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1. Category I: Very High Importance
These antimicrobials are considered of very high importance in human medicine as they meet the criteria of being essential for the treatment of serious bacterial infections and limited or no availability of alternative antimicrobials for effective treatment in case of emergence of resistance to these agents. Examples include:
1.1 Carbapenems
1.2 Cephalosporins – the third and fourth generations
1.3 Fluoroquinolones
1.4 Glycopeptides
1.5 Glycylcyclines
1.6 Ketolides
1.7 Lipopeptides
1.8 Monobactams
1.9 Nitroimidazoles (metronidazole)
1.10 Oxazolidinones
1.11 Penicillin-β-lactamase inhibitor combinations
1.12 Polymyxins (colistin)
1.13 Therapeutic agents for tuberculosis (e.g., ethambutol, isoniazid, pyrazinamide and rifampin)
2. Category II: High Importance
Antimicrobials in this category consist of those that can be used to treat a variety of infections including serious infections and for which alternatives are generally available. Bacteria resistant to drugs of this category are generally susceptible to Category I drugs which could be used as the alternatives. Examples include:
2.1 Aminoglycosides (except topical agents)
2.2 Cephalosporins – the first and second generations (including cephamycins)
2.3 Fusidic acid
2.4 Lincosamides
2.5 Macrolides
2.6 Penicillins
2.7 Quinolones (except fluoroquinolones)
2.8 Streptogramins
2.9 Trimethoprim/sulfamethoxazole
3. Category III: Medium Importance
Antimicrobials in this category are used for treatment of bacterial infections for which alternatives are generally available. Infections caused by bacteria resistant to these drugs can, in general, be treated by Category II or I antimicrobials. Examples include:
3.1 Aminocyclitols
3.2 Aminoglycosides (topical agents)
3.3 Bacitracins
3.4 Fosfomycin
3.5 Nitrofurans
3.6 Phenicols
3.7 Sulphonamides
3.8 Tetracyclines
3.9 Trimethoprim
4. Category IV: Low Importance
Antimicrobials in this category are currently not used in human medicine. Examples include:
4.1 Flavophospholipols
4.2 Ionophores
This means even furan 2 requires a script. Thats just ridiculous as its rarely if ever used in humans.
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Antibiotics in Our Food System
The rise of dangerous antibiotic-resistant bacteria have become a critical public health problem, fueled in part by their use in industrial animal agriculture.
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Since the 1940s, antibiotics have played a critical role in protecting public health, and have saved millions of lives. However, the non-therapeutic use of antibiotics by the modern food animal industry is now responsible for the emergence of drug-resistant bacteria that pose a grave threat to public health.
A push in the communities of public health, science and consumer advocacy is happening to end the inappropriate use in livestock production of drugs that are medically important for people. 1 Yet so far, most reforms have been the result of voluntary changes by the industry.
Antibiotics and Antibiotic-Resistance
Bacteria are everywhere and are vital to the proper functioning of our bodies. In fact, humans have roughly an equal number of bacteria to human cells. 2 However, while most bacteria are beneficial to and synergistic with human health, some cause serious illnesses and death.
Since their discovery in the early twentieth century, antibiotics, or antimicrobials, have been used to cure a wide range of bacteria-caused diseases including pneumonia, meningitis, syphilis, food poisoning, ear and skin infections and many others. Drugs, such as penicillin, tetracycline, amoxicillin and others, kill or inhibit the growth of bacteria without causing significant harm to people.
Misuse of antibiotics, however, leads to evolution of antibiotic-resistant bacteria, which render these powerful, life-saving drugs ineffectual and therefore obsolete. When bacteria are continually exposed to low doses of an antibiotic, those resistant to the drug survive and reproduce while the rest die off, resulting in a new bacteria population that resists the antibiotic. 3
Prescription of antibiotics to treat conditions caused by viruses like the cold or flu (which cannot be treated this way) and patients’ failure to complete their antibiotic regimen are two common examples of antibiotic misuse 4, which enable the appearance of new, resistant strains. 5 In hospitals, poor infection controls, lax hygiene and sanitary practices and the lack of rapid laboratory tests can all contribute to the spread of antimicrobial resistance. 6
Antibiotics and the Animal Industry
Nowhere are antibiotics used more widely and subject to less oversight than in the livestock industry. According to the FDA, more than 20 million pounds of medically important antibiotic drugs were sold for use in food producing farm animals in 2014 — that’s up to 80 percent of all antibiotics sold. 7 The notion of administering antibiotics to people on a daily basis would never be considered, let alone condoned.
Antibiotics have been used in livestock feed since the 1940s, when studies 8 showed that the drugs caused animals to grow faster and put on weight more efficiently, increasing meat producers’ profits. Up until the recent past, when the FDA banned the practice, non-therapeutic antibiotics — those used for purposes other than treating disease — were routinely given to livestock, poultry and fish on industrial farms to promote faster growth. 9 The medication has the added benefit to producers of preventing disease that would otherwise be caused by the crowded, unsanitary conditions in which the animals are raised; the FDA’s ban of antibiotic use in animals for growth promotion means very little when antibiotics are still allowed for disease prevention, a practice common in confined animal feeding operations (CAFOs), or factory farms. According to the FDA, from 2009 through 2014, domestic sales and distribution of antibiotics approved for use in food producing animals increased by 22 percent. 10 Further, 97 percent of these drugs were purchased over the counter, without any veterinary involvement or oversight, and administered to animals primarily through feed or water, which makes precise dosing impossible. 11 While the 2013 FDA rule (that went into effect in 2017) includes provisions for veterinary oversight of antibiotic administration, many – including several US Senators – worry the FDA “may lack the authority to ensure veterinarians adhere to the criteria
Then again maybe theres plenty of proof out there