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| In the battle
against infectious disease, humankind has inadvertently given rise to deadly
enemies. Antibiotic resistance is a stunning example of evolution by natural
selection. Bacteria with traits that allow them to survive the onslaught
of drugs can thrive, re-ignite infections, and launch to new hosts on a
cough. Evolution generates a medical arms race. The bad news is that bacteria
-- with their fast doubling times and ability to swap genes like trading
cards -- evolve quickly. The good news is that in the 150 years since
Darwin, we have grown to understand the rules of the race. But can we win
this war? |
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Question
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 George
W. Beran is distinguished professor of preventive
veterinary medicine at Iowa State University in
Ames, Iowa. His research and teaching career has
been in the epidemiology of antimicrobial resistance
and diseases transmitted between animals and humans
through foods of animal origin. He was a member
of the National Research Council Committee on Drug
Use in Animals. |
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Antibiotics are very important in the health
and production of animals, as they are in human
health. But, antibiotic use leads to the
selection of resistant bacteria which can be transferred
between people, between animals, but also from
animals to humans (and vice versa).
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| In pet animals, antibiotics
control and shorten diseases, and prevent infection
of other animals and infection from animals to people. But,
the antibiotics that work best for pets are basically
the same or similar to those used for humans
-- which increases the risk of transferring resistance
between animals and humans. |
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| In food animals, antibiotic
use for the purpose of disease therapy and prevention
is advantageous since it decreases suffering, increases
productivity, and protects people, other animals,
and the environment from transfer of pathogenic
bacteria. Preventive low-level feeding of antibiotics
to food animals is useful for increased animal growth,
since it suppresses bacteria, but antibiotics should
be carefully selected for their effectiveness
in the specific species of animals and for their
use at critical stages in the animals' growth. |
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| Antibiotics also enhance
food animal growth by suppressing bacteria competing
for nutrients, maintaining a thinner, more absorptive
intestinal mucosa, and favorably modifying the intestinal
bacteria. Their use is an effective adjunct to
-- but not a substitute for -- optimal management,
control of exposure and stress, nutrition, and sanitation
in the food animal industry. There is also a
move in the industry toward the increased use of
antimicrobials that are not used in human medicine.
Other methods of fighting disease and increasing
productivity in food animals are in development,
such as vaccination, immune enhancement measures,
enhanced nutrition, and genetic selection. |
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| Judicious use of antibiotics
in food animals, pet animals, and human patients
is crucial. The monitoring of resistant strains
in all of these populations, however, must also be enhanced. |
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| (Boldface added.) |
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