Strategic measures for the control of surging antimicrobial resistance in Hong Kong and mainland of China

Cheng, Vincent CC; Wong, Sally CY; Ho, Pak-Leung; Yuen, Kwok-Yung

In light of the association between antibiotics used on farms and the subsequent identification of MDROs in food animals and food products, the control of antibiotic use in farms has become one of the most important upstream control measures ( Figure 3 ). Restriction of antibiotic use as growth promoters in farms was first introduced in Sweden in 1986. Swedish farmers supported the ban because the consumer confidence in meat safety dropped when the public learned that 30 tons per year of antibiotics had been used in Sweden for food animal production. Similarly, because of consumers' concerns regarding antimicrobial resistance, farmers in Denmark voluntarily stopped all antimicrobial use as growth promoters in 1999, after the government banned the use of avoparcin in 1995 and virginiamycin in 1998, respectively. The avoparcin ban in 1995 was followed by a decrease in the occurrence of glycopeptide-resistant E. faecium in broilers from 68 Many European countries have demonstrated marked decreases in antimicrobial resistance after the restriction of antimicrobial use in food animals. 69 Consequently, the use of certain antimicrobial agents (avoparcin, tylosin, spiramycin, bacitracin and virginiamycin) as animal growth promoters have been banned by the European Union in 2001, and the Health Ministries in the European Union have subsequently agreed to discontinue the use of all antimicrobial growth promoters. 70 There is an urgency to perform intensive surveillance on the type, the amount and indications for use of antibiotics in farming. Such data must be transparent to the public, and their usage must be audited. Use of antibiotics for growth promotion must be banned (Table 1) . Animal health is better served by better biosecurity than antimicrobial abuse.