Submitted to: Foodborne Diseases
Publication Type: Book / chapter
Publication Acceptance Date: 9/14/2004
Publication Date: 9/10/2007
Citation: Poole, T.L., Callaway, T.R., Nisbet, D.J. 2007. Alternatives to antimicrobials. In: Shabbir, S., editor. Foodborne Diseases. Totowa, NJ: Humana Press. p. 419-433. Interpretive Summary: Antibiotics have been in use for fifty years to combat bacterial infections. When antibiotics were first discovered many thought bacterial diseases would be eradicated; however this has not happened because, over time, many bacterial organisms have developed resistance to the antibiotics used against them. When resistance first became evident it was to single antibiotics. Today many bacteria have acquired resistance to multiple drugs, and a few have become resistant to all known drugs. There is a world-wide need for alternatives to decrease our reliance on antibiotics. This book chapter entitled 'Alternatives to Antibiotics' reviews alternative prevention and treatment options for both human and veterinary medicine.
Technical Abstract: The emergence of multi-drug resistant pathogens has stimulated a need to find alternatives to antimicrobials. Currently, no single treatment is available that can eliminate the need for antimicrobials; particularly in immunocompromised individuals. Prudent use protocols have been called for to decrease consumption of antimicrobials. These protocols include the use of antimicrobials for individuals clinically diagnosed with bacterial infections, and excludes antimicrobial treatment for viral infections, disease prophylaxis and growth promotion. Most clinicians and scientists agree that unnecessary use of antimicrobials should be eliminated; however, few agree on what constitutes unnecessary use. Modern medicine as well as modern food animal production practices have contributed to the current problem, and more than cessation of antimicrobial use for prophylaxis and growth promotion is necessary to reduce the incidence of multi-drug resistant pathogens in hospitals and the environment. There are many pre-harvest protocols in food animal production for disease prophylaxis and many more are currently under investigation. Potential strategies that could be incorporated with current management practices include: new diagnostic procedures, vaccination and new treatment-based technologies, competitive exclusion, and the use of probiotics. New treatment options under study include: bacteriophage therapy and compounds directed at new bacterial metabolic targets (eg. programmed cell death pathways). The combined application of pre-harvest prevention and treatment strategies has the potential to greatly reduce the amount of antimicrobials currently in use.