistance.

Davies told the conference that there was a “discovery void” in the development of new antibiotics. Patrick Vink, senior vice president at the US based company Cubist Pharmaceuticals, which has three new antibiotics in the pipeline for use in acute care, told the BMJ that academia also had a role in encouraging researchers to study antimicrobial resistance.

“Oncology is more popular in academia than anti-infectives,” he said. He added that investors wanted predictability and that “moving the goal posts” on drug prices was not helpful to smaller companies developing new drugs.

Notes

Cite this as: BMJ 2013;347:f6050

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