Implications for the United States drawn from European Union Experiences with Antimicrobial Use, Policy, and Resistance

Spurred on by heavy antimicrobial use in healthcare systems worldwide, antimicrobial resistance (AMR) is a preeminent global health crisis. Antimicrobials are also economically important as antimicrobial growth-promotants (AGPs) for food animals. Due to connections between antimicrobial use in food animals and increased AMR arising in zoonotic pathogens, many governments worldwide have enacted or proposed legislation intended to curb veterinary antimicrobial use. Starting in 2012, the United States Food and Drug Administration (FDA) began to release a set of industry guidances that proposed a phase-out of medically important antimicrobials as AGPs in food animals. Effective January 1st, 2017, these new regulations have left many questions as to their economic and logistical impacts on the food animal industry, as well as their effects on food animal and human health. The European Union and its member states have had similar regulations for several decades now, with the constituent nations of Sweden and Denmark being particularly strong examples. These nations and their data-collection infrastructures offer a wealth of information as to the possible economic and health effects of AGP restrictions in the United States. We reviewed this information to propose possible implications of the recent AGP regulations in the United States