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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

Rapid Response:

Food for thought: Can restriction of antibiotic overuse help tackle the human obesity epidemic?

Antibiotics are widely used not only to prevent infections in poultry and animals but also as growth promotors and weight gain enhancers in livestock reared for the food industry. The pathophysiological mechanisms underlying these growth enhancing properties of antibiotics are not well understood. (1) (2).

As regards humans, a systemic review has found that "Antibiotics have a growth promoting effect in prepubertal children in low and middle income countries" (3). In a recent study, Antibiotic overuse has been linked to childhood obesity and obesity rates (4).

So it is reasonable to hypothesise that antibiotics may be partly responsible for the obesity epidemic in humans and that restriction of antibiotic usage both in livestock and humans would positively impact the obesity epidemic.


1. Sheldon T. Saving antibiotics for when they are really needed: the Dutch example. BMJ 2016; 354 doi:

2. Dibner JJ, Richards JD. Antibiotic growth promoters in agriculture: history and mode of action. Poultry Science (2005) 84 (4):634-643. doi: 10.1093/ps/84.4.634.

3. Gough EK, Moodie EE, Prendergast AJ, Johnson SM, Humphrey JH, Stoltzfus RJ, et al. The impact of antibiotics on growth in children in low and middle income countries: systematic review and meta-analysis of randomised controlled trials. BMJ. 2014 Apr 15;348:g2267. doi: 10.1136/bmj.g2267.

4. Bailey LC, Forrest CB, Zhang P, Richards TM, Livshits A, DeRusso PA. Association of antibiotics in infancy with early childhood obesity. JAMA Pediatr. 2014 Nov;168(11):1063-9. doi: 10.1001/jamapediatrics.2014.1539

Competing interests: No competing interests

23 August 2016
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospital NHS Trust