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End non-essential use of antimicrobials in livestock

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k259 (Published 29 January 2018) Cite this as: BMJ 2018;360:k259
  1. Alison Holmes, professor1,
  2. Mark Holmes, reader2,
  3. Thomas Gottlieb, senior specialist3,
  4. Lance B Price, professor4,
  5. Arnfinn Sundsfjord, professor5
  1. 1Department of Infectious Diseases and the NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, UK
  2. 2Department of Veterinary Medicine, University of Cambridge, UK
  3. 3Department of Microbiology and Infectious Diseases, Concord Hospital, Sydney, Australia
  4. 4Milken Institute School of Public Health, George Washington University, Washington DC, US
  5. 5Department of Medical Biology, Faculty of Health Sciences, University of Tromsø -The Arctic University of Norway
  1. Correspondence to: alison.holmes{at}imperial.ac.uk

A rational response by WHO to the crisis in antimicrobial resistance

Tackling antimicrobial resistance (AMR) is a priority of the World Health Organization’s public health agenda, and in November 2017 the organisation launched guidelines on the use of medically important antimicrobials in the food production industry. Their unambiguous recommendations were that their routine use for animal growth promotion and disease prevention in healthy animals should be discontinued (box 1).1 In line with the global action plan on AMR,2 the aim is to help preserve the effectiveness of antimicrobials critical for human medicine. As a supranational body, WHO has taken the opportunity to put independent pressure on healthcare policy makers to now respond to its challenge.

Box 1

Recommendations from WHO1

  1. An overall reduction in use of all classes of medically important antimicrobials in food producing animals

  2. Complete restriction of use of all classes of medically important antimicrobials in food producing animals for growth promotion

  3. 3 Complete restriction of use of all classes of medically important antimicrobials in food producing animals for prevention of infectious diseases that have not yet been clinically diagnosed

  4. 4a Suggest that antimicrobials classified as critically important for human medicine should not be used for control of the dissemination of a clinically diagnosed infectious disease identified within a group of food producing animals

  5. 4b Suggest that antimicrobials classified as highest priority (see below) critically important for human medicine should not be used for treatment of food producing animals with a clinically diagnosed …

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