JAC Advance Access published online on July 1, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg313
© 2003 by The British Society for Antimicrobial Chemotherapy
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Review
1 University of London,
London
* Corresponding author. E-mail: casewell{at}netcomuk.co.uk.
Received 19 December 2002
; 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
The European ban on growth-promoting antibiotics
and emerging consequences for human and animal health
2 Royal Veterinary and Agricultural University, Copenhagen,
Denmark
3 B & M
Consulting, Barcelona, Spain
4 Poultry Health Services
Ltd, Thirsk, North Yorkshire, UK
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