Antimicrobial use in food-producing animals selects for antimicrobial resistance that can be transmitted to humans via food or other transmission routes. The World Health Organization (WHO) in 2005 ranked the medical importance of antimicrobials used in humans. In late 2017, to preserve the effectiveness of medically important antimicrobials for humans, WHO released guidelines on use of antimicrobials in food-producing animals that incorporated the latest WHO rankings.
WHO commissioned systematic reviews and literature reviews, and convened a Guideline Development Group (GDG) of external experts free of unacceptable conflicts-of-interest. The GDG assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and formulated recommendations using a structured evidence-to-decision approach that considered the balance of benefits and harms, feasibility, resource implications, and impact on equity. The resulting guidelines were peer-reviewed by an independent External Review Group and approved by the WHO Guidelines Review Committee.
These guidelines recommend reductions in the overall use of medically important antimicrobials in food-producing animals, including complete restriction of use of antimicrobials for growth promotion and for disease prevention (i.e., in healthy animals considered at risk of infection). These guidelines also recommend that antimicrobials identified as critically important for humans not be used in food-producing animals for treatment or disease control unless susceptibility testing demonstrates the drug to be the only treatment option.
To preserve the effectiveness of medically important antimicrobials, veterinarians, farmers, regulatory agencies, and all other stakeholders are urged to adopt these recommendations and work towards implementation of these guidelines.
Eloit M, Graziano da Silva J, Chan M. Super bugs: Why we need action now. Huffington Post. http://www.huffingtonpost.com/dr-monique-eloit/post_13193_b_11992538.html. Accessed 26 Oct 2017.
WHO Global Strategy for Containment of Antimicrobial Resistance. World Health Organization, 2001. http://www.who.int/antimicrobial-resistance/publications/WHO_Global_Strategy.htm/en/. Accessed 26 Oct 2017.
Molbak K. Human health consequences of antimicrobial rug-resistant salmonella and other foodborne pathogens. Clin Infect Dis. 2005;4:1613–20.
WHO Antimicrobial Resistance. Global report on surveillance 2014. http://www.who.int/drugresistance/documents/surveillancereport/en/. Accessed 26 Oct 2017.
Tackling drug-resistant infections globally: Final report and recommendations. The review on antimicrobial resistance chaired by Jim O’Neill. May 2016. https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf. Accessed 26 Oct 2017.
Resolution WHA 68-7 (Global Action Plan on Antimicrobial Resistance) of the sixty-eighth World Health Assembly, Geneva, Switzerland, 26 May, 2015. http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_R7-en.pdf?ua=1. Accessed 26 Oct 2017.
Global Action Plan on Antimicrobial Resistance. World Health Organization. http://www.wpro.who.int/entity/drug_resistance/resources/global_action_plan_eng.pdf. Accessed 26 Oct 2017.
Resolution 4/2015 (Antimicrobial Resistance) of thirty-ninth session of the Conference of the Food and Agriculture Organization (FAO). Rome, Italy, 6-13 June 2015. http://www.fao.org/3/a-mo153e.pdf. Accessed 26 Oct 2017.
Resolution 26 (Combating Antimicrobial Resistance and Promoting the Prudent Use of Antimicrobial Agents in Animals) of the World Assembly of Delegates of the World Organisation for Animal Health (OIE). Paris, France, 26 May, 2015. http://www.oie.int/fileadmin/Home/eng/Our_scientific_expertise/docs/pdf/AMR/A_RESO_AMR_2015.pdf. Accessed 26 Oct 2017.
Codex texts on foodborne antimicrobial resistance. Codex Alimentarius, 2015. http://www.fao.org/publications/card/en/c/7209750e-2c7a-4694-a0fe-8d7f0050acae/. Accessed 26 Oct 2017.
Food and Agriculture Organization (FAO), World Animal Health Organization (OIE); World Health Organization (WHO). Joint FAO/OIE/WHO Expert Workshop on Non-Human Antimicrobial Usage and Antimicrobial Resistance: Scientific assessment. Geneva, Switzerland, 1-5 December 2003. http://www.who.int/foodsafety/publications/amr-management/en/. Accessed 26 Oc 2017.
Angulo FJ, Nargund VN, Chiller TC. Evidence of an association between use of antimicrobial agents in food animals and antimicrobial resistance among bacteria isolated from humans and the human health consequences of such resistance. J Vet Med Series B Infect Dis Vet Public Health. 2004;51(8-9):374–9. CrossRef
Critically important antibacterial agents for human medicine for risk management strategies of non-human use. World Health Organization, 2005. http://www.who.int/foodsafety/publications/antibacterial-agent/en/. Accessed 26 Oct 2017.
Critically important antimicrobials for human medicine: Ranking of medically important antimicrobials for risk management of antimicrobial resistance due to non-human use. World Health Organization. Fifth revision, 2016. http://www.who.int/foodsafety/publications/antimicrobials-fifth/en/. Accessed 26 Oct 2017.
WHO Handbook for Guideline Development. Second Edition. World Health Organization, 2012. http://apps.who.int/medicinedocs/en/d/Js22083en/. Accessed 26 Oct 2017.
Schunemann HBJ, Brozek J, Guyatt G, Oxman A, editors. GRADE handbook for grading the quality of evidence and strength of recommendations. The GRADE Working Group. http://www.guidelinedevelopment.org/handbook/. Accessed 26 Oct 2017.
Tang KL, Caffrey NP, Nóbrega DB, et al. Restriction in the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and humans – a systematic review and meta-analysis. Lancet Planetary Health In press.
Swann MM. Report of the joint committee on the use of antibiotics in animal husbandry and veterinary medicine (Swann report). London: Her Majesty’s Stationery Office; 1969.
The Medical Impact of the Use of Antimicrobial in Food-producing animals: Report of a WHO Meeting. Berlin, Germany. October 13-17, 1997. http://apps.who.int/iris/bitstream/10665/64439/1/WHO_EMC_ZOO_97.4.pdf. Accessed 26 Oct 2017.
WHO Global Principles for the Containment of Antimicrobial Resistance in Animals Intended for Food: Report of a WHO Consultation with the participation of the Food and Agriculture Organization of the United Nations and the Office International des Epizooties. Geneva, Switzerland. June 5-9, 2000 http://apps.who.int/iris/bitstream/10665/68931/1/WHO_CDS_CSR_APH_2000.4.pdf. Accessed 26 Oct 2017.
Impacts of Antimicrobial Growth Promoter Termination in Denmark: The WHO international review panel’s evaluation of the termination of the use of antimicrobial growth promoters in Denmark. Foulum, Denmark. November 6-9, 2002. http://apps.who.int/iris/bitstream/10665/68357/1/WHO_CDS_CPE_ZFK_2003.1.pdf. Accessed 26 Oct 2017.
McDonald’s Global Vision for Antimicrobial Stewardship in Food-producing animals. http://corporate.mcdonalds.com/content/dam/AboutMcDonalds/2.0/pdfs/sustainability/McDonalds-Global-Vision-for-Antimicrobial-Stewardship-in-Food.pdf. Accessed 26 Oct 2017.
Norris SL, Ford N. Improving the quality of WHO guidelines over the last decade: progress and challenges. Lancet. 2017;5:e855–6. PubMed
- World Health Organization (WHO) guidelines on use of medically important antimicrobials in food-producing animals
Frederick J. Angulo
John M. Conly
Ellen K. Silbergeld
Scott A. McEwen
Peter J. Collignon
for the WHO Guideline Development Group
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II