The development of antimicrobials is considered to be one of the most important scientific discoveries in the modern time. Millions of people used to die from infectious diseases as there were no known treatments which in return significantly affected the public health and general well being of the human and animal population. Since the introduction of penicillin in the middle of 20th century, 4 there has been a breakthrough revolution in how Physicians provide care. Better outcomes have been noted in all aspect of medicine; including safer childbirth, surgical procedures, organ transplantation. 4
However, an emerging obstacle threatens people’s and animals life which is Antimicrobial resistance (AMR). It also has implications for both food safety and security and the economic well-being of millions of farming households. 5 In the United States, AMR causes more than 2 million infections and are associated with approximately 25000 death annually. 5 Which in return increases the cost of medical expenditure of $20 billion in excess. 5 This condition threatens the ability to treat bacterial, parasitic and viral infections in humans and animals. Over the last decade, studies have raised concerns and discussions regarding the possible role of antimicrobial use in animals in the selection of resistance in bacteria of human health. 2 Unfortunately, not much attention has been given to the impacts of resistance on animal health and welfare. 2
Multiple factors have been to proven to contribute to the alarming rates of AMR. Most antibiotic use is in two areas: in humans in the community to treat infections, and in animals for growth promotion and prophylaxis. 4 Data suggest that up to 75 % of antibiotic use is of questionable therapeutic value. 4 The increasing resistance problems are probably related to the increasing use of broad-spectrum antibiotics, in addition to this is the allowance of over the counter antibiotics purchase in developing countries as a way to reduce healthcare costs. 4 Factors contributing to AMR are lack of regulation, lack of appropriate knowledge and evidence-based practice, use of antibiotics not as medicine but as growth promoters in animals, over the counter and internet sale of antibiotics. 6 As a result, antimicrobials that were once very effective in treating the life-threatening condition are now useless and has a reduced ability to successfully treat infection, production in agriculture and reduced livelihoods and food security. 6?
It is important to understand the factors contributing to AMR. One aspect is bacterial replication that emerges de novo mutations. 5 Each replication cycle offers the opportunity for mutation, allowing the emergence of genetic factors that contribute to the resistance of antimicrobials. 5 Although naturally occurring resistance factors contribute to AMR, human activity plays an important role in the evolution of resistance. The agricultural use of antibiotics for animal growth. In the United States, antibiotic use in animals raised for food represents 80% of total antibiotics consumption, 74% of these antibiotics are administered as a method to promote animal growth rather than to treat and prevent infection. 5 Although the direct influence of such practices on human health is difficult, the possibility of transmission of resistant bacteria via animal-to-human contact and consumption of animal products continue to emerge. 5 Therefore an association has been demonstrated between antibiotic consumption by animals and the existence of commensal organisms resistant to the same antibiotic classes. 5
Zinsstag has noted the global relationship between human health, animal health, and the Ecosystem. 1 He discussed it in details on his articles ” Mainstreaming One Health”. 1 He mentioned that one of the main factors that are driving animal and human interaction is the global livestock production, especially its main goal which is profit. 1 There has to be a cooperation between human and animal health in order to achieve a healthy ecosystem. More effort to understand zoonotic diseases, how to appropriately prevent, diagnose and treat them in a way that minimizes AMR and achieve the best outcome. 1 It is important to understand the environmental changes and the epidemiology of diseases and the factors that lead to spread of infectious diseases globally. 1 That would be the way to offer treatments and solutions once a crisis happens.
Zinsstag J, Mackenzie JS, Jeggo M, Heymann DL, Patz JA, Daszak P. Mainstreaming One Health. Ecohealth. 2012;9(2):107-110. doi:10.1007/s10393-012-0772-8.
McEwen SA, Boerlin P, Raji? A, Reid-Smith R. Special Issue — Antimicrobial Resistance. Canadian Journal of Veterinary Research. 2008;72(2):81.
Frey, Rebecca J. “Antimicrobial Resistance.” The Gale Encyclopedia of Public Health, edited by Laurie J. Fundukian, vol. 1, Gale, 2013, pp. 70-74. Global Issues In Context, website: http://link.galegroup.com/apps/doc/CX2760500026/GIC?u=bidd97564;sid=GIC;xid=fb789bf2. Accessed June 24, 2018.
Wise R, Hart T, Cars O, et al. Antimicrobial resistance. BMJ : British Medical Journal. 1998;317(7159):609.
Marston HD, Dixon DM, Knisely JM, Palmore TN, Fauci AS. Antimicrobial Resistance. JAMA. 2016;316(11):1193–1204. doi:10.1001/jama.2016.11764
Antimicrobial Resistance. Food and Agriculture Organization of the United Nations website. http://www.fao.org/antimicrobial-resistance/background/fao-role/en/. Accessed on June 24, 2018.