The risk of low concentrations of antibiotics in agriculture for resistance in human health care.
The contribution of antibiotic resistance originally selected for in the agricultural sector to resistance in human pathogens is not known exactly, but is unlikely to be negligible. It is estimated that 50% to 80% of all antibiotics used are applied in agriculture and the remainder for treating infections in humans. Since dosing regimens are less controlled in agriculture than in human health care, veterinary and environmental microbes are often exposed to sublethal levels of antibiotics. Exposure to sublethal drug concentrations must be considered a risk factor for de novo resistance, transfer of antimicrobial resistant (AMR) genes, and selection for already existing resistance. Resistant zoonotic agents and commensal strains carrying AMR genes reach the human population by a variety of routes, foodstuffs being only one of these. Based on the present knowledge, short treatments with the highest dose that does not cause unacceptable side-effects may be optimal for achieving therapeutic goals while minimizing development of resistance. Novel approaches such as combination or alternating therapy are promising, but need to be explored further before they can be implemented in daily practice.
Department of Molecular Biology and Microbial Food Safety, University of Amsterdam, Swammerdam Institute of Life Sciences, 1098 XH, Amsterdam, the Netherlands Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority, Catharijnesingel 59, 3511 GG Utrecht, the Netherlands B.H.terKuile@uva.nl.
Benno H
BH
Ter Kuile
Department of Molecular Biology and Microbial Food Safety, University of Amsterdam, Swammerdam Institute of Life Sciences, 1098 XH, Amsterdam, the Netherlands.
Nadine
N
Kraupner
Department of Molecular Biology and Microbial Food Safety, University of Amsterdam, Swammerdam Institute of Life Sciences, 1098 XH, Amsterdam, the Netherlands.
Stanley
S
Brul
D000383:Agriculture; D016573:Agrochemicals / Q000032:analysis* / Q000494:pharmacology*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000032:analysis* / Q000494:pharmacology*; D054796:Drug Dosage Calculations; D004352:Drug Resistance, Microbial / Q000235:genetics*; D020387:Food Chain; D005516:Food Microbiology; D022761:Gene Transfer, Horizontal; D006801:Humans; D013559:Symbiosis; D015047:Zoonoses
D016573:Agrochemicals; D000900:Anti-Bacterial Agents
Antibiotic resistance; agriculture; dosing regime; transfer of resistance