Genesis of Antibiotic Resistance LXVI: Mechanism(s) of a Minimum Antibiotic Footprint (AF) Wane Prospective Infectious Diseases Pandemic, A critical appraisal with a global perspective

Abstract

Antibiotic Footprint (AF) is a cumulative measure of the amount of antibiotics consumed by the general population inclusive of healthcare, educational activities, and agrochemical – livestock industries reported by each country. The principal objective of AF is to limit intentional and unintentional misuse/overuse curbing the resistance in bacteria (https://amr-review.org/). Defined Daily Dosage (DDD)/1,000 people/day and milligrams per Population Correction Unit (PCU) are utilized for comparison of consumption rate for specific antibiotics in general population and agricultural - livestock industries. The AF is calculated as the total amount (tones) / country in which the antibiotic usage ‘per person's lifetime’ or ‘per consumer product inclusive of antibiotics’ could be derived. According to the Antibiotic Footprint.net Thailand reported that a personal level as Human consumption 2,162.1 tonnes (32%) and Consumption in animal agriculture (ANIM) as 4,688.4 tonnes (68%). Whereas France reported that Human consumption in the community (Including the primary care sector) (COMM)860.7 tonnes (93%), Human consumption in the hospitals (HOSP) 62.7 tonnes (7%). U.S. reported that consumption in animal agriculture (ANIM) as 5,559.2 tonnes. Also, per person consumption was 99.2 grams/person. Though a detailed ESAC-Net Reporting Protocol 2020 and classes of antimicrobials are presented on ESAC-Net home page, it is our contention that the reporting method is flawed as it failed to factor in the number of unused antibiotics/antimicrobials collected each year which should be part of reporting as presented in our earlier work. As an effective means of instilling personal responsibility in each and every human being across the globe to minimize the AF has been presented by the https://www.antibioticfootprint.net/infobox.aspx?pageID=102 to track each individual's AF. In addition to well know measures such as vaccination for infectious diseases with imminent potential for pandemic as identified by CDC, better personal hygiene antibiotic stewardship in healthcare facilities, antibiotic prescription based on the clinical antibiogram of each patient, clean toilet facilities, clean portable water. In addition to that, we have found that the following specific objective measures were compelling as they are pivotal in reducing the AF: i. When was the last time you took antibiotics? ii. Was that possibly overuse? iii. How many times have you had antibiotics since birth? iv. How many times were possibly overuse? v. Do you know how many grams of antibiotics were used to raise the chicken that you are eating? vi. Which meat has a low Antibiotic Footprint? vii. How can you reduce your own and your country's Antibiotic Footprint to a minimum? Taken together, effective implementation of regulatory measures across the globe curbing the misuse and overuse of antibiotics in humans and animals would suffice to minimize the morbidity and mortality rate of a prospective incidence of infectious diseases pandemic inflicted by antibiotic-resistant bacterial pathogens which in turn reduce the consumption of antibiotics.