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There is more evidence to support the use of antibiotics in livestock than in humans. In 2001, the WHO declared that antimicrobial resistance was growing rapidly, particularly in resistant pathogenic strains of Enterobacteriaceae. This is especially troubling considering that livestock are involved in large areas of human disease and antibiotic use is common practice in agriculture and as part of general veterinary practice. The issue is especially relevant since antimicrobial susceptibility is important for treating patients in intensive care units for whom antibiotics do not provide effective relief. In clinical studies, the average duration of antibiotic treatment required by an intensive-care unit was around 20–23 days [12,20]. The WHO and the United States government estimate that by the year 2020, the number of non-compliant ICU patients will increase by over 40% [28,29]. The World Health Organization estimates that 1 million global, non-human infectious diseases will be caused or exacerbated by antimicrobial resistance in livestock between 2010 and 2050 , and one-half of such diseases will continue to arise in livestock .
The introduction of resistant strains in humans is associated with reduced survival. In a study of more than 2,300 patients with non-specific sepsis, antibiotic-resistant gram-negative organisms (GABGs) outnumbered those belonging to the Gram-negative community by more than 1,500:1 .
Infectious disease is a global public health concern of enormous public health magnitude. We hope that the adoption of improved antimicrobial stewardship in livestock will improve the success of antimicrobial stewardship for human health. Our studies demonstrate that the use of beneficial bacterial metabolites as antibiotics to improve clinical efficacy is associated with decreased incidence of antimicrobial-resistant infections. This finding supports the use of antimicrobial medications for livestock and suggests that other microbial metabolites, both beneficial and harmful in nature, can also act as antimicrobials to promote the control of infections with beneficial bacteria, especially Escherichia coli.
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