New Paradigms Concerning the Production of Antibiotics: Between Ecological Responsibility and Revalorization of Narrow Spectrums

Dear Colleagues,

Despite clear warnings of increasing bacterial resistance and antimicrobial treatment failures due to inappropriate and excessive antibiotic use, there has been little progress in antibiotic stewardship over the past few decades. In this Special Issue, we share our views on the possible courses of action that could mitigate and even hopefully reverse the current situation, based on multifaceted approaches, which rely on a strong commitment on the part of governments, manufacturers, prescribers, and consumers. Although the detrimental role of antibiotics as growth factors in the food industry has been known for many years, few countries have taken the necessary steps, and only in Europe has this practice been discontinued. Recent studies have shown that it accounts for 20% of bacterial resistance in humans. Lately, awareness has been raised of the major role in the emergence and spread of antimicrobial resistance resulting from the production of antimicrobials in developing economies.

Stricter government control of antimicrobial manufacturing practices and of antimicrobial use in livestock should reduce the spread of antibacterial agents in the environment. This should be a mandatory requirement prior to granting a marketing license in any country. The addition of growth-promoting antibiotics in livestock should be banned. Physicians who have lost their clinical skills, due to the ease with which a broad-spectrum agent can cover a wide array of bacteria, need to acquire a keener knowledge of pathogen-specific clinical presentations. This would ensure targeted prescriptions with narrow-spectrum antimicrobial agents, thus limiting their impact on the gut flora and the emergence of resistance, while preserving more potent (?), broad-spectrum agents for severe conditions. Lastly, many patients remain unaware of the potential dangers of resistant bacteria and should be taught to refrain from consuming antimicrobials for conditions which are most often benign and/or of viral origin. Promotion of alternative approaches in such situations should be encouraged.

We would like this Special Issue to focus on a One Health perspective encompassing antimicrobial production, animal and human use, and related environmental concerns and give several practical proposals in order to initiate a reflection on change.

Dr. Véronique Mondain
Guest Editor

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• one health
• environmental pollution
• human health
• antimicrobial production
• livestock
• antimicrobial resistance
• antimicrobial stewardship