While it is widely known that antimicrobial resistance (AMR) is a consequence of antibiotic overuse in patients, the contribution of routine antibiotic use in animal agriculture to this emerging public health crisis is often overlooked. According to the CDC, agricultural antibiotic use is responsible for ~20% of resistant infections in humans. Just as physicians led an anti-smoking campaign to educate patients and communities, so too should we draw attention to the association between routine antibiotic use in animals and the declining efficacy of antibiotics in treating human infections. In this article, we highlight the health and economic consequences of antibiotic misuse in animal production and detail how physicians can use their role and influence to reduce AMR from agriculture.

Agricultural antibiotics became widespread more than a half century ago when AMR was not recognized to be a public health problem. At that time, antibiotics were discovered to accelerate pig and chicken growth when administered in conjunction with vitamins [1, 2]. Since then, antimicrobial use in animal agriculture has become widespread, and sale of these drugs for veterinary use exceeds that for human use by nearly threefold. While organic animal production (which by definition does not include the use of antimicrobials) is increasing in the poultry sector, less than 1% of US farmland dedicated to livestock production is certified as organic, suggesting that the vast majority of meat, egg, and dairy products in the grocery store are raised with antibiotics [3]. Among the most commonly used agricultural antibiotics are tetracyclines, aminoglycosides, sulfas, and penicillins [4]. A February 2017 World Health Organization report declared AMR the leading public health threat of our time. The report named 12 antibiotic-resistant superbugs, including superbugs resistant to the above antibiotics commonly used in food production, which pose an enormous health and bioterrorism threat.

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