1 University of London, London; 4 Poultry Health Services Ltd, Thirsk, North Yorkshire, UK; 2 Royal Veterinary and Agricultural University, Copenhagen, Denmark; 3 B & M Consulting, Barcelona, Spain
Received 19 December 2002; returned 20 March 2003; revised 27 April 2003; accepted 28 April 2003
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Abstract |
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Keywords: growth promoters, Europe, antibiotic use
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The bans on growth promoters and their immediate effects |
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The ban has resulted, as intended, in the complete removal of the banned compounds as growth promoters. In Denmark, for example, where over 105 metric tonnes of antibiotics were used for growth promotion in 1996, the usage fell to nil by 2000.4 This was accompanied by a diminution of resistance to avoparcin, macrolides and virginiamycin among enterococci, studied as an indicator species, in food-animal faeces, in Denmark and elsewhere,46 although vancomycin-resistant Enterococcus faecium has persisted in samples from Danish broilers7 and pork.8 Nevertheless, the pool of antibiotic resistance genes in animal faecal enterococci appears, overall, to have diminished.
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Consequences for human infections |
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The antibiotic susceptibility of salmonellae and campylobacters, responsible for the major zoonoses in Europe, could not have been expected to be affected by the ban to the benefit of human health (except possibly in relation to macrolides in the case of campylobacters) since they are Gram-negative organisms whereas the banned growth promoters had a Gram-positive spectrum of activity. However, human salmonellosis has not responded to control measures in some parts of Europe, and microbiologically confirmed infections actually increased in prevalence in Denmark in 20015 after they had declined for 3 years.16 Increased antibiotic resistance in salmonella might be expected in response to the increased use of therapeutic antibiotics in animals consequent to the ban, and there is an increase in tetracycline and sulphonamide resistance in S. typhimurium isolates from pigs and from human domestic infections in Denmark in 2001.5 The case of campylobacter appears to be worse: in Denmark, it has steadily increased in prevalence over the past decade16 and there is more tetracycline and fluoroquinolone resistance in human than in animal isolates.5 One possibility is that the persistence or even increase in prevalence of these two zoonoses might in part be related to the removal of growth-promoting antibiotics but so far as we are aware this hazard has not been explored. For example, the variation in size of broilers not given growth promoters leads to more frequent rupture of the gastrointestinal tract at slaughter, faecal spillage, and potential contamination with salmonella and campylobacter.17 The possible contribution of increasing international travel to countries with poor food and water hygiene to the increased prevalence of campylobacter and salmonella infections has yet to be defined.
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Consequences for animal health |
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Increased use of therapeutic antibiotics in food animals |
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Conclusion |
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Acknowledgements |
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Footnotes |
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References |
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