TY - JOUR T1 - Use of colistin-containing products within the European Union and European Economic Area (EU/EEA): development of resistance in animals and possible impact on human and animal health. JF - Int J Antimicrob Agents Y1 - 2015 A1 - Boudewijn Catry A1 - Cavaleri, Marco A1 - Baptiste, Keith A1 - Grave, Kari A1 - Grein, Kornelia A1 - Holm, Anja A1 - Jukes, Helen A1 - Liebana, Ernesto A1 - Lopez Navas, Antonio A1 - Mackay, David A1 - Magiorakos, Anna-Pelagia A1 - Miguel Angel Moreno Romo A1 - Moulin, Gérard A1 - Muñoz Madero, Cristina A1 - Matias Ferreira Pomba, Maria Constança A1 - Powell, Mair A1 - Pyörälä, Satu A1 - Rantala, Merja A1 - Ruzauskas, Modestas A1 - Sanders, Pascal A1 - Teale, Christopher A1 - Threlfall, Eric John A1 - Törneke, Karolina A1 - van Duijkeren, Engeline A1 - Jordi Torren Edo KW - Acinetobacter baumannii KW - Animals KW - Anti-Bacterial Agents KW - Bacterial Infections KW - Chemoprevention KW - Colistin KW - Drug Resistance, Bacterial KW - Enterobacteriaceae KW - European Union KW - Humans KW - Pseudomonas aeruginosa AB -

Since its introduction in the 1950s, colistin has been used mainly as a topical treatment in human medicine owing to its toxicity when given systemically. Sixty years later, colistin is being used as a last-resort drug to treat infections caused by multidrug-resistant (MDR) Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae (e.g., Escherichia coli, Klebsiella pneumoniae), for which mortality can be high. In veterinary medicine, colistin has been used for decades for the treatment and prevention of infectious diseases. Colistin has been administered frequently as a group treatment for animal gastrointestinal infections caused by Gram-negative bacteria within intensive husbandry systems. Given the ever-growing need to retain the efficacy of antimicrobials used to treat MDR infections in humans, the use of colistin in veterinary medicine is being re-evaluated. Despite extensive use in veterinary medicine, there is limited evidence for the development of resistance to colistin and no evidence has been found for the transmission of resistance in bacteria that have been spread from animals to humans. Since surveillance for colistin resistance in animals is limited and the potential for such transmission exists, there is a clear need to reinforce systematic monitoring of bacteria from food-producing animals for resistance to colistin (polymyxins). Furthermore, colistin should only be used for treatment of clinically affected animals and no longer for prophylaxis of diseases, in line with current principles of responsible use of antibiotics.

VL - 46 CP - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26215780?dopt=Abstract M3 - 10.1016/j.ijantimicag.2015.06.005 ER -