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By David Warmflash

David WarmflashWorried about excessive, inappropriate use of antibiotics in medical settings? There certainly is great reason to be concerned. This is why other AAPS authors have been covering misuse and overuse of antimicrobial treatment by health professionals as well as efforts by various governments to solve the problem, which is global. International borders are of little help, because antibiotic resistance genes (ARGs) undergo horizontal transfer between organisms. Thus, the world health organization (WHO) has initiated a new surveillance program for antimicrobial resistance (AMR). In concert with added and strengthened regulations by governments around the planet, the inappropriate distribution of antibiotics can be curbed, thereby mitigating the emergence and amplification of ARGs globally.

But there is another dimension to the issue: farm animals. When animals are crowded together in factory farm pens laden with feces, they are often given small, subtherapeutic doses of antibiotics. This is not only to prevent infection, but also to promote growth and improve the efficiency of feeding. The practice is used both in livestock and poultry, and drugs used have included salinomycin, virginiamycin (poultry), bacitracin (poultry), lasalocid, bambermycin (poultry and cattle), and monensin (cattle and sheep). The crowding that provokes meat and poultry farmers to use antimicrobials in the first place contrasts with free-range animal farming. The latter practice actually is much healthier; it’s not merely a dietary fad.

Even with strong regulations emerging over the last several years around the world in Europe, the United States, and other countries, the quantities of antibiotic use in farm animals far outweighs the use in clinical settings to treat people. In the United States, for instance, livestock applications accounted for as much as 80 percent of antibiotic use as recently as 2011. The European Union now has strong regulations effectively prohibiting the use of antibiotics for animal growth, but introduction of the tightened restrictions has followed alarming revelations of exponentiating AMR.

But China is the biggest threat. About half of China’s antibiotic supply goes into livestock, and with livestock farming to support a population of 1.5 billion people, that ends up contributing more to the problem globally than use of antibiotics on farms anywhere else. Thus, diverse antimicrobial resistance has been specifically identified throughout Chinese swine farms, according to a study published in the Proceedings of the National Academy of Sciences. China also is reported as one of the worst locations for excessive antibiotic administration to patients.

Worry is a word and a half. All of these reports are serious, leading us to worry that in the years to come people could be dying from simple infections that are easy to treat today, as if we were back in the year 1914. It is not exaggerated and requires continued and expanded global health cooperation.

David Warmflash, M.D., is an astrobiologist, science writer, and physician. He is principal investigator on a Planetary Society-sponsored investigation of the effects of the space environment on organisms.