Intended for healthcare professionals

Feature Antimicrobial Resistance

Saving antibiotics for when they are really needed: the Dutch example

BMJ 2016; 354 doi: (Published 03 August 2016) Cite this as: BMJ 2016;354:i4192
  1. Tony Sheldon, journalist
  1. Netherlands
  1. tonysheldon5{at}

Doctors have responded well to the call to reduce unnecessary antibiotic prescriptions. But what about farming? The Dutch have shown that antibiotic use can be slashed in agriculture too. So why isn’t everybody doing it? Tony Sheldon reports

“Dutch healthcare uses the fewest antibiotics in the world,” is the bold and justifiable claim of the Dutch Health Council, the government’s independent scientific advisers. The country has had low use for decades.1 Yet in veterinary medicine the Netherlands, the world’s second largest exporter of agri-food products (after the United States), was, until a few years ago, among the highest users. This mismatch sparked action that saw the country cut antibiotic use in farm animals by nearly 60% from 2007 to 2015.2 3

Today the Netherlands has one of the lowest levels of antimicrobial resistance in the world, and it believes the only way to keep resistance levels down is for health and agricultural sectors everywhere to work together in what it calls a “One Health” approach.

“If we want to control a problem in healthcare we need to act everywhere where antibiotics are used. Because of the continuous evolution of resistance, any reservoir could be a source of resistant organisms to humans,” says Dik Mevius, head of the National Reference Laboratory on Antimicrobial Resistance in Animals at the Central Veterinary Institute at Wageningen University.

In June, after pushing the issue for six months while holding the rotating EU presidency, the Netherlands convinced the 28 countries of the EU to commit to launching One Health national antimicrobial resistance action plans by mid-2017.4

Edith Schippers, Dutch health minister, said that even though countries have different situations and are at different stages in developing national plans to tackle antimicrobial resistance, “differences between member states cannot be a reason to hinder progress …

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