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Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment
Citation:
Pruden, A., J. Larsson, A. Amezquito, P. Collignon, K. Brandt, D. Graham, Jim Lazorchak, S. Suzuki, P. Silley, J. Snape, E. Topp, T. Zhang, AND Y. Zhu. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 121(8):878-885, (2013).
Impact/Purpose:
This paper is an overview from an international workshop on antibiotic resistance. This is the outcome of a breakout group on management options for reducing the spread of antibiotic resistance.
Description:
Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resistance determinants via environmental pathways, with the ultimate aim of 80 extending the useful lifespan of antibiotics. Incentives and disincentives for action are noted. 81 Methods: We focused on management options with respect to antibiotic manufacturing and 82 use, agricultural operations, wastewater treatment plants, and aquaculture based on current 83 literature. 84 Discussion: Several options were identified, such as nutrient management, runoff control, 85 and infrastructure upgrades. Where appropriate, a cross section of examples is provided 86 across various regions of the globe. The importance of monitoring and validating 87 effectiveness of management strategies is also highlighted. Finally, we close with a case 88 study in Sweden illustrating the critical role of communication to engage stakeholders and 89 promote action. 90 Conclusions: Environmental releases of antibiotics and antibiotic resistant bacteria can in 91 many cases be reduced at little or no cost. Some management options are also synergistic 92 with existing policies and goals. The anticipated benefit is an extended useful lifespan for 93 current and future antibiotics. Although the risk reductions often are still difficult to quantify, 94 the severity of the accelerating world-wide morbidity and mortality rates associated with 95 antibiotic resistance strongly motivate action. 96
