Agriculture and food animals as a source of antimicrobial-resistant bacteria

Figures & data

Table 1 Sales (tons of active ingredient) of veterinary antimicrobial agents applicable mainly for food-producing animals, including horses, on average per European Union member state between 2005 and 2012^22–25

Antimicrobial class	2005	2006	2007	2008	2009	2011	2012
Tetracyclines	148.6	143.7	157.4	134.4	119.0	123.2	113.2
Amphenicols	1.0	1.1	1.3	1.1	1.1	2.0	2.2
Penicillins	34.7	35.7	35.0	35.7	37.1	77.9	68.5
Cephalosporins (total)	1.7	1.9	1.9	1.9	1.7	0.6	0.8
First- and second-generation cephalosporins	1.3	1.3	1.3	1.1	1.3	0.3	0.3
Third- and fourth-generation cephalosporins	0.4	0.4	0.4	0.4	0.4	0.6	0.5
Sulfonamides and trimethoprim (total)	53.7	53.3	56.6	51.6	48.7	72.6	36.7
Sulfonamides	46.0	45.7	48.9	44.6	42.0	36.3	31.8
Trimethoprim	7.7	7.6	7.7	7.0	6.7	5.5	5.0
Macrolides	21.3	24.0	24.4	23.3	21.0	27.2	24.5
Lincosamides	2.3	2.0	2.0	1.7	1.7	9.7	9.0
Aminoglycosides	14.6	14.4	13.9	13.0	13.0	6.6	11.2
Quinolones (total)	4.6	4.6	4.4	4.0	3.3	10.9	7.2
Fluoroquinolones	0.9	1.0	1.0	0.9	1.0	5.5	5.2
Other quinolones	3.7	3.6	3.4	2.9	2.1	2.2	1.9
Polymyxins	10.0	10.1	11.3	10.1	10.3	22.4	21.0
Pleuromutilins	2.7	2.6	3.0	3.6	3.6	8.5	8.8
Others*	0.4	0.4	0.4	0.6	0.7	9.0	3.9
Total	295.6	293.7	311.6	280.9	261.1	336.8	307.0

Notes:

* Others include bacitracin, paromycin, spectinomycin, polymyxins, and amphenicols. Data were derived for cumulative reports involving seven European Union member states in 2005-2009, 25 in 2011, and 26 in 2012. Data from the European Medicines Agency.^22–25

Table 2 Antimicrobial drugs approved for use in food-producing animals actively marketed in the United States between 2009 and 2012 (tons of active ingredient)

Drug class	2009	2010	2011	2012
Aminoglycosides	223.12	211.79	214.89	273.53
Cephalosporins	20.14	24.59	26.61	27.65
Lincosamides	93.33	154.65	190.1	218.14
Macrolides	562.06	553.23	582.84	616.27
Penicillins	691.64	884.42	885.3	965.2
Sulfonamides	505.9	517.13	383.1	493.51
Tetracyclines	5,260.99	5,602.28	5,652.85	5,954.36
Ionophores	3,739.35	3,820	4,122.4	4,573.79
Not independently reported (medically important)*	329.39	281.22	319.99	344.43
Not independently reported (not medically important)†	1,161.54	1,237.78	1,190.94	1,151.53
Total	14,618.43	12,587.46	13,287.1	13,569.04

Notes:

* Amphenicols, diaminopyrimidines, fluoroquinolones, and streptogramins;

† aminocoumarins, glycolipids, pleuromutilins, polypeptides, and quinoxalines. Data from the FDA Center for Veterinary Medicine.^25–28

Abbreviation: FDA, US Food and Drug Administration.

Table 3 Priority actions agreed in the Third World Healthcare Associated Infections Forum

Stakeholders	Priority actions
Policy makers and health authorities	1. Animals. Stop the administration of antibiotics used in human medicine and limit antibiotics to therapeutic use only. It is imperative to reserve the most important classes of antibiotics for humans.
	2. Banish, in all countries, the use of antibiotics as growth promoters in animal feed.
	3. Regulate the sale of antibiotics for use in human medicine and prohibit over-the-counter sales worldwide.
	4. Have international organizations (World Health Organization, European Union) develop a charter on good antibiotic stewardship and have all the ministries of health worldwide sign it and commit to respecting it.
Human and veterinary health care communities	1. Establish standardized, universal surveillance of antibiotic use and resistance and monitor the emergence and spread of new forms of bacterial resistance.
	2. Include, in medical and veterinary school curricula, a solid training in bacterial resistance and the prudent use of antibiotics, and establish on-the-job training programs for health care workers, taking into account the cultural specificities of each country.
General public	1. Develop culturally sensitive awareness campaigns, targeted to the general public, explaining the importance of protecting antibiotics and using them only when absolutely necessary.
	2. Provide education about fundamental hygiene, such as handwashing, to prevent the spread of infection. It is imperative to improve sanitation systems to eliminate resistant bacteria in wastewater.
	3. Include consumers in the development and implementation of action plans.
Industry	1. Develop point-of-care and rapid diagnostic tests, which can be used at the patient’s bedside or in the doctor’s office, to guide the prescription of antibiotics and avoid their prescription for viral infections.
	2. Stimulate research and development of novel antibiotics.
	3. Find new economic models that reconcile public health interests with Industry needs for profitability.

Note: Data from Jarlier V, Carlet J, McGowan J, et al; Participants of the 3rd World Healthcare-Associated Infections Forum. Priority actions to fight antibiotic resistance: results of an international meeting. Antimicrob Resist Infect Control. 2012;1(1):17.¹⁴²

European Medicines AgencyTrends in the Sales of Veterinary Antimicrobial Agents in Nine European Countries (2005–2009)European Medicines Agency2011 Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Report/2011/09/WC500112309.pdfAccessed December 15, 2014

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FDA Center for Veterinary Medicine2009 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing AnimalsUS Food and Drug Administration2014 Available from: http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM231851.pdf Accessed December 15, 2014

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FDA Center for Veterinary Medicine2012 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing AnimalsUS Food and Drug Administration 2014 Available from: http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM416983.pdfAccessed December 15, 2014

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JarlierVCarletJMcGowanJParticipants of the 3rd World Healthcare-Associated Infections ForumPriority actions to fight antibiotic resistance: results of an international meetingAntimicrob Resist Infect Control2012111722958318

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