title: Restrictions on antimicrobial use in food animal production: an international regulatory and economic survey.
abstract: BACKGROUND
  The administration of antimicrobial drugs to food animals at low doses for extended durations for growth promotion and disease prevention has been linked to the global health crisis of antimicrobial resistance. Internationally, multiple jurisdictions have responded by restricting antimicrobial use for these purposes, and by requiring a veterinary prescription to use these drugs in food animals. Opponents of these policies have argued that restrictions have been detrimental to food animal production where they have been adopted.
  
  
  METHODS
  We surveyed the antimicrobial use policies of 17 political jurisdictions outside of the United States with respect to growth promotion, disease prevention, and veterinary oversight, and reviewed the available evidence regarding their production impacts, including measures of animal health. Jurisdictions were included if they were a top-five importer of a major U.S. food animal product in 2011, as differences between the policies of the U.S. and other jurisdictions may lead to trade barriers to U.S. food animal product exports. Jurisdictions were also included if information on their policies was publicly available in English. We searched the peer-reviewed and grey literatures and corresponded with jurisdictions' U.S. embassies, regulators, and local experts.
  
  
  RESULTS
  Jurisdictions were categorized by whether they prohibit use of antimicrobials for growth promotion and/or use of antimicrobials without a veterinary prescription. Of the 17 jurisdictions surveyed, six jurisdictions have prohibited both types of use, five jurisdictions have prohibited one use but not the other use, and five jurisdictions have not prohibited either use, while information was not available for one jurisdiction. Data on the production impacts of these prohibitions were limited, although available data, especially from Denmark and Sweden, suggest that restrictions on growth promotion use can be implemented with minimal production consequences.
  
  
  CONCLUSIONS
  A majority of leading U.S. trade partners have more stringent policies regarding antibiotic use and veterinary oversight in food animal production. Available data suggest that restrictions on growth promotion may not be detrimental to production in the long run, although additional research could be useful. There is evidence that discordance between the U.S. and other jurisdictions with respect to antimicrobial use in food animals may be detrimental to U.S. access to export markets for food animal products. The available economic evidence strengthens the rationale for restricting antimicrobial use in U.S. food animals.
authors.forename: Dina Fine
authors.initials: DF
authors.lastname: Maron
authors.forename: Tyler J S
authors.initials: TJ
authors.lastname: Smith
authors.affiliation: Johns Hopkins Center for a Livable Future, Johns Hopkins University, 615 North Wolfe Street, Suite W7010, Baltimore, MD 21205, USA. knachman@jhsph.edu.
authors.forename: Keeve E
authors.initials: KE
authors.lastname: Nachman
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003132:Commerce / Q000191:economics / Q000331:legislation & jurisprudence; D003625:Data Collection; D004352:Drug Resistance, Microbial; D019649:Food Industry / Q000191:economics / Q000331:legislation & jurisprudence; D014943:Global Health; D006128:Growth; D006801:Humans; D038622:Internationality; D008460:Meat; D055656:Prescriptions; D011634:Public Health; D011640:Public Policy; D014481:United States; D014730:Veterinary Medicine
chemical_list: D000900:Anti-Bacterial Agents