External Societal Costs of Antimicrobial Resistance in Humans Attributable to Antimicrobial Use in Livestock.

Gabriel K Innes,Pranay R Randad,Christopher D Heaney,Meghan F Davis,Lance B Price,Anthony D So,Anton Korinek

doi:10.1146/annurev-publhealth-040218-043954

Abstract

Antimicrobial use (AMU) in animal agriculture contributes to antimicrobial resistance (AMR) in humans, which imposes significant health and economic costs on society. Economists call these costs negative externalities, societal costs that are not properly reflected in market prices. We review the relevant literature and develop a model to quantify the external costs of AMU in animal agriculture on AMR in humans. Parameters required for this estimate include (a) the health and economic burden of AMR in humans,(b) the impact of AMU in animal agriculture on AMR in animals, (c) the fraction of AMR in humans attributable to animal agriculture, and (d) AMU in animals. We use a well-documented historic case to estimate an externality cost of about US$1,500 per kilogram of fluoroquinolones administered in US broiler chicken production. Enhanced data collection, particularly on the third and fourth parameters, is urgently needed to quantify more fully the externalities of AMU in animal agriculture.

Highlights

The rising rates of antimicrobial resistance (AMR) in bacterial populations threaten treatment options for these infections globally [35]
We present a historic case study—the application of the fluoroquinolone antibiotic enrofloxacin to US broiler chickens—and quantify the societal externality costs generated in the form of the additional fluoroquinolone resistance (FR) of one specific pathogen, Campylobacter spp., in the United States in 1999, before the use of fluoroquinolones was banned in the chicken industry
An additional kilogram of enrofloxacin administered to chickens imposed an externality cost of about US$1,500 on human society, which translated into a 7-cent social cost per chicken just from FR-Campylobacter alone

Summary

INTRODUCTION

The rising rates of antimicrobial resistance (AMR) in bacterial populations threaten treatment options for these infections globally [35]. Regional- and national-level surveillance systems for foodborne pathogens estimate the proportion and total number of infections attributable to animal agriculture Such surveillance www.annualreviews.org Antimicrobial Resistance from Livestock 147. Given different dosing requirements for different species of animals, estimates of AMS or AMU should ideally be stratified by animal species and standardized to the total number of that animal species raised for meat This standardization would allow direct comparisons of antimicrobials sold (and used) per animal produced in each sector of animal agriculture among different countries and may give insight into use, animal husbandry, and animal welfare practices. Our externality estimate cannot be used directly as a corrective tax on AMU in animal agriculture (in the spirit of a Pigouvian tax in economics) because imposing the tax would likely reduce AMU and alter the steady state and the magnitude of the associated externality

Results

DISCUSSION

DISCLOSURE STATEMENT