Journal Article

World Health Organization (WHO) guidelines on use of medically important antimicrobials in food-producing animals

Angulo, Frederick J., Silbergeld, Ellen K., Collignon, Peter J., Aidara-Kane, Awa, Conly, John M., McEwen, Scott A., Minato, Yuki

2018

Overview

Background Antimicrobial use in food-producing animals selects for antimicrobial resistance that can be transmitted to humans via food or other transmission routes. The World Health Organization (WHO) in 2005 ranked the medical importance of antimicrobials used in humans. In late 2017, to preserve the effectiveness of medically important antimicrobials for humans, WHO released guidelines on use of antimicrobials in food-producing animals that incorporated the latest WHO rankings. Methods WHO commissioned systematic reviews and literature reviews, and convened a Guideline Development Group (GDG) of external experts free of unacceptable conflicts-of-interest. The GDG assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and formulated recommendations using a structured evidence-to-decision approach that considered the balance of benefits and harms, feasibility, resource implications, and impact on equity. The resulting guidelines were peer-reviewed by an independent External Review Group and approved by the WHO Guidelines Review Committee. Results These guidelines recommend reductions in the overall use of medically important antimicrobials in food-producing animals, including complete restriction of use of antimicrobials for growth promotion and for disease prevention (i.e., in healthy animals considered at risk of infection). These guidelines also recommend that antimicrobials identified as critically important for humans not be used in food-producing animals for treatment or disease control unless susceptibility testing demonstrates the drug to be the only treatment option. Conclusions To preserve the effectiveness of medically important antimicrobials, veterinarians, farmers, regulatory agencies, and all other stakeholders are urged to adopt these recommendations and work towards implementation of these guidelines.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Advisors / Agriculture / Animal Husbandry / Animals / Anti-infective agents / Anti-Infective Agents - adverse effects / Anti-Infective Agents - analysis / Anti-Infective Agents - standards / Anti-Infective Agents - therapeutic use / Antimicrobial agents / Antimicrobial resistance / Antimicrobial use / Bacteria / Biomedicine / Disease control / Dosage and administration / Drug Resistance / Drug Resistance, Microbial - drug effects / Environment / Experts / Farmers / Food / Food Analysis - standards / Food industry / Food Safety / Guidelines / Guidelines Article / Guidelines as Topic / Handbooks / Health consequences / Health risks / Humans / Infections / Infectious Diseases / Medical Microbiology / Pathogens / Production management / Public health / Veterinarians / Veterinary medicine / World Health Organization / Writing / Zoonoses / Zoonoses - drug therapy