Antibiotic Stewardship in Food-producing Animals: Challenges, Progress, and Opportunities

Sameer J. Patel*, Matthew Wellington, Rohan M. Shah, Matthew J. Ferreira

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

132 Scopus citations

Abstract

Purpose: Approximately two thirds of the tonnage of antibiotics sold in the United States are intended for use in food production, and global use is projected to increase. This review summarizes the rationale for antibiotic use in animal agriculture, therapeutic classes used, risks from antibiotic-resistant organisms, and limits of existing regulation. In addition, opportunities for improved surveillance, stewardship, and advocacy will be highlighted. Methods: A transdisciplinary narrative review of drivers of antibiotics in food production was conducted, including concepts from population health, infectious diseases, veterinary medicine, and consumer advocacy. Findings: Globally, antibiotics of many important classes in human medicine are given to animals for the treatment of a diagnosed illness, disease control and prevention, and growth promotion. Extensive antibiotic use on farms drives the emergence of antibiotic-resistant organisms in food-producing animals, which can be transmitted to people and the environment. Antibiotic stewardship in food production has been associated with decreased rates of resistance in both animals and humans, without reducing farm productivity. Multiple European nations have successfully implemented stewardship strategies, including banning uses for disease prevention, benchmarking antibiotic utilization, and setting national reduction targets. In the United States, medically important antibiotics are no longer permitted for growth promotion; however, antibiotics may be prescribed for other indications with limited veterinary oversight and requirements for reporting. Marked reductions in use have been achieved in the poultry industry, although use in the pork and beef industries remain high. Implications: Despite some progress, significant challenges in surveillance and regulatory oversight remain to prevent the overuse of antibiotics in food production. Consumers remain a potent force via market pressure on grocery stores, restaurants, suppliers, and farmers. Improved, verified labelling is important for informing consumer choices. Numerous public health agencies, consumer groups, and professional societies have called for judicious antibiotic use, but increased direct advocacy from health care professionals is needed.

Original languageEnglish (US)
Pages (from-to)1649-1658
Number of pages10
JournalClinical Therapeutics
Volume42
Issue number9
DOIs
StatePublished - Sep 2020

Funding

M. Wellington is the Public Health Campaigns Director of US PIRG and US PIRG Education Fund and the Director of the Comprehensive Champions in Antibiotic Stewardship (CCCAS) Collaborative. US PIRG advocates for the responsible use of antibiotics in animal agriculture. The CCCAS Collaborative is a joint committee of Health Care Without Harm, the Pediatric Infectious Diseases Society, the Sharing Antimicrobial Reports for Pediatric Stewardship group, and the US Public Interest Research Group, which advocates for responsible use of antibiotics in animal agriculture. S. Patel is a steering committee member of CCCAS and a volunteer with US PIRG and Illinois PIRG and has received education funding from the Ann & Robert H. Lurie Children's Hospital of Chicago for advocacy work related to promoting antibiotic stewardship in animal agriculture. M. Ferreira is an employee of the Directorate of Operational Medicine, Bureau of Medical Services with the US Department of State. The authors have indicated that they have no conflicts of interest with regard to the content of this article.

Keywords

  • Food production
  • Resistance
  • Stewardship

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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