Does antibiotic use in animals contribute to antibiotic resistance levels in human beings?

In this month's TLID we try to answer this question in the journal's first forum-a debate section where different perspectives are presented from both human and animal medicine to better understand the complexity of the problem of antibiotic resistance. Antibiotics are used therapeutically and prophylactically in animals, but their use as growth promoters in animal husbandry has recently come under fire, and there is growing concern over the transmission of resistant bacteria via the food chain. The six invited experts from Europe and the USA are all in agreement that antibiotic use in animals does affect antibiotic resistance in human beings, but that the contribution is likely to be small. The limited understanding of the nature of antibiotic resistance, and the absence of studies enabling us to quantify and trace precisely the contribution of animal use to the resistance levels in human beings are major challenges.

Where there does seem to be a difference in opinion is whether banning antibiotics as animal growth promoters might have a beneficial effect on human health.

This issue is discussed in The Leading Edge editorial which makes a strong stand towards banning these growth promoters, arguing that their use should be restricted for treatment and prevention only.

PROGRESS ON SLEEPING SICKNESS
In a Personal view, OC Hutchinson and colleagues discuss the lessons learned from the emergence of a new Trypanosoma brucei rhodesience sleeping sickness focus in Uganda. The progress in molecular biology has meant that diagnosis of infection is greatly improved, and, together with advances in field and epidemiological techniques, successful disease control management in the future is now feasible.

Other reviews:
The effect of drug resistance on the fitness of Mycobacterium tuberculosis
Travel and spread of HIV-1 genetic variants
Mutation rate and the efficacy of antimicrobial drug treatment
Is clinical outcome of dengue-virus infections influenced by coagulation and fibrinolysis A critical review of the evidence

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