Caister Academic Press

Overuse of Antibiotics: Non-medical Applications

Nelson Kardos
from: Antibiotics: Current Innovations and Future Trends (Edited by: Sergio Sánchez and Arnold L. Demain). Caister Academic Press, U.K. (2015) Pages: 113-146.

Abstract

The decreasing effectiveness of antibiotics in treating common infections results from the spread of antimicrobial resistance (AMR), and is building up to become an epic global public health crisis. Extended periods of antibiotic overuse and misuse since their introduction have applied strong selective pressure towards high level AMR and multiple drug resistance (MDR), rendering entire classes of antibiotics ineffective. The primary driving force for this global AMR pandemic is the widespread misuse and overuse of antibiotics, in both medical and non-medical applications. The introduction of every antibiotic product has been closely followed by emerging resistance to that antibiotic. Levels of antibiotic consumption correlate with levels of AMR. Antibiotics have been misused in all of their applications, including:

Hospital and outpatient use by physicians through unnecessary, indiscriminate or incorrect prescribing
By patients, through incorrect dosing and course durations
Large scale use in agriculture for disease treatment, prophylaxis and growth promotion in animal husbandry and food production

These actions not only have provoked the emergence of resistant microbes, but also have provided optimal environments for the spread of and selection of resistance determinants. It has been established in many countries that the levels of antibiotic consumption consistently correlate with levels of antibiotic resistance (i.e. the more antibiotics are being used in a population, the more resistance to antibiotics there will be in bacteria responsible for infections in that population). The increase in resistance from overuse of antibiotics in turn leads to cross transmission of AMR microbes between humans, between animals and between humans and animals and the environment. Almost two million Americans per year develop hospital acquired infections (HAI), resulting in 99,000 deaths per year. The vast majority of these HAI related deaths are due to AMR infections. Based on studies of the costs of infections caused by antibiotic resistant pathogens vs. antibiotic susceptible pathogens, the annual cost to the US health system of antibiotic resistant infections is to billion, and 8 million additional hospital days. This chapter will focus on the overuse of antibiotics through non- medical applications; by their extensive use in animal agriculture & aquaculture and their effect as environmental contaminants on land and water systems. These non-human medical applications are a primary cause of AMR and ultimately impact negatively on human health read more ...

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