Antibiotics: expect to use less, more responsibly

Abstract

Antibiotic resistance has probably been around for a few billion years. After all, most modern antibiotics have their origins in bacteria and fungi (balz 2007, Silver 2011), organisms that have long waged pharmacological warfare against one another. it is possible, for example, to find multidrug-resistant bacteria deep within caves that have been isolated for millions of years (bhullar and others 2012). However, 65 years of widespread medical and veterinary antibiotic use has exerted strong evolutionary pressures on the populations of bacteria that human and veterinary health systems routinely encounter. Resistance has become more common and more troublesome; no longer a narrow technical problem for microbiologists and drug developers. in the past five years, antimicrobial drug resistance has climbed the political agenda (Davies 2011, Department of Health and Defra 2013) (Fig 1), with initiatives underway at the European level, in the USA, the UK, Holland, Denmark, and many other countries. in 2014, the Prime Minister established an independent Review on Antimicrobial Resistance, the o'neill Review. this was charged with analysing the situation and proposing concrete national and international actions to help tackle the problem (Review on Antimicrobial Resistance 2015). We, and colleagues at the innogen institute at Edinburgh university, were commissioned by the Economic and Social Research council (ESRc) and the o'neill Review to assess the barriers to the development and introduction of new antimicrobial drugs and diagnostics for both human and veterinary use (tait and others 2014, Scannell and bruce 2014). We focused on regulatory hurdles and on the challenges seen by commercial drug and diagnostics companies. We reviewed the literature, and interviewed drug and device regulators, trade associations, investors, and drug, biotechnology and diagnostic companies. in this article, we illustrate some of our findings. no one knows yet exactly what the o'neill Review will recommend, nor how the recommendations of the various overlapping policy initiatives from around the world will play out. However,

Consumer Preferences and Attitudes towards Antibiotic Use in Food Animals

“…The pressure to reduce use of antibiotics in animal agriculture will continue. To quote: "It would be a brave politician who, after having made the electorate and their children jump through inconvenient and expensive hoops before being prescribed an antibiotic, would not expect livestock and companion animals to jump even higher" ( [40], p. 169).…”

Introduction to the World Association for Veterinary Dermatology and the Clinical Consensus Guidelines

“…In recent years there has been a growing contribution from social scientists in relation to the eradication of notifiable diseases such as tuberculosis in cattle––where, for example, engagement with farmers has been seen as a major factor in supporting the implementation of measures to control the spread of disease . Another area where veterinarians have seen the need and value to call upon social scientists is in the (wider) debate about who uses antibacterial agents in animals (in livestock and pets) and how their use can be rationalized, given the growing concerns about antimicrobial resistance …”