JAC Advance Access originally published online on July 1, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 159-161
© 2003 The British Society for Antimicrobial Chemotherapy
Review |
The European ban on growth-promoting antibiotics and emerging consequences for human and animal health
1 University of London, London; 4 Poultry Health Services Ltd, Thirsk, North Yorkshire, UK; 2 Royal Veterinary and Agricultural University, Copenhagen, Denmark; 3 B & M Consulting, Barcelona, Spain
Received 19 December 2002; returned 20 March 2003; revised 27 April 2003; accepted 28 April 2003
Following the ban of all food animal growth-promoting antibiotics by Sweden in 1986, the European Union banned avoparcin in 1997 and bacitracin, spiramycin, tylosin and virginiamycin in 1999. Three years later, the only attributable effect in humans has been a diminution in acquired resistance in enterococci isolated from human faecal carriers. There has been an increase in human infection from vancomycin-resistant enterococci in Europe, probably related to the increased in usage of vancomycin for the treatment of methicillin-resistant staphylococci. The ban of growth promoters has, however, revealed that these agents had important prophylactic activity and their withdrawal is now associated with a deterioration in animal health, including increased diarrhoea, weight loss and mortality due to Escherichia coli and Lawsonia intracellularis in early post-weaning pigs, and clostridial necrotic enteritis in broilers. A directly attributable effect of these infections is the increase in usage of therapeutic antibiotics in food animals, including that of tetracycline, aminoglycosides, trimethoprim/sulphonamide, macrolides and lincosamides, all of which are of direct importance in human medicine. The theoretical and political benefit of the widespread ban of growth promoters needs to be more carefully weighed against the increasingly apparent adverse consequences.
Keywords: growth promoters, Europe, antibiotic use
* Correspondence address. Department of Infectious Diseases, Guy’s, King’s & St Thomas’s School of Medicine (King’s College Hospital Campus), Bessemer Road, London SE5 9RS, UK. Fax: +44-20-7346-3404; E-mail: casewell{at}netcomuk.co.uk
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