Antimicrobial resistance (AMR) is a global public health and environmental concern.
The problems associated with AMR have been known for quite some time; the European Union has adopted important policies and legislation to tackle this issue from the human, and animal perspectives. 1 2 3 Further efforts are needed, however, to tackle this growing problem: one important step in the fight against AMR is to ensure the public is aware of the use of antibiotics in food animal veterinary practices. Although antibiotics can be indispensable in veterinary medicine, they are often used unnecessarily.
Historically, antibiotics have been used to promote growth in food animals – a practice now banned in the EU since 2006.4 Antibiotics, however, are still widely used in some countries for disease prevention - to help animals endure crowded, dirty, and stressful conditions in farms. This routine and non-therapeutic use of antibiotics in intensive livestock farming and aquaculture may cause an increase in harmful antibiotic resistant bacteria, including E.coli, Salmonella, and Campylobacter. These bacteria can make their way from the farm to our supermarkets, (as recently reported in the United Kingdom5), and therefore our tables - leading to increased exposure and subsequent potentially un-treatable infections. More action should be taken by European policy makers to prohibit the preventive use of antibiotics in animal agriculture, restrict collective treatment of animals to very specific cases, and put an end to online sales of antibiotics, vaccines, and psychotropic substances.6 In addition, close monitoring on how antibiotics are used on which animals and on which farms should be carried out, as currently such information is unknown.
In addition, it is not only animal-based products that can be contaminated with antimicrobial resistant bacteria and/or antimicrobial resistance genes. Other ingredients intentionally added during food processing (such as starter cultures, probiotics, bioconserving microorganisms, and bacteriophages) can spread antimicrobial resistant bacteria.7 Such bacteria can also be spread through cross-contamination (for example when raw food is mixed with other ingredients). As the cooking process often kills resistant bacteria, raw food products pose a substantial risk of transferring antimicrobial resistance to humans through consumption.7
Hospitals and health systems are on the front line when it comes to treating infections, yet they purchase thousands of kilos of meat annually, increasing exposure to antibiotic resistant bacteria for food service workers, and more broadly farm workers in the community.
In the US, Practice Greenhealth’s Healthier Hospitals Initiative includes more than 1,000 hospitals working to serve meat and poultry raised without unnecessary antibiotics, and empowers the healthcare sector to utilise its purchasing influence and moral authority to preserve the efficacy of these medicines).8 9 10 11 Also taking inspiration from the Healthy Food in Health Care programme of HCWH US & Canada, Health Care Without Harm Europe follows in their footsteps to encourage hospitals to purchase animal-based products produced without routine and non-therapeutic antibiotics, to serve as much as possible organic meat, and educate staff and patients about AMR.
Another strategy that hospitals should adopt is a reduction in the amount of meat served - by serving fewer and smaller portions of red meat and poultry, and increasing the availability of healthy plant-based foods. Meals should be enriched with larger portions of fruits, vegetables, grains, and provide other forms of protein such as fish and pulses. Hospitals have the power to transform markets and supply chains and change practices in farms that allow the increase of antibiotic-resistant bacteria.
As Dr Antoine Andremont, Professor at the Faculty of Medicine at the University Paris-Diderot and Head of Bacteriology at Bichat-Claude Bernard Hospital stated:
"We must re-focus the use of antibiotics on their original purpose: to protect human health and save lives, and we must re-assess whether other uses of antibiotics are justified, so that we can preserve the miracle of antibiotics for future generations".12
More awareness is needed around AMR so healthier food choices can be delivered in hospitals and other public institutions across Europe. EU Antibiotic Awareness Day 2016 takes place on Friday November 18th. Read more about it here.
- Paola Hernández, Sustainable and Healthy Food Programme Assistant
Preview image: US Dept. of Agriculture via Flickr cc
(1) European Commission – Directorate General for Health and Consumers (2011) Communication from the Commission to the European Parliament and the Council Action plan against the rising threats from Antimicrobial Resistance. Brussels, 2011
(2) European Commission (2016) Commission staff working document - Evaluation of the Action Plan against the rising threats from antimicrobial resistance. Brussels, 2016.
(3) European Commission (2015). Commission staff working document - Progress report on the Action plan against the rising threats from Antimicrobial Resistance in reference to the Regulation (EU) 2016/429 of the European Parliament and of the Council of 9 March 2016 on transmissible animal diseases and amending and repealing certain acts in the area of animal health (‘Animal Health Law’)
(4) European Commission (2005) Ban on antibiotics as growth promoters in animal feed enters into effect.
(6) European Parliament (2016) Superbugs: MEPs want to curb use of antibiotics in farming.
(8) Health Care Without Harm US & Canada Promoting and Marketing Antibiotic Stewardship Through Food Services.
(9) Health Care Without Harm US & Canada (2014). Expanding Antibiotic Stewardship The Role of Health Care in Eliminating Antibiotic Overuse in Animal Agriculture. https://noharm-uscanada.org/sites/default/files/documents-files/2735/Expanding%20Antibiotic%20Stewardship.pdf
(10) Health Care Without Harm US & Canada (2016) Webinar on Marketing and Promotion to Support Purchasing Strategies
(11) More information about current news and events in antibiotic policy can be found in the Health Care Without Harm US & Canada Blog
(12) World Health Organization (WHO) (2015) What to do about resistant bacteria in the food-chain? Bulletin of the World Health Organization, 2015; 93(4), 209-284.
More reading on AMR in the food supply
- Health Care Without Harm US & Canada. Promoting and Marketing Antibiotic Stewardship Through Food Services.
- Health Care Without Harm US & Canada (2014) Expanding Antibiotic Stewardship The Role of Health Care in Eliminating Antibiotic Overuse in Animal Agriculture.
- Health Care Without Harm US & Canada (2016) Webinar on Marketing and Promotion to Support Purchasing Strategies.
- More information about current news and events in antibiotic policy can be found in the Health Care Without Harm US & Canada Blog
- Alliance to save our Antibiotics (2014). Antimicrobial resistance - why the irresponsible use of antibiotics in agriculture must stop. https://www.sustainweb.org/publications/antimicrobial_resistance/
- Heinrich Böll Foundation and Friends of the Earth Europe (2014) Meat Atlas: Facts and figures about the animals we eat.
- European Public Health Alliance (EPHA) (2016) Drug Resistance through the back door: how the pharmaceutical industry is fuelling the rise of superbugs through pollution in its supply chains.