Reduced Antibiotic Use in Livestock: how Denmark tackled Resistance

Antibiotic Use in Livestock and the need for international standards

Reduced Antibiotic Use in Livestock image
Denmark’s experience shows a practical way of moving toward a different future—one that holds both a healthy livestock industry and viable antibiotic therapies for people who need them.

At the dawn of the antibiotic era, the danger of creating resistant bacteria was already clear. “The time may come when penicillin can be bought by anyone in the shops,” warned Alexander Fleming while accepting his Nobel Prize for the drug’s discovery. “Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant.”1

Toward the end of Fleming’s life, in the 1950s, farmers discovered that feeding low doses of antibiotics to their livestock caused the animals to gain weight faster.2 Nobody knows for sure why or how this worked, but the amount of antibiotics used for livestock today is believed to dwarf the amount used in human medicine.3

Widespread, indiscriminate use of these drugs is having the impact Fleming predicted. The World Health Organization has named resistance to antimicrobial agents one of the most significant global threats to public health.4 In the United States alone, antibiotic-resistant pathogens are conservatively estimated to cause at least 2 million infections and 23,000 deaths each year.5

However, one country—Denmark—is leading the way in reversing this trend. Over the past two decades the country has instituted reforms to antibiotic use for livestock that are showing solid progress in reducing the prevalence of resistant bacteria.

Continue reading Reduced Antibiotic Use in Livestock: How Denmark Tackled Resistance, Environ Health Perspectives; DOI:10.1289/ehp.122-A160, June 2014.

Antimicrobial resistance strategy: will the U.K. be ready on time in case of superbug outbreak?

British superbug outbreak ‘could kill 80,000’

UK-Antimicrobial-Resistance
A Government report warns that tens of thousands could die because of new strains of bacteria and viruses resistant to drugs. The report describes some of the actions being taken.

An increasingly serious issue is the development and spread of AMR, which occurs when drugs are no longer effective in treating infections caused by microorganisms. Without effective antibiotics, even minor surgery and routine operations could become high-risk procedures, leading to increased duration of illness and ultimately
premature mortality. Much of modern medicine (for example, organ transplantation, bowel surgery and some cancer treatments) may become unsafe due to the risk of infection. In addition, influenza pandemics would become more serious without effective treatments.

The numbers of infections complicated by AMR are expected to increase markedly over the next 20 years. If a widespread outbreak were to occur, we could expect around 200,000 people to be affected by a bacterial blood infection that could not be treated effectively with existing drugs, and around 80,000 of these people might die. High numbers of deaths could also be expected from other forms of antimicrobial resistant infection.

AMR is a global problem and the UK Government, in conjunction with the devolved administrations, is leading work with international partners to secure support for concerted action at a global level. Coordinated international action is needed to tackle AMR as a priority issue through the World Health Organization (WHO) and other UN bodies.

The Department of Health, the NHS, the Department for Environment, Food and Rural Affairs and the Veterinary Medicines Directorate are working together with other partners to lead the implementation of the UK five-year Antimicrobial Resistance Strategy, published in September 2013. This work is overseen by a cross-government highlevel steering group comprising government departments and agencies and the devolved administrations. In June 2014 it published the measures which are being used to assess the impact of the actions being taken across the UK to reduce the spread of AMR and improve antibiotic prescribing. The high-level steering group’s Progress report and implementation plan was published on 11 December 2014.

In addition, in July 2014, the Prime Minister commissioned a review of AMR. The review, chaired by Jim O’Neil, is independent of government and is international in focus. It will explore how the development of new antibiotics can be stimulated and will also examine how best to encourage innovative thinking and research in order to change methods for treating infectious diseases. The review has already produced two reports. The first of these – Antimicrobial resistance: Tackling a crisis for the health and wealth of nations – appeared in December. It quantifies the likely global economic burden of AMR between now and 2050. The second – Tackling a global health crisis: Initial steps – was published on 5 February. It describes steps the reivew believes could and should be taken now in the international effort to tackle AMR. Further reports are expected to be published during 2015. By the summer of 2016, the review will recommend a set of actions to be agreed on at an international level in order to deal with the challenge of AMR.

Sources and more information
Media releases
  • Superbug ‘could kill 80,000 people’ experts warn, nursingtimes, 14 April, 2015.
  • UK Government Warns Possible Death Of Thousands Due To Superbug Infection Outbreak, au.ibtimes, 07 April, 2015.
  • Superflu pandemic is biggest danger to UK apart from a terrorist attack – and could kill 80,000 people, The Independent, 06 April 2015.
  • British superbug outbreak ‘could kill 80,000’, The Telegraph, 05 April 2015.

Stop the superbugs linked to antibiotics daily use in livestock

Tell the meat industry to clean up its act

0% of all antibiotics are used on factory farm animals which eventually leads to antibiotic resistant super-bugs. We can fix this problem. Support meat without drugs and help stop the superbugs.

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Ten reasons you should be worried about the antibiotic resistance increase

Antibiotics are essential for treating many infections but they’re losing their effectiveness

Antibiotic Resistance

Antibiotics are essential for treating many infections but they’re losing their effectiveness. Bacteria are fighting back by adapting and finding ways of surviving the effects of our medicines.

Antibiotic-resistance image
Bacteria adapt, find ways of surviving the effects of our medicines; becoming naturally resistant to antibiotics over time .

The bugs are smart – they can naturally become resistant to antibiotics over time but we’re making it worse because of overuse and misuse of our medications. This is already a risky situation and it will only get worse if we don’t take urgent action. Here are ten reasons YOU should be worried.

  1. No antibiotics = 1930s style healthcare
    If we lose our antibiotics it will be like going back to the 1930s where infections we now regard as trivial could be fatal. An infected cut could be life threatening and an illness like pneumonia would again become a mass killer. Look at the image below and imagine a return to those primitive days when we had no effective ways to treat infections.
  2. There may be no new medicines
    No new class of antibiotics has hit the pharmacy shelves for some time. Even if we discover more medicines simply replacing old antibiotics with new ones is not the only answer as they could also become ineffective. Governments and pharmaceutical companies are considering ways of tackling this situation but for now we may have to rely on the medicines we have, making it essential we ensure they remain useful.
  3. Green vaginal/penile discharge. Does that worry you?
    An unusual discharge down below is not the sort of thing that you want to leave untreated, but antibiotic resistant gonorrhoea is a serious, and scary, business. Some have called it the ‘sex superbug’ as gonorrhoea is passed on through unprotected sex or oral sex leading to symptoms including thick green or yellow discharge from the vagina or penis and pain when urinating. If it isn’t treated it can lead to serious complications but we are already running out of antibiotics that can kill the bacteria and fight the infection.
  4. Antibiotic resistance is already here.
    When we discuss antibiotic resistance we talk about a frightening future and rightly ask for action to stop the problem from getting worse. But this doesn’t mean it’s all just an issue for future generations. It’s estimated that 25,000 people already die every year in Europe because of infections resistant to antibiotics and in the USA the figure is 23,000 people, every year.
  5. Cancer chemotherapy and effective antibiotics go hand in hand
    Chemotherapy is an important weapon in the fight against cancer, but did you know the procedure destroys our white blood cells, which we need to fight off infection? Without antibiotics chemotherapy will become increasingly dangerous.
  6. Our greatest medical advancements, ruined
    Organ transplants are a miracle of modern medicine but we need antibiotics to help a transplant patient survive, both because the transplant procedure itself may lead to infection but also because patients receive drugs that intentionally suppress their immune system to ensure their body doesn’t reject their new organ. This suppression of the immune system makes a patient more prone to bacterial infections. If we lose our antibiotics, transplants would become more risky or even impossible.
  7. It is your problem
    Sometimes talk of antibiotic resistance being a “global problem” and “threat to healthcare as we know it” may make it easy to switch off. Maybe it’s all too big? Maybe something for scientists or politicians to worry about? Think again, as this problem affects us all directly. For instance, if you are given antibiotics when you don’t need them you run the risk of carrying antibiotic resistant bacteria in your gut. If these bacteria go on to cause an infection, antibiotics may not work when you really need them.
  8. Sometimes we need antibiotics really urgently
    Heard of sepsis? It’s a common and potentially life-threatening condition triggered by an infection. Each year in the UK more than 100,000 people are admitted to hospital with sepsis and around 37,000 people will die. The best way to deal with sepsis is to treat it quickly with antibiotics. We probably don’t need to tell you what would happen if we run out of antibiotics to treat this infection.
  9. We have to save our surgery
    None of us want to think about getting ill or having a serious operation but we all understand that surgery can save lives. But complex surgery brings with it the risk of infection. Take heart bypass operations or joint replacements for instance – if we don’t have antibiotics these procedures designed to help people and ease suffering could actually lead to many more deaths caused by bacterial infections.
  10. It costs us a packet
    The human cost of antibiotic resistance is considerable but the problem also hits us in the pocket. As far back as 2009 the European Centre for Disease Prevention and Control said that antibiotic resistance was already costing the EU about €1.5 billion a year in healthcare expenses and lost productivity. This figure, although high, is believed to be a significant underestimate. If we don’t act this is going to get more and more costly, not only cutting into our precious healthcare budgets but individuals and families productivity too

What can we do about it?

Antibiotic Guardian Certificate image
We have to stop the overuse and misuse of antibiotics which is leading to many bacteria becoming resistant to these essential medicines.

This problem affects us all and we can all do something to help. Firstly, you can take a simple personal action by visiting our Antibiotic Guardian website and choosing one pledge that you will carry out to help save these vital medicines. There are pledges for the public, healthcare professionals and leaders.

There are plenty more things you can do too. Watch our video and learn more and talk to your family and friends about antibiotic resistance, and the fact that we don’t always need antibiotics when we’re ill. The Treat Yourself Better website will help you make good choices.

If you’re a health professional, alongside making your Antibiotic Guardian pledge, we urge you to read this blog and share our antimicrobial resistance information and resources.

Sources and more information

New antibiotic kills pathogens without detectable resistance, might help fight future superbugs

U.S. scientists have discovered a new class of antibiotics that can kill a wide range of dangerous, drug-resistant bacteria

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U.S. scientists have discovered a new class of antibiotics that can kill a wide range of dangerous, drug-resistant bacteria. Image via Lee Maguire.

Abstract

Antibiotic resistance is spreading faster than the introduction of new compounds into clinical practice, causing a public health crisis. Most antibiotics were produced by screening soil microorganisms, but this limited resource of cultivable bacteria was overmined by the 1960s. Synthetic approaches to produce antibiotics have been unable to replace this platform. Uncultured bacteria make up approximately 99% of all species in external environments, and are an untapped source of new antibiotics. We developed several methods to grow uncultured organisms by cultivation in situ or by using specific growth factors. Here we report a new antibiotic that we term teixobactin, discovered in a screen of uncultured bacteria. Teixobactin inhibits cell wall synthesis by binding to a highly conserved motif of lipid II (precursor of peptidoglycan) and lipid III (precursor of cell wall teichoic acid). We did not obtain any mutants of Staphylococcus aureus or Mycobacterium tuberculosis resistant to teixobactin. The properties of this compound suggest a path towards developing antibiotics that are likely to avoid development of resistance.

Sources and more information
  • A new antibiotic kills pathogens without detectable resistance, Nature (2015) doi:10.1038/nature14098, 07 January 2015 – full article.
  • A New Drug in the Age of Antibiotic Resistance, theatlantic, Jan 7 2015.
  • Antibiotics: US discovery labelled ‘game-changer’ for medicine,
    BBC News, 7 January 2015.
  • Revolutionary New Antibiotic Kills Drug-Resistant Germs,
    livescience, 7 January 2015.

Antibiotics daily use in livestock help superbugs spread from farms into our communities

When the meat industry routinely misuses and overuses antibiotics, it threatens public health when essential drugs no longer work to treat infections, making us all less safe

Did you know that superbugs — dangerous bacteria resistant to antibiotics — are spreading from farms and into our communities? When antibiotics are used day after day to raise animals, drug resistant bacteria flourish, making antibiotics less effective for people. Take a look at a day in the life of this pig to learn why this is happening on industrial farms around the country.

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Yes taking unnecessary antibiotics is risky and some side-effects can be pretty bad

Patients Don’t Understand Risks of Unnecessary Antibiotics

Over prescription of antibiotics is a major factor driving one of the biggest public health concerns today: antibiotic resistance. In a first-of-its-kind study, research led by the George Washington University suggests that public health educational materials may not address the misconceptions that shape why patients expect antibiotics, driving doctors to prescribe them more. The research appeared in October in the journal Medical Decision Making.

George Washington University image
George Washington University Professor David Broniatowski who led the study urges members of the public health community to reconsider their communication tactics and adjust educational materials to address patients’ concerns and beliefs.

Researchers from George Washington, Cornell and Johns Hopkins universities surveyed 113 patients in an urban hospital to test their understanding of antibiotics. They discovered a widespread misconception: patients may want antibiotics, even if they know that, if they have a viral infection, the drugs will not make them better. These patients believe that taking the medication will not worsen their condition—and that the risk of taking unnecessary antibiotics does not outweigh the possibility that they may help.

Patients figure that taking antibiotics can’t hurt, and just might make them improve. When they come in for treatment, they are usually feeling pretty bad and looking for anything that will make them feel better. These patients might know that there is, in theory, a risk of side effects when taking antibiotics, but they interpret that risk as essentially nil,” said David Broniatowski, assistant professor in GW’s School of Engineering and Applied Science.

Contrary to these patients’ beliefs, there are risks associated with taking unnecessary antibiotics, such as secondary infections and allergic reactions.

More than half of the patients we surveyed already knew that antibiotics don’t work against viruses, but they still agreed with taking antibiotics just in case,” Dr. Broniatowski said. “We need to fight fire with fire. If patients think that antibiotics can’t hurt, we can’t just focus on telling them that they probably have a virus. We need to let them know that antibiotics can have some pretty bad side effects, and that they will definitely not help cure a viral infection.”

Dr. Broniatowski’s research found that most educational tools used to communicate the dangers of taking unnecessary antibiotics focus on the differences between bacteria and viruses—the idea that “germs are germs”—but do not address patients’ widespread “why not take a risk” belief.

While the study – Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics In an Inner-City Emergency Department – was small, the results signal the need for a shift in the way health care officials educate patients and caretakers. Dr. Broniatowski urges members of the public health community to reconsider their communication tactics and adjust educational materials to address patients’ concerns and beliefs.

In the future, Mr. Broniatowski and his team, which included Eili Klein at Johns Hopkins and Valerie Reyna at Cornell, hope to test these communication strategies in a clinical setting and, ultimately, reduce the rate of over prescription.

Sources and more information

  • Patients Don’t Understand Risks of Unnecessary Antibiotics, GW Study Shows, GWU, December 15, 2014.
  • Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics in an Inner-City Emergency Department, Medical Decision Making, October 20, 2014 .

Are you an Antibiotic Guardian ?

Did you pledge to be an Antibiotic Guardian?
Choose one simple pledge and get your certificate!

Poster_AG_EAAD_Centrepiece_NHS_logo
Watch @DES_Journal health posters album on Flickr.

Do you know that antibiotic resistance continues to rise due to increase in use in the UK? Did you pledge to be an #AntibioticGuardian for #EAAD2014? Not yet? Visit antibioticguardian.com and choose one simple pledge about how you’ll make better use of antibiotics and help save this vital medicine from becoming obsolete.

On Flickr®

Get Your Antibiotic Guardian Certificate

Did you pledge to be an Antibiotic Guardian?
Choose one simple pledge and get your certificate!

Antibiotic Guardian Certificate image
Watch @DES_Journal health posters album on Flickr.

Do you know that antibiotic resistance continues to rise due to increase in use in the UK? Did you pledge to be an #AntibioticGuardian for #EAAD2014? Not yet? Visit antibioticguardian.com and choose one simple pledge about how you’ll make better use of antibiotics and help save this vital medicine from becoming obsolete.

On Flickr®

Sharp rise in the misuse of antibiotic ceftiofur in livestock poses a threat to public health

Ceftiofur, wonder drug for dairy farmers, endangers public health

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The antibiotic ceftiofur is a wonder drug for dairy farmers. But its strength – and the frequency at which it’s used improperly in cattle – pose a threat to public health.

It is one of the most potent antibiotics used by U.S. cattle and dairy farmers, the key component in the top-selling drug line of Zoetis, the world’s largest animal health company. But the strength of the antibiotic ceftiofur – and the frequency with which it’s being misused on farms across America – has created a threat to human health that may overshadow the drug’s effectiveness, a Reuters examination shows

The U.S. Food and Drug Administration cautioned in 2012 that ceftiofur could pose a “high public health risk,” in part because the drug belongs to a class of antibiotics considered critically important in human medicine. The warning is the FDA’s strongest kind. The concern is that ceftiofur in animals could spawn antibiotic-resistant bacteria, superbugs that can infect people and defeat conventional medical treatment, even when the drug is used as directed. ”

continue reading Reuters Investigation Farmaceuticals, The drugs fed to farm animals and the risks posed to humans, includes:

  • The antibiotic ceftiofur is a wonder drug for dairy farmers. But its strength – and the frequency at which it’s used improperly in cattle – pose a threat to public health
  • Floored by a superbug
More press releases
  • Abusing Chickens We Eat,
    nytimes, Nicholas D. Kristof, DEC. 3, 2014
  • Watch What It’s Like to Be a Factory-Farmed Chicken,
    motherjones, Dec. 4, 2014.
  • Perdue Whistleblower Video Reveals Horrors,
    opednews, Martha Rosenberg, Dec. 4, 2014.
  • Hoping to Change the Industry, a Factory Farmer Opens His Barn Doors, wired, Dec. 4, 2014.
  • Better Chicken Initiative, CWIF.