World Health Organization (WHO) guidelines on use of medically important antimicrobials in food-producing animals.
World Health Organization (WHO) guidelines on use of medically important antimicrobials in food-producing animals.
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世界卫生组织（WHO）关于在食品生产动物中使用医学重要抗菌药物的准则。
DOI：
10.1186/s13756-017-0294-9
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发表时间：
2018
影响因子：
5.5
通讯作者：
WHO Guideline Development Group
中科院分区：
文献类型：
--
作者：
Aidara-Kane A;Angulo FJ;Conly JM;Minato Y;Silbergeld EK;McEwen SA;Collignon PJ;WHO Guideline Development Group
在食用动物中使用抗菌剂会选择可通过食物或其他传播途径传播给人类的抗菌剂耐药性。2005年，世界卫生组织（WHO）对人类使用的抗菌药物的医学重要性进行了排名。2017年底，为了保持具有医学重要性的人类抗菌剂的有效性，世卫组织发布了关于在食用动物中使用抗菌剂的指南，其中纳入了世卫组织的最新排名。世卫组织委托进行了系统审查和文献审查，并召集了一个由外部专家组成的指南制定小组，该小组没有不可接受的利益冲突。GDG使用建议评估、发展和评价分级（GRADE）方法评估了证据，并使用结构化的证据决策方法制定了建议，该方法考虑了利益和危害的平衡、可行性、资源影响和对公平的影响。由此产生的准则由一个独立的外部审查小组进行了同行审查，并得到了世卫组织准则审查委员会的批准。这些指南建议减少食用动物中医学上重要的抗菌剂的总体使用，包括完全限制用于促进生长和预防疾病的抗菌剂的使用（即，在被认为有感染风险的健康动物中）。这些指南还建议，被确定为对人类至关重要的抗菌剂不得用于食用动物的治疗或疾病控制，除非药敏试验证明该药物是唯一的治疗选择。为了保持医学上重要的抗菌剂的有效性，敦促兽医、农民、监管机构和所有其他利益相关者采纳这些建议，并努力实施这些指南。
Antimicrobial use in food-producing animals selects for antimicrobial resistance that can be transmitted to humans via food or other transmission routes. The World Health Organization (WHO) in 2005 ranked the medical importance of antimicrobials used in humans. In late 2017, to preserve the effectiveness of medically important antimicrobials for humans, WHO released guidelines on use of antimicrobials in food-producing animals that incorporated the latest WHO rankings. WHO commissioned systematic reviews and literature reviews, and convened a Guideline Development Group (GDG) of external experts free of unacceptable conflicts-of-interest. The GDG assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and formulated recommendations using a structured evidence-to-decision approach that considered the balance of benefits and harms, feasibility, resource implications, and impact on equity. The resulting guidelines were peer-reviewed by an independent External Review Group and approved by the WHO Guidelines Review Committee. These guidelines recommend reductions in the overall use of medically important antimicrobials in food-producing animals, including complete restriction of use of antimicrobials for growth promotion and for disease prevention (i.e., in healthy animals considered at risk of infection). These guidelines also recommend that antimicrobials identified as critically important for humans not be used in food-producing animals for treatment or disease control unless susceptibility testing demonstrates the drug to be the only treatment option. To preserve the effectiveness of medically important antimicrobials, veterinarians, farmers, regulatory agencies, and all other stakeholders are urged to adopt these recommendations and work towards implementation of these guidelines.