Abstract
The global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a postantibiotic world and simple injuries could once again be life threatening. New antibiotics are needed urgently, but better use of existing agents is just as important. More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria. Given the current crisis, it is vital that the nonmedical use of antibiotics is critically examined and that any nonessential use halted.
Highlights
The crisis of antibiotic resistance compromises the ability to treat infections and threatens many areas of medicine, including surgery
In May 2014, WHO documented the global extent of antimicrobial resistance, reiterating the need for urgent action [1], while the World Health Assembly has emphasised the need to implement a global action plan [2]
There is a potentially large selective window of antibiotic concentrations favouring the growth of resistant bacteria, especially when resistance is at no fitness cost to the bacterium
Summary
More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria.
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