The growth in occurrence in the clinic of antibiotic resistance, and then multiple drug resistance pathogens has been a concern for decades, but recently it has grown to alarming proportions drawing more attention and engaging more scientists, disciplines, policy makers and even the general public. This has naturally led to the need to more fully evaluate what is
driving this trend. Of course the widespread and continued global growth in use of antibiotics is the long-known driver, but identifying the many factors that underlay this relationship is needed for determining effective interventions. Recently there are efforts in this direction such as WHO’s 2014 release of ‘Antimicrobial Resistance: Global Report on Surveillance’ and, in late 2013, the U.S. Food and Drug Administration Center for Veterinary Medicine’s
Guidance for Industry #213, which asks drug producers to ‘voluntarily align use conditions’ [meaning reduce growth promotion uses] over a 3-year period while they observe the progress.