In trying to deal with AMR, banning of growth-promoting uses of AMs in Scandinavian countries has proven to work. I don't think asking for voluntary removal from labels will, as is being proposed in my country, will be sufficient. I also wonder if doing so only for medically-important AMs will be sufficient, as resistance can move among bacteria.
Considering the enormously challenging and expensive task of discovering and developing new antibacterial drugs for human use, and considering the inestimable importance of effective antibacterials to the practice of medicine, measures to slow down the inevitable development of resistance to those drugs are crucial. One way to do that is to prevent their use as animal growth promoters.
Since antibacterial drug resistance mechanisms are typically specific to the class of drugs (beta-lactams, macrolides, aminoglycosides, fluoroquinolones, etc), the distinction between medically important and medically unimportant drugs should be framed instead in terms of medically important versus unimportant classes of drugs. New medically important classes of drugs come along very infrequently. Their useful life before clinical resistance frequency and severity shelve them should be protected, in my personal opinion, by an absolute ban on their use as animal growth promoters. For existing drug classes for which resistance mechanisms are already in place and increasing in prevalence, the utility of such a ban might be reduced.
The Obama administration recently announced the National Action Plan for Combating Antibiotic-Resistant Bacteria
https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf
One aspect of this plan is to reduce the use of antibacterials as animal growth promoters (goal 1.2)
"Eliminate the use of medically-important antibiotics for growth promotion in food- producing animals and bring other agricultural uses of antibiotics, for treatment, control, and prevention of disease, under veterinary oversight."
I don't think it is likely that growth-promoting use of antibacterials in animal husbandry will end voluntarily as long as there is a financial benefit to the producers of the compounds, the animal feed, and the animals for it to continue. Consumers may also benefit in the form of lower prices for meat. My opinion is that legislation would be required to stop it, but such legislation would be difficult to achieve because of opposition from the above-mentioned interest groups. Moreover, since bacteria and animals and people bearing them cross international borders, any such legislation would have to be enacted all over the world to be truly effective.
Thank you very much Mr Adam for your reply.
Voluntary withdrawal wuld atleast partially work. Mandatory withdrawal is likely to help in a bigger way. But question is that we all are talking aboiut the use of antibiotics in animals. but not in Human-- say for example In India without prescription over the counter one can get almost all kinds of antibiotics. Further many are not consulting Medical practioners and following their self prescribed medication(specially antibiotics) which is creating big problem. Further in a country like India very few treatment are done by practically evaluating the sensitivity pattern and mostly antibiotics are prescribed assuming that it will work. Further there is no national antibiotic consumption record (both in Human and in Veterinary Medicine ) and there is no concerted effort in surveillance of Antimicrobial resistance and their spatio-temporal distribution from wwhich one can learn and make use of the antibiotics effectively.
Further, Most amnimal and Human pathogens are clonally distinct. Eventhough host jump is established, directly one can not simply attribute random pathogen jump to host. T%ake for example of MRSA or ESBL producers--In India if one sees the scenario in Human medicine and Veterinary medicine -- one would find that in comparison to Hospital set up(human medicine), very negligible resisnce vis found in animal p[athogens (less than 5% for both MRSA and ESBL producer).
Therefore, it is a much bigger problem than we generally perceive. Worldwide it has received attention and its impact on actions taken are becoming visible in many countries, but in developing countries including India it is in very bad shape. Political leadership and the scientific fraternity should use their wisdom and make action plan before it becomes too late (in developing countries).
I am fustrated that the funding agencies are not using their wisdom to appreciate the dimension of the problem in a country like india still.
Past experience seems to indicate that the reaction of the farmers to any attempt to ban an antibiotic used as growth promoter or as a prophylactic is "This will destroy the sector of (fill in animal of choice) raising". This has of course turned out to be untrue in those cases when such a ban was implemented (see avoparcin). HOWEVER: in my opinion the link between the use of growth promoters and resistance emergence has not been unequivocally proven and the literature showing that such links are are dubious, is rich (I'm probably going to get flamed for this). You may look up papers dealing with the influence of banning growth promoters on the prevalence of resistant bacteria or the magnitude of such prevalence in the absence of such drugs. This said, in addition to an eventual influence of growth promoters, these drugs may have additional negative impacts such as the one on the enteric microflora and thus the tendency to stop their use is justified.
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