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| Background The use of antibiotics in food animals has been suggested as a cause of antibiotic resistance in humans. Many government regulatory authorities, including the U.S. Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM), encourage using science based methods to assess if animal antibiotic use poses a threat to human health via the food supply. A risk assessment combines information on the consequence of an event with the probability of occurrence of that event. New Peer-Reviewed Assessment A new article “The Public Health Consequences of Macrolide Use in Food Animals A Deterministic Risk Assessment”, published in the May 3, 2004, issue of Journal of Food Protection (Vol. 67, No. 5), details a risk assessment of macrolide antibiotics that was conducted using guidelines issued by the U.S. FDA in Regulatory Guidance Document 152. This macrolide risk assessment used numerical estimates of the probabilities instead of categorical (low/medium/high) estimates, resulting in a deterministic (numerical) risk assessment that is transparent and interpretable. The objective was to estimate the risk so appropriate actions could be taken to protect both the public and animal health. Rationale Hurd et al. reviewed the uses of the macrolide antibiotics tylosin* and tilmicosin* in U.S. food animal production, and analyzed the potential risk for a person to either acquire macrolide-resistant Campylobacter, a food-borne bacterium, or macrolide-resistant E. faecium, which is thought to carry antibiotic resistance genes. Defining the Hazard and Risk To determine the risk of farm-to-patient infection and treatment failure, the authors developed a mathematical model in which they first defined the hazard as using tylosin and tilmicosin in cattle, poultry, or swine. Then they tracked this hazard through the food chain, from farm to consumption, to the consequence of treatment failure in humans caused by resistant Campylobacter or E. faecium. Results The results showed the yearly probability that an average person in the U.S. would be affected by the macrolide-resistant bacteria and then experience treatment failure (e.g., longer duration of symptoms such as diarrhea; progression to more severe disease; or in the worst-case scenario, mortality.) Risk to Humans of Acquiring a Resistant Infection Resulting in Treatment Failure Beef Campylobacter: Less than one in 236 million people per year E. faecium: Less than one in 29 billion people per year Poultry Campylobacter: Less than one in 14 million people per year E. faecium: Less than one in 3 billion people per year Pork Campylobacter: Less than one in 53 million people per year E. faecium: Less than one in 21 billion people per year Dr Ian Lean applauds new Australian research. A note to journalists about the use of Dr Ian Lean as a spokesperson. You can find out more about Ian Lean on his corporate pages. The full (337 page) report is available here. The recent release from McDonalds is here. |