As we use more and more antibiotics, infections get harder to treat. Bacteria become resistant to antibiotics and they spread. Increasingly, we cannot treat infections: each year in the European Union, Iceland and Norway alone, over 25 000 people die from infections caused by antibiotic-resistant bacteria.

Antibiotic resistance is also a food safety problem. Antibiotics are used and misused in food animals, not only for treatment, but also to promote growth or prevent disease. In some countries, animal use seems to outweigh the use in human medicine. This has important public health consequences, as resistance can be passed from animals to humans through the food chain.
What you can do

Farmers, veterinarians and veterinary and food safety authorities have an important role. They can help to preserve the power of antibiotics at the origin of the food chain. The use of antibiotics has to be balanced, meaning that they should be used only when they are needed and justified for therapeutic reasons, and not otherwise.
Advice to farmers or other producers of food animals

    * Do not use antibiotics as promoters of animal growth. In the European Union, this has been banned since 2006.
    * Administer antibiotics to food animals only when prescribed by a veterinarian, and in the right dose and for the right treatment duration.
    * Reduce the need for antibiotics in animal husbandry by improving animal health, through good hygiene and management practices and good infection control measures (including vaccine use).
    * Be informed and updated on guidelines about the prudent use of antibiotics, to reduce use and misuse in food animals.

Advice to veterinarians

    * Do not prescribe to animals antibiotics identified as critically important for human medicine, unless justified.
    * Support farmers/food animal producers in their implementation of guidelines on the prudent use of antibiotics.

Advice to food safety and veterinary authorities

    * Eliminate the use of antibiotics as growth promoters where this still occurs.
    * Require that antibiotics be available for food animals only by veterinary prescription.
    * Take part in developing and implementing intersectoral national strategies on antibiotic resistance, including a food safety perspective, and in promoting the prudent use of antibiotics in all sectors.
    * Ensure collaboration and communication with public health authorities in addressing antibiotic resistance.
    * Eliminate economic incentives that facilitate the inappropriate prescription of antibiotics.
    * · Establish a surveillance system for the usage of antibiotics in food animals.
    * Establish an integrated system for the surveillance of antibiotic resistance in selected foodborne bacteria. The surveillance should include food bacteria (such as Salmonella spp.) from animals, food and humans. This will provide data on how resistance is moving through the food chain, and how antibiotic use in animals is having an impact on human health.
    * Develop national guidelines to reduce the use and misuse of antibiotics in food animals, and provide training to farmers/food animal producers to ensure their implementation.

Antibiotic resistance: a food safety problem

As a result of the use of antibiotics, food can contain antibiotic-resistant bacteria and resistance genes. This has important public health consequences as resistant foodborne disease-causing bacteria, as well as resistance genes, can be passed on to humans through the food chain. Resistance in Salmonella and Campylobacter spp. is clearly linked to antibiotic use in food animals; and foodborne diseases in humans caused by such resistant bacteria are well documented.

Of special concern is resistance to antibiotics that are critically important to human medicine. For instance, in 2007 in the European Union, the reported resistance level to ciprofloxacin, one of the most important antibiotics, among Salmonella spp. bacteria from broiler meat was 29%. In addition, farmers in many countries can obtain antibiotics without a prescription. Further, although antibiotics are banned as growth promoters in the European Union and some other countries, this is not the case throughout the WHO European Region. Finally, travel and the globalization of trade further increase the risk of spreading antibiotic-resistant bacteria, as they travel with people, animals or food products.
Definitions: antibiotics and antibiotic resistance

Antibiotics are a subclass of antimicrobial agents that are active only against bacteria. They can either be naturally derived from bacteria or moulds (fungi) or produced synthetically. Scientifically, “antibiotic” refers only to naturally produced antimicrobial agents, but this text uses the term to mean all drugs or agents against bacterial infections.

The emergence of resistance to antibiotics is a natural biological phenomenon that occurs when antibiotics are used. Antibiotic resistance results from the ability of bacteria to withstand attack by antibiotics, which can develop either through mutation or by acquiring resistance genes from other bacteria that are already resistant.

The main drivers of antibiotic resistance are the use of antibiotics, especially overuse (but also misuse and underuse) and the transmission and spread of already resistant bacterial strains or genes that carry the information on resistance.
For further information on antibiotic resistance, please contact:

Dr Bernardus Ganter
Senior Adviser, Antimicrobial Resistance, Division of Communicable Diseases, Health Security and Environment
WHO Regional Office for Europe
Scherfigsvej 8
DK-2100 Copenhagen Ø
Denmark
Tel.: +45 39 17 14 23
E-mail: bga@euro.who.int

Dr Hilde Kruse
Programme Manager, Food Safety
WHO European Centre for Environment and Health, Rome
WHO Regional Office for Europe
Tel.: +39 064877525
E-mail: hik@ecr.euro.who.int
For further information and interview requests, please contact:

Ms Viv Taylor Gee
Regional Adviser, Communications
WHO Regional Office for Europe
Scherfigsvej 8
DK-2100 Copenhagen Ø
Denmark
Tel.: + 45 39 17 12 31
E-mail: VGE@euro.who.int