Antimicrobial Resistance: An Emerging Public Health Issue
Antimicrobials -- a set of agents which includes antibiotics, synthetic anti-effective drugs, antibacterial agents, and disinfectants -- had had significant beneficial effects on public health, medicine, animal husbandry, agriculture, and food processing. By making many diseases and infections, which were once difficult to treat and often lethal, readily curable, antibiotics have revolutionised human and veterinary medicine. In agricultural use, besides treating specific infections in animals, antibiotics are also given to farm animals to speed their growth, to promote the efficient use of the feed, and to be sprayed on crops as pesticides. The widespread use of antimicrobials, however, is causing some to lose their ability to control disease. The Food and Drug Administration (FDA) approves antimicrobials for human and veterinary use if the manufacturer of the antimicrobial has met all FDA's safety and efficacy requirements. FDA's approval system is not designed to respond to the development of resistant strains, subsequent to approval of the product for human drugs. However, the federal government does run several surveillance programs designed to estimate the scope of the resistance problem, supports research directed at discovering new antibiotics or strategies to circumvent resistance, and promotes voluntary activities on the part of practitioners, consumers, and agricultural producers to reduce the risk. Legislative concerns regarding policies to control antimicrobial resistance focus on whether policy actions should seek to influence the root causes of the problem, encourage new treatments, or address its symptoms. Defining appropriate policy responses is particularly difficult given the complexity of the microbial resistance problem, the lack of data to assess the problems, and the disagreement over the seriousness of the extent of the health threat to resistance. Use of antimicrobials in human medicine, for example, is thought to be the primary source of resistance and some wonder whether the government should regulate such uses. Included in the debate are the uses of antibiotics in the agricultural sector. The conflict there is over how much antibiotic use, both for treating disease and promoting growth, in food-producing animals contributes to resistant strains of bacteria. FDA has proposed a framework in its animal drug approval system to ensure some tracking of resistance development if it takes place.
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Current Approaches to the Problem of Resistance
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abstract available Acta Vet Scand agencies agricultural animal drug Animal Health Institute antibacterial antibiotic resistance antibiotics in animals antibiotics in food antimicrobial agents antimicrobial drug antimicrobial resistance Approval Process bacterial resistance bacterium Campylobacter Center class of antibiotics Clin clinical development of resistance Drug Approval drug resistance effective Emerging England Journal enrofloxacin Enterococcus faecium estimated federal feed fluoroquinolone food animals Food Safety food-producing animals foodborne pathogens genetic growth promoters guidelines hospital human drugs human health human medicine humans and animals increased Infectious Diseases laboratories manufacturer methicillin microorganisms NARMS Nosocomial Infections organisms pathogens patients physicians PMID PMJD poultry prescribed prescription programs recent Report resistance problem resistance to antimicrobial resistant bacteria resistant infections resistant strains Review Salmonella sarafloxacin Scand Suppl Scientists spread Staphylococcus aureus strains of bacteria Streptococcus pneumoniae Streptogramins surveillance systems Synercid tests therapeutic therapy transfer treat triclosan U.S. Congress vaccine vancomycin vancomycin-resistant Enterococcus veterinary Washington Zyvox