Farms have long reduced the use of antimicrobials, obtaining excellent results. Unfortunately, according to the latest EFSA report, this is not the case in human medicine. Consumption of antibiotics remains high, and therapies are inappropriate in one out of four cases.

According to the last data released by EFSA, the European Food Safety Agency, which with the EMA (European Medicines Agency) and ECDC (European Centre for Disease Control), has monitored the evolution of the situation between 2016 and 2018, antibiotics consumption in farming in Europe dramatically decreased. For some molecules, such as polymyxins, consumption has even halved. Significant decreases then affected the group of penicillins and tetracyclines. On the other hand, consumption has remained high in the medical field, so much so that the use of antimicrobials is now higher in humans (130 mg/kg) than in animals (108.3 mg/kg).

It is worth noting this first extraordinary result is the consequence of the responsible behaviour of the livestock production chain, from meat to eggs and milk. And it represents a significant step forward in the fight against the growth of AMR, acronym of Antimicrobial Resistance, or antibiotic resistance.

It is estimated that over 30 thousand people in Europe alone lose their lives each year because of AMR. Shocking numbers, comparable to those of known diseases, such as flu, tuberculosis, and AIDS combined. This is stated by ECDC studies’ results, published in 2019. This is due to excessive and improper use of antibiotics, which favours new resistant bacterial strains. If we do not intervene, treating even trivial infections in the future could be difficult, if not impossible. And mortality, already unacceptable, would be increasing.

The problem has not arisen today. It has been debated so much that already in 2007, EFSA developed the first guidelines to monitor the resistance of certain bacteria (Salmonella and Campylobacter), which affect humans and animals. Since then, research has not stopped, following two strands: to control the evolution of the problem and trace the guidelines to stop the growth of AMR. Thus, creating new antibiotic molecules capable of overcoming the microorganisms’ defenses has been entrusted to research. It is a long and winding road that requires considerable investment and does not promise short-term results.

The most immediate solution is a reduction in antibiotics and, above all, a rational and targeted use of them. It aims to be pursued with determination in every health area, whether it is a stable or a clinic. Concepts typical of the One Health strategy, which sees human and animal medicine towards common and interconnected health goals.

Low-dose antibiotics (auxins) for production purposes have been forbidden for quite a long time in the animal field. The current veterinary prescription has general therapeutic purposes, aimed at the individual animal or a defined group. The introduction of electronic veterinary prescription has contributed to the more rational and controlled use of all drugs.

At the same time, livestock farms have put in place several strategies to reduce the use of antimicrobials, including an increase in the level of biosecurity to prevent the entry of pathogens into the stable. Where therapeutic intervention was not possible, alternative solutions were sought: antibacterial algae, short-chain fatty acids, tannins, and many other natural substances able to interact with microbial cells, exerting a bacteriostatic and also bactericidal action. This is the “secret” that allowed the drastic reduction of the use of antibiotics in farms.

Unfortunately, human medicine did not achieve similar results, and the consumption of these drugs remains high. The Italian Agency for Medicine (AIFA) complaint concerning the frequent misuse of antibiotic therapies, which in humans are inappropriate in one out of four cases, is worrying in this regard. Without forgetting that the EFSA report indicates that a similar reduction has not matched the decrease in antibiotics in the zootechnical field in the human area.

When dealing with antibiotic resistance, it is then wrong to point the finger at farms that are “victims” of this problem. The path to follow is outlined by the One Health strategy, as long as everyone plays their part.