Antibiotics Factsheet
Background
What is AMR?
Antimicrobials refer to drugs that kill or inhibit the growth of microorganisms, such as bacteria, viruses, fungi, and parasites. Antimicrobials include antibiotics, antifungals, antiprotozoals, and antivirals. Antimicrobial resistance (AMR) occurs when microorganisms evolve to become partially or fully resistant to once effective antimicrobial drugs. Antimicrobial resistance is a natural phenomenon which occurs as microbes become exposed to antimicrobial substances. However, antimicrobial resistance is accelerated by the overuse or misuse of antimicrobials, notably in animal agriculture and aquaculture.
How is AMR a threat?
Antimicrobial resistance is a threat to public health and can occur in humans, animals and the environment. Antimicrobial resistant microorganisms can spread to humans directly from animals, either through contact with animals or via consumption of animal-derived products such as meat, or indirectly, via the environment such as through drinking water, contaminated air or soil. As a result, antimicrobial resistance renders a lot of antimicrobials, including antibiotics, ineffective in treating common infectious diseases.
How is animal agriculture a major driver of AMR?
The routine use of antimicrobials developed after WWII, enabling the evolution and acceleration of industrial farm animal production, by limiting the incidence and spread of diseases in animals with weakened immune systems due to high stress levels and unsanitary housing conditions. The use of antimicrobials in industrial farm animal production has been a significant driver of antimicrobial resistance, and hence poses major risks to human and animal health. Approximately 70% of all antimicrobials worldwide are used in food animals. Antimicrobials are used across all animal source food production sectors, in terrestrial animals, but also aquatic animals, like fish. Although the type and extent of use of antimicrobials in animal agriculture varies greatly between jurisdictions, mainly due to differences in regulation, the use of antimicrobials for both therapeutic and non-therapeutic purposes within intensive systems is common practice globally.
Despite regulatory efforts in meat and fish-producing countries, it is estimated that the use of antimicrobials in animal agriculture will continue to grow, especially in countries where the demand for animal source proteins is increasing, such as in the BRIC countries. Today, there already are multidrug resistant microorganisms, such as Staphylococcus aureus, which is prevalent in pigs, and has spread to humans via livestock workers.
How and Why Antimicrobials Used?
Therapeutic use refers to the administration of antibiotics to treat diseases that have been diagnosed by a licensed veterinarian. On the other hand, non-therapeutic use of antimicrobials involves the administration of low, sub-therapeutic doses of antimicrobial agents to otherwise healthy animals that have not been diagnosed with a disease. Non-therapeutic use pursues two, overlapping, purposes: first, a preventive purpose to control the spread of infections, also called prophylaxis; second, a productivity purpose, as the use of very low, sub-therapeutic levels of antimicrobials have the effect of stimulating growth in animals (i.e., the animals grow faster and fatter).
Some administration methods can blur the lines between therapeutic use and non-therapeutic use. Such is the case of metaphylaxis, whereby a whole herd or flock of animals is administered a high dose of antimicrobials (usually antibiotics) after a few animals are found to be carrying a disease.
Similarly, it is hard to differentiate between the non-therapeutic use of antimicrobials for prevention purposes and the non-therapeutic use of antimicrobials as growth promoters because, in both cases, the antimicrobials and volumes administered are similar.
In any case, many of the antimicrobial agents for non-therapeutic use are the same agents as antimicrobials used to cure diseases, including in humans. For this reason, the non-therapeutic use of antimicrobials in food production is restricted in some jurisdictions, such as the EU, where the use of antimicrobials as growth promoters is prohibited.
Key Considerations
When evaluating, drafting or comparing laws and policies related to the use of antimicrobials, local context, political feasibility and the regulatory environment all influence what one considers “Better Practice.” With that caveat in mind, the following considerations indicate better and worse practices for laws and policies.
1. Prohibiting the Misuse of Antimicrobials in Animal Agriculture
Regulation on the use of antimicrobials in animal agriculture should prohibit practices that are tantamount to a misuse of antimicrobials. This would entail a ban on the use of antimicrobials for all non-therapeutic purposes.
A good example of a regulation in the use of antimicrobials for non-therapeutic purposes can be found at Article 107 of the EU Regulation 2019/6 on Veterinary Medicinal Products, which lists prohibited use, including: the routine use of antimicrobials, the use of antimicrobials to compensate for poor hygiene or inadequate animal husbandry; and the use of antimicrobials for growth promotion purposes.
2. Accurate Classification of Antimicrobial Agents
Regulation on the use of antimicrobials in animal agriculture should also properly categorise antimicrobial agents. Such categorisation should distinguish whether or not a particular agent is an antimicrobial, in addition to grading the agent on the level of its importance for human and animal health. This categorisation should follow the classification established by the World Health Organisation so that the list is consistent across jurisdictions. The use of antimicrobials that are critically important to human and animal health should be subject to a moratorium followed by a prohibition on their use. Furthermore, a product that has antimicrobial properties should automatically be categorised as an antimicrobial rather than a feed additive.
The French Legislation on Public Health provides a positive example of a proper classification of antimicrobials by listing antimicrobials of critical importance for human and animal health, and strictly limits their use.
3. Enforcement Mechanisms
The regulation on the use of antimicrobials should also provide enforcement mechanisms to ensure the proper implementation of rules, preferably by imposing that all prescriptions for antibiotics be recorded and that the levels of use of antimicrobials be tracked and monitored.
A number of EU countries have implemented positive enforcement mechanisms. For example, Denmark established the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP), a programme tasked with monitoring the volumes and types of antimicrobials being used in animals and humans, as well as trends in antimicrobial resistance. There exist other surveillance centres in the EU, in Sweden (SVARM) and in the Netherlands (MARAN), all operating under the EU's European Antimicrobial Resistance Surveillance Network (EARS-Net).
Other examples of a better practice to closely monitor the use of antimicrobials can be found in Italian and Spanish law, which require the use of electronic prescriptions for all antimicrobials. The data collected on the amount and types of antimicrobials that are prescribed can be used as a proxy to assess the extent to which antibiotics are used in animal agriculture, and ultimately to help reduce the use.
4. Policy Coherence
Regulations pertaining to the judicious use of antimicrobials should further be coherent with other policies which shape animal agricultural production. These policies are:
- Agricultural policy: Because the overuse of antimicrobials is rooted in “bad” husbandry practices, better regulation of antimicrobials would necessitate a shift away from industrial farm animal methods of production as a way to mitigate AMR.
- Animal welfare legislation: The law should provide for higher animal welfare standards as preventive measures against disease outbreaks, as an alternative to the use of antimicrobials.
- Environmental regulations: Antimicrobials should be listed as pollutants given the adverse impacts they have on the environment.
An example of a better practice regarding policy coherence in public health and agricultural policies is the inclusion of training on farm practices which prevent the development of antimicrobial resistance to the services offered by the Farm Advisory System – a public administration which provides free and on-demand services to EU farmers.
References
References
Claas Kirchhelle, Pharming Animals: A Global History of Antibiotics in Food Production (1935–2017), Palgrave Communications (2018).
José Luis Martinez, Environmental Pollution by Antibiotics and by Antibiotic Resistance Determinants, Environ. Pollut. (2009).
Thomas P. Van Boeckel et al., Global Trends in Antimicrobial Use in Food Animals, Proceedings of the National Academy of Sciences (2015).
Thomas P. Van Boeckel et al., Global Trends in Antimicrobial Resistance in Animals in Low-and Middle-Income Countries, Science (2019).
World Health Organization, List of Critically Important Antimicrobials (CIA).
Further Readings
Alex Blanchette, “Intimate Biosecurity and Posthuman Labor” in Porkopolis, Duke University Press (2020).
Center for Diseases Dynamics, Economics, and Policy, “Antimicrobial Consumption in Livestock,”, (last visited 21 August 2021).
The Danish Integrated Antimicrobial Resistance Monitoring and Research Programme, (last visited 20 September 2021).
The European Antimicrobial Resistance Surveillance Network (ERAS-Net), (last visited 20 September 2021).
FAIRR, Feeding Resistance – Antimicrobial Stewardship in the Animal Health Industry (2021).
Sudeshna Ghosh and Timothy LaPara, The Effects of Subtherapeutic Antibiotic Use in Farm Animals on the Proliferation and Persistence of Antibiotic Resistance Among Soil Bacteria, The ISME Journal (2007).
R. H. Gustafson, R. E. & Bowen, Antibiotic Use in Animal Agriculture, Journal of Applied Microbiology (1997).
Anette M. Hammerum et al., Danish Integrated Antimicrobial Resistance Monitoring and Research Program, Emerging Infectious Diseases (2007).
Pei-Ying Hong, et al., Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes, Antibiotics (2013).
Timothy F. Landers, et al., A Review of Antibiotic Use in Food Animals: Perspective, Policy, and Potential, Public Health Reports (2012).
Sharon Levy, Reduced Antibiotic Use in Livestock: How Denmark Tackled Resistance, Environmental Health Perspectives (2017).
Maureen Ogle, Riots, “Rage and Resistance: A Brief History of How Antibiotics Arrived on the Farm,” Scientific American, 2013, (last visited 10 August 2021).
Ellen K. Silbergeld, Jay Graham, and Lance B. Price, Industrial Food Animal Production, Antimicrobial Resistance, and Human Health, Annual Review of Public Health (2008).
World Health Organization, List of Critically Important Antimicrobials (CIA).
Changwon Yang, Gwonhwa Song, and Whasun Lim, A Review of the Toxicity in Fish Exposed to Antibiotics, Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology (2020).
Law / Policy Name of the text | Topic The topic of the legislation or policy covered by the text | Species The animal, or type of food production, covered by the text | Type of Act Whether the act is a law, regulation, or policy, or another type of text | Status Indicates whether the act is in force or not |
|---|---|---|---|---|
| AgricultureAnimal healthAnimal welfare | All animals | Legislation | In force | |
| Animal healthAnimal welfareAntimicrobial resistance | Farmed animals | Legislative Proposal | Bill proposal | |
28-Hour Law USA | Animal welfare | Farmed animals | Legislation | In force |
| Alternative ProteinsPublic procurement | Farmed animals | Legislative Proposal | Bill proposal | |
| AgricultureAnimal healthAntimicrobial resistance | Farmed animals | Policy | In force | |
| Animal healthAnimal welfareWild-caught fishing | Fish | International Convention | In force | |
| AgricultureAnimal welfareClimate & environmental protection | Farmed animals | Legislative Proposal | In force | |
| Animal welfare | All animals | Constitution | In force | |
| Animal welfareRecognition of sentience | All animals | Legislation | In force | |
| Animal welfare | All animals | Constitution | In force | |
| Recognition of sentience | All animals | Legislation | In force | |
| Animal welfare | All animals | Constitution | In force | |
Article 80 of the Swiss Constitution Switzerland | Animal welfare | All animals | Constitution | In force |
| Animal welfareAquacultureRecognition of sentience | Farmed animalsFish | Legislation | In force | |
| AgricultureAnimal healthAntimicrobial resistance | All animals | Legislation | In force | |
| Recognition of sentience | All animals | Legislation | In force | |
| AgricultureAnimal welfare | Broiler chickens | Legislation | In force | |
| AgricultureAnimal healthAnimal welfareSales Bans | CalvesPigs | Legislation | In force | |
| AgricultureAnimal welfare | Calves | Legislation | In force | |
Canada 2020 NDC Canada | Climate & environmental protection | Farmed animals | Policy | In force |
| You're viewing 20/113 Entries | ||||