Critically important antibiotics: criteria and approaches for measuring and reducing their use in food animal agriculture

Scott, H. M.; Acuff, G. R.; Bergeron, Gilles; Bourassa, Megan W.; Gill, Jason J.; Graham, David W.; Kahn, Laura H.; Morley, Paul S.; Salois, Matthew; Simjee, Shabbir; Singer, Randall S.; Smith, Tara C.; Storrs, Carina; Wittum, Thomas E.

doi:10.1111/nyas.14058

Cited by 101 publications

(67 citation statements)

References 6 publications

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“…This is in accordance with previous reports from the same region [ 10 ]. Fluoroquinolones are one of the most valuable antibiotic classes for the treatment of human infections and many countries have reduced their use in food-producing animals [ 2 , 27 ]. Thus, the careful monitoring of resistance to these agents is needed, especially among animals sent for slaughter and subsequently reaching the consumers.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance in Fecal Escherichia coli from Humans and Pigs at Farms at Different Levels of Intensification

et al. 2020

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The overall aim of the current study was to test the hypotheses that (i) antibiotic resistance in bacteria were more frequent in clinically health pigs in intensified company owned, medium-scale farms (MSFs) (100–500 sows) than in pigs in family-owned, small-scale farms (SSFs) (1–50 sows) and (ii) that farmers working at the MSFs were more prone to attain antibiotic resistant bacteria than farmers working at SSFs. The study was conducted in North-Eastern Thailand, comprising fecal Escherichia coli isolates from pigs, farmers working with the pigs (contact humans) and persons living in the same household as the farmer (non-contact humans) at 51 MSFs and 113 SSFs. Samples from all farms were also screened for methicillin-resistant staphylococcus aureus (MRSA), which was not detected in pig samples, but was found in one human sample. Susceptibility was tested by disc-diffusion for seven antibiotics commonly used in the study area. Resistance in pig isolates from MSFs were more frequent for chloramphenicol which (P < 0.001), trimethoprim/sulfamethoxazole (P < 0.001) and gentamicin (P < 0.05) compared with isolates from SSFs, whereas the opposite was true for tetracycline (P < 0.01). Resistance in the human isolates was lower than those in the isolates from pigs for tetracycline, trimethoprim/sulfamethoxazole and chloramphenicol (P < 0.001). The frequency of resistance in the contact human samples from SSFs and MSFs did not differ. There was no difference between isolates from contact and non-contact humans for any of the tested antibiotics. Multidrug resistance in isolates from pigs was 26%, significantly higher (P < 0.01) than the 13% from humans. The data indicate that (i) resistance to antibiotics, including those critical and highly important for human medicine, were more common in fecal E. coli from pigs at the MSFs than at the SSFs, whereas (ii) the resistance in fecal E. coli from pig farmers seemed not to be influenced by the level of intensification of the farm they were working at.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance in Fecal Escherichia coli from Humans and Pigs at Farms at Different Levels of Intensification

et al. 2020

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“…Increased marketing efforts were undertaken by some marketing authorization holders for veterinary medicinal products containing fluoroquinolones shortly after the amendment of the regulation came into force, but might have been conducted for products containing cephalosporins of the 3 rd or 4 th generation as well. Without the provision of use data, the situation cannot be profoundly evaluated [ 63 , 65 , 77 ].…”

Section: Discussionmentioning

confidence: 99%

Eight years of sales surveillance of antimicrobials for veterinary use in Germany—What are the perceptions?

et al. 2020

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A surveillance system for sales volumes of antimicrobial agents for veterinary use was established in Germany in 2011. Since then, pharmaceutical companies and wholesalers have been legally obliged to report annual volumes of veterinary antimicrobial products sold to veterinary practices or clinics located in Germany. The evaluation of sales volumes for eight consecutive years resulted in a considerable total decrease by 58% from 1706 tons to 722 tons. During the investigation period, two legally binding measures to control the risk of antimicrobial resistance resulting from the veterinary use of antimicrobials were introduced, a) the German treatment frequencies benchmarking in 2014 and b) the obligation to conduct susceptibility testing for the use of cephalosporins of the 3 rd and 4 th generation and of fluoroquinolones in 2018. Both had a marked impact on sales volumes. Nonetheless, the category of Critically Important Antimicrobials as defined by the World Health Organization kept accounting for the highest share on sales volumes in Germany in 2018 with 403 tons, despite an overall reduction by 53%. Sales surveillance is considered essential for data retrieval on a global scale and inter-country comparison. However, the usability of a surveillance system based on sales data for risk management of antimicrobial resistance has limitations. The German system does not include off-label use of antimicrobial products authorized for human medicine and does not allow for identification of areas of high risk according to animal species, farm and production types and indications for treatment. For further reduction and enhanced promotion of a prudent use of antimicrobials, targeted measures would be required that could only be deducted from use data collected at farm or veterinary practice level. A surveillance system based on use data is currently lacking in Germany but will be established according to Regulation (EU) 2019/6 on veterinary medicinal products.

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“…In addition to soil-transmitted helminths, there is increasing recognition of the food-borne trematode infections and concerns around the development of resistance to triclabendazole ( Fairweather et al, 2020 ). However, in our communications around resistance we must take care not to confound the discussion about anthelmintic resistance, with the concerns around the use of critically important antibiotics in human and veterinary medicine ( Scott et al, 2019 ). One advantage here is that parasites are typically host-selective and specific, so there are few parasites that are both (1) infectious for both humans and animals; and (2) exposed to anthelmintics in both worlds ( Sibley and Hunt, 2003 ).…”

Section: Challenge Of Resistance and Ongoing Managementmentioning

confidence: 99%

Where are all the anthelmintics? Challenges and opportunities on the path to new anthelmintics

Nixon

Welz

Woods

et al. 2020

International Journal for Parasitology: Drugs and Drug Resistan

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Control of helminth parasites is a key challenge for human and veterinary medicine. In the absence of effective vaccines and adequate sanitation, prophylaxis and treatment commonly rely upon anthelmintics. There are concerns about the development of drug resistance, side-effects, lack of efficacy and cost-effectiveness that drive the need for new classes of anthelmintics. Despite this need, only three new drug classes have reached the animal market since 2000 and no new classes of anthelmintic have been approved for human use. So where are all the anthelmintics? What are the barriers to anthelmintic discovery, and what emerging opportunities can be used to address this? This was a discussion group focus at the 2019 8th Consortium for Anthelmintic Resistance and Susceptibility (CARS) in Wisconsin, USA. Here we report the findings of the group in the broader context of the human and veterinary anthelmintic discovery pipeline, highlighting challenges unique to antiparasitic drug discovery. We comment on why the development of novel anthelmintics has been so rare. Further, we discuss potential opportunities for drug development moving into the 21st Century.

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Critically important antibiotics: criteria and approaches for measuring and reducing their use in food animal agriculture

Cited by 101 publications

References 6 publications

Antimicrobial Resistance in Fecal Escherichia coli from Humans and Pigs at Farms at Different Levels of Intensification

Antimicrobial Resistance in Fecal Escherichia coli from Humans and Pigs at Farms at Different Levels of Intensification

Eight years of sales surveillance of antimicrobials for veterinary use in Germany—What are the perceptions?

Where are all the anthelmintics? Challenges and opportunities on the path to new anthelmintics

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