Talk:Antibiotic use in livestock

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Project ratings

I tagged this article as being of high importance to several WikiProjects because this article describes a huge amount of antibiotic use which is rapidly changing several fields of study. Blue Rasberry (talk) 20:36, 26 August 2013 (UTC)

Bluerasberry - As said below (and I will clean that section up later today) I think it is great that you are digging into this and looking for more information. While I strongly disagree with your stance and pov on this, you have impressed me with your willingness to ask questions and discuss things politely. I will come back later and tweek the talk page sections to hopefully be more useful to other editors - as you said, the interweaving of comments were somewhat confusing. Merck Veterinary manual (available on-line) is a good place to start for background on this topic. Kerani (talk) 15:22, 25 October 2013 (UTC)

Here is the Merck Veterinary Manual. What do you think could come of this? It seems like a WP:HOWTO guide. I checked it out and did not immediately see policy statements or theories in here - just guidelines for an individual veterinarian's practice. Blue Rasberry (talk) 17:30, 27 October 2013 (UTC)

Sources

I found more news than science in this article but the news must have come from scientific papers. More scientific citations would be appreciated. Blue Rasberry (talk) 20:25, 26 August 2013 (UTC)

More sources

• Landers, T. F.; Cohen, B.; Wittum, T. E.; Larson, E. L. (2012). "A review of antibiotic use in food animals: Perspective, policy, and potential". Public health reports (Washington, D.C. : 1974). 127 (1): 4–22. PMC 3234384. PMID 22298919.
• Darwish, W. S.; Eldaly, E. A.; El-Abbasy, M. T.; Ikenaka, Y.; Nakayama, S.; Ishizuka, M. (2013). "Antibiotic residues in food: The African scenario". The Japanese journal of veterinary research. 61 Suppl: S13–S22. PMID 23631148.

this one is unusual in this list because it is about food safety and has localized information

• Garcia-Alvarez, L.; Dawson, S.; Cookson, B.; Hawkey, P. (2012). "Working across the veterinary and human health sectors". Journal of Antimicrobial Chemotherapy. 67: i37–i49. doi:10.1093/jac/dks206. PMID 22855878.
• Croney, C. C.; Apley, M.; Capper, J. L.; Mench, J. A.; Priest, S. (2012). "BIOETHICS SYMPOSIUM: The ethical food movement: What does it mean for the role of science and scientists in current debates about animal agriculture?". Journal of Animal Science. 90 (5): 1570–1582. doi:10.2527/jas.2011-4702. PMID 22573840.
• Soulsby, L. (2007). "Antimicrobials and animal health: A fascinating nexus". Journal of Antimicrobial Chemotherapy. 60: i77–i78. doi:10.1093/jac/dkm164. PMID 17656389.
• Roe, M. T.; Pillai, S. D. (2003). "Monitoring and identifying antibiotic resistance mechanisms in bacteria". Poultry science. 82 (4): 622–626. doi:10.1093/ps/82.4.622. PMID 12710483.
• Horrigan, L.; Lawrence, R. S.; Walker, P. (2002). "How sustainable agriculture can address the environmental and human health harms of industrial agriculture". Environmental health perspectives. 110 (5): 445–456. doi:10.1289/ehp.02110445. PMC 1240832. PMID 12003747.
• Collignon, P.; Powers, J. H.; Chiller, T. M.; Aidara-Kane, A.; Aarestrup, F. M. (2009). "World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies for the Use of Antimicrobials in Food Production Animals". Clinical Infectious Diseases. 49 (1): 132–141. doi:10.1086/599374. PMID 19489713.
• Barbosa, T.; Levy, S. B. (2000). "The impact of antibiotic use on resistance development and persistence". Drug Resistance Updates. 3 (5): 303–311. doi:10.1054/drup.2000.0167. PMID 11498398.
• Popowska, M.; Rzeczycka, M.; Miernik, A.; Krawczyk-Balska, A.; Walsh, F.; Duffy, B. (2011). "Influence of Soil Use on Prevalence of Tetracycline, Streptomycin, and Erythromycin Resistance and Associated Resistance Genes". Antimicrobial Agents and Chemotherapy. 56 (3): 1434–1443. doi:10.1128/AAC.05766-11. PMC 3294877. PMID 22203596.
• Infectious Diseases Society of America (IDSA); Spellberg, B.; Blaser, M.; Guidos, R. J.; Boucher, H. W.; Bradley, J. S.; Eisenstein, B. I.; Gerding, D.; Lynfield, R.; Reller, L. B.; Rex; Schwartz, D.; Septimus, E.; Tenover, F. C.; Gilbert, D. N. (2011). "Combating Antimicrobial Resistance: Policy Recommendations to Save Lives". Clinical Infectious Diseases. 52 (Suppl 5): S397–S428. doi:10.1093/cid/cir153. PMC 3738230. PMID 21474585.
• Marshall, B. M.; Levy, S. B. (2011). "Food Animals and Antimicrobials: Impacts on Human Health". Clinical Microbiology Reviews. 24 (4): 718–733. doi:10.1128/CMR.00002-11. PMC 3194830. PMID 21976606.
• United States Department of Health and Human Services; Food and Drug Administration; Center for Veterinary Medicine (13 April 2012), Guidance for Industry #209: The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals (PDF), Rockville, Maryland: Food and Drug Administration, retrieved 27 October 2013{{citation}}: CS1 maint: year (link)
• Food and Drug Administration (11 April 2012), FDA's Strategy on Antimicrobial Resistance - Questions and Answers, Silver Spring, Maryland: Food and Drug Administration, retrieved 27 October 2013
• Alliance for the Prudent Use of Antibiotics (15 December 2010), Levy, Stuart B.; Marshall, Bonnie (eds.), "Antibiotics in food animal production: A forty year debate" (PDF), APUA Newsletter, vol. 28, no. 2, Tufts University, retrieved 27 October 2013
• Ritterman, J. B. (2006). "Preventing antibiotic resistance: The next step". The Permanente journal. 10 (3): 35–39. PMC 3078778. PMID 21519468.
• American Veterinary Medical Association (2013 (last update)), Antimicrobial Use and Antimicrobial Resistance FAQ, American Veterinary Medical Association, retrieved 27 October 2013 {{citation}}: Check date values in: |year= (help)CS1 maint: year (link)

This is not a scientific presentation. It is the only criticism I found during this search, and it is light criticism because it does not respond to arguments that antibiotics cause problems. It cites some papers but I did not find those papers worth citing again.

• Mathew, A. G.; Cissell, R.; Liamthong, S. (2007). "Antibiotic Resistance in Bacteria Associated with Food Animals: A United States Perspective of Livestock Production". Foodborne Pathogens and Disease. 4 (2): 115–133. doi:10.1089/fpd.2006.0066. PMID 17600481.
• Khachatourians, G. G. (November 3, 1998). "Agricultural use of antibiotics and the evolution and transfer of antibiotic-resistant bacteria". Canadian Medical Association Journal. 159 (9): 1129–1136.
• Threlfall, E. J.; Ward, L. R.; Frost, J. A.; Willshaw, G. A. (2000). "The emergence and spread of antibiotic resistance in food-borne bacteria". International Journal of Food Microbiology. 62 (1–2): 1–5. doi:10.1016/S0168-1605(00)00351-2. PMID 11139009.
• McEwen, S. A.; Fedorka-Cray, P. J. (2002). "Antimicrobial Use and Resistance in Animals". Clinical Infectious Diseases. 34: S93–S106. doi:10.1086/340246. PMID 11988879.
• Witte, W. (2000). "Selective pressure by antibiotic use in livestock". International Journal of Antimicrobial Agents. 16: 19–24. doi:10.1016/S0924-8579(00)00301-0.
• Martinez, J. L. (2009). "Environmental pollution by antibiotics and by antibiotic resistance determinants". Environmental Pollution. 157 (11): 2893–2902. doi:10.1016/j.envpol.2009.05.051. PMID 19560847.

Blue Rasberry (talk) 12:51, 27 October 2013 (UTC)

• Hollis, A.; Ahmed, Z. (2013). "Preserving Antibiotics, Rationally". New England Journal of Medicine. 369 (26): 2474–2476. doi:10.1056/NEJMp1311479. PMID 24369073.

This paper is rather high-profile and I expect that it will be criticized in response. I perceive it as being biased in assuming that a reduction in antibiotic use is a goal, but it does try to address some arguments against doing this. It is still not the source I want but it seems useful. Blue Rasberry (talk) 13:03, 30 December 2013 (UTC)

• Bywater, R. J.; Casewell, M. W. (2000). "An assessment of the impact of antibiotic resistance in different bacterial species and of the contribution of animal sources to resistance in human infections". Journal of Antimicrobial Chemotherapy. 46 (4): 643–645. doi:10.1093/jac/46.4.643. PMID 11020270.

One from Pfizer Animal Health! It is just a letter but still very cool. Blue Rasberry (talk) 16:42, 30 December 2013 (UTC)

Name of this article

This is an important issue and I think that the Wikipedia article did not get created for this topic because it was awkward to name the issue, and even the media does not have a consistent name for this issue. I am calling this "antibiotic use in livestock" but this name includes proper medicinal use, which is not something I really wanted to include. There is another article, Subtherapeutic antibiotic use in swine, but I did not want to name this article "subtherapeutic use" because "subtherapeutic" is not a word regularly used in many sources. For now, the article's name is "Antibiotic use in livestock". If anyone has better names then share. Blue Rasberry (talk) 20:25, 26 August 2013 (UTC)

I agree that 'antibiotic use in livestock' is not a good name for this article. It seems to me that is actually an article about the controversy of antibiotic use in food animal feed and water. To me, there would be two options on how to proceed with this article:

• Fully discuss the use of antibiotics and other drugs in food and other animals, both from a food safety and environmental aspect. This would allow for an examination of the history of the use of drugs in animals, their regulation, and the development of interest in the antibiotic resistance issue and the carcinogenic feed ingredients issue which pre-dates the more recent resistence concerns. This would also allow for the discussion of antifungals, cocciostats, pesticides and other non-antibiotics which are given to food animals, and would also allow discussion of the issue of banned drugs used in horses which are then sold for slaughter for human use or pet food. Consumer food safety could be addressed and withdrawal periods. However, this would be a large article, bringing together a number of issues which (to my knowledge) are not yet well addressed on WP.

Alternatively, it might be simpler to describe the anti-microbial controversy - as the article does articulate the anti-medicine pov pretty well - rather than try to describe the complete use of drugs in animals and the associated effects. However, for an article this limited in scope,calling it 'antibiotic use in livestock' would be misleading, imo. Kerani (talk) 15:48, 25 October 2013 (UTC)

I am not sure what is best. I do think that what you stated should be covered, but I also think that this article should summarize both of those issues and others. Perhaps a lot of content here should be forked into other articles with different names, and this article can be the hub for connecting to a range of topics. Perhaps there should be sub articles right now for these things:

• Veterinary internal medicine (confer Internal medicine) to give an overview of using drugs in animals. Probably Veterinary medicine is not covering that topic in the way that complements this article. Blue Rasberry (talk) 19:23, 25 October 2013 (UTC)

Alternatively, this should be covered under Veterinary Production Medicine which is a name for the type of vet med that tends to cover 'herd health' and other aspects of providing care for animals based on their economic return rather than their emotional value to their owners. Agreed the current Vet med articles are...lacking.Kerani (talk) 18:05, 26 October 2013 (UTC)

• Veterinary medicine and consumer food safety, which is about the industry practices for limiting the amount of veterinary medicine, including non-antibiotics, in food which goes to market. I think these practices are defined and made scientific, and this issue can exist independently of any discussion of microbial resistance. This could also apply for small-scale production; it need not have any relationship with industrial farming or environmental impact over time. Blue Rasberry (talk) 19:23, 25 October 2013 (UTC)

I'm okay this one, especially with the note that food safety concerns apply to food no matter where they are produced. Cancerous materials don't care if they are used on a backyard tomato plant or on a large field, and salmonella has no way of knowing if they are on organic chicken or non-certified chicken. The biological & physical processes apply regardless of the politics of the farm manager.Kerani (talk) 18:05, 26 October 2013 (UTC)

• Antibiotic use in industrial livestock production could describe industrial practices of consuming large amounts of antibiotics, and this article could contain the discussions about microbial resistance which is purported to occur only when large numbers of animals are exposed to drugs over generations of time. These effects need not be a part of a discussion on the practice of veterinary medicine or food safety. Blue Rasberry (talk) 19:23, 25 October 2013 (UTC)

I disagree here - this is not consistent with the literature I have seen. Resistance is a matter simply of exposing microbes to antibiotics (or other factors, such as metals, temperature, acidity, etc). There is no resistance that "only" occurs when "large numbers" of patients (human or animal) are exposed. Resistance happens one pathogenic organism at a time, can and does arise within a single patient, and while the effects can be magnified by increasing the number of patients treated, and by the manner in which they are treated, this does not mean that smaller exposures do not also produce resistance. Furthermore, discussions about restricting the use of OTC or prescription veterinary drugs is absolutely within the scope of veterinary medicine. Part of the problem with public debate on this issue is that it has been framed by some as simply a matter of "industrial" farm practices, and an appreciation for how resistance considerations are an integral part of any treatment plan, be they on a gerbil or a dairy of 1000 cows.Kerani (talk) 18:05, 26 October 2013 (UTC)

Hmmm... okay, then how would you name the controversy? Is there a better way to do it than call it the "Antiobiotics in livestock controversy"? I would rather call the controversy what it is than just name it as "the controversy". Whatever the controversy is can be sorted with literature. I just added some sources to the sources section. Blue Rasberry (talk) 17:24, 27 October 2013 (UTC)

Of course, none of these articles need to be developed immediately, and we can develop this article for a while and then make a decision. I think it would be best to start by identifying the best sources and summarize what the sources say rather than have any agenda for going forward. If we get enough content to make another article, then a new article can WP:FORK into that direction and we move content there. Thoughts? Blue Rasberry (talk) 19:23, 25 October 2013 (UTC)

• Agreed that this will take a while. I have been chewing over tackling parts of this for a while (several years) - Wikipedia's offerings on animal husbandry in general and modern agriculture in particular are very superficial and (as you said) do not provide the needed background information to get a good grip on the paticulars of the topic. (The on-going political debates that have resulted in the Factory Farming article are highly unfortunate.) I'm going to take another look at Animal Husbandry again and see how much I have to replicate in these new articles. In order to adequately & honestly explain the situation, a lot of info needs to be written up. While everyone eats, and everyone should (IMO) have a opinion on how food resources are allocated, actual knowledge on how the economics of farming work is not widely distributed, and the actual biological and technological processes are even less well understood. (Even more so among the computer-oriented sorts who make up a lot of WP editors.) This is not to call people ignorant or stupid, but there is too much information in the world for everyone to have all of it.Kerani (talk) 18:05, 26 October 2013 (UTC)

User:Jytdog took the lead on merging Factory farming into Industrial agriculture (animals), and I hope that this is a start toward presenting less bias and putting like conversations into a single place. Regardless of the best name for this topic the content of the two articles was similar and the concepts needed to be presented together. Sorting this will take time but I have interest in presenting things fairly. Thanks for bringing it up - I think everyone wants a more balanced presentation. Blue Rasberry (talk) 14:46, 4 November 2013 (UTC)

Conflict of Interest

Hello, my name is Lane and I am user:bluerasberry. I am employed by an advocacy organization called Consumers Union. One of the organization's perspectives is that antibiotics should not be used in meat production. In these edits I added information about my organization's advocacy campaign relating to antibiotics in livestock production.

When I edit I edit for myself also and I have my own bias in addition to my employer's bias. Wikipedia has a conflict of interest policy at WP:COI. I want to respect it. If anyone has anything to say about my creation of this page then feel free to be public with any thoughts you have. Thanks. Blue Rasberry (talk) 20:15, 27 August 2013 (UTC)

Blue Raspberry - HUG THUMBS UP to you being clear on COI. I am very glad to see you being transparent on this. Hopefully a variety of backgrounds will lead to a good article.Kerani (talk) 15:56, 25 October 2013 (UTC)

Hi Lane, from my perspective on COI:

• It is great that you declared it here. Thank you.
• it is unambiguously over the line, that you added content to the article about your employer's activity in this area. You should have posted a request here on Talk for someone else to add that content to the article.
• it is over the line that you created this article and that you directly edit it, as you work for an advocacy organization that advocates this position. There are people who might disagree with me on this, and I would be interested in hearing their arguments.
• please see my comments away below. Jytdog (talk) 22:39, 4 November 2013 (UTC)

This is Kerani. I am a veterinarian in the USA with an interest in food animals and public health. I hold that humans have a responsibility for the animals we care for, that good husbandry prevents a lot of illness but can not prevent all sickness in animals or people, that sick things generally need medicine, and that careful use of medicines is important to protect the environment and the food we eat. I am not employeed by any commercial animal industry organization.Kerani (talk) 15:56, 25 October 2013 (UTC)

• There was a recent FDA announcement on antibiotics in livestock. My employer Consumer Reports had things to say about this - see this video in which a representative speaks.

Greene, Anne-Marie; Halloran, Jean (11 December 2013). "Use of antibiotics in animals contribute to 23,000 American deaths a year". Up to the Minute, CBS News. New York: CBS. Retrieved 12 December 2013.

I am aware that some people shared some sources which present perspectives which are alternatives to this one, and that I said that I would integrate those sources and perspectives into the article a bit. I still intend to do this. I hope that I can do a bit in the next 1-2 weeks. Blue Rasberry (talk) 16:44, 12 December 2013 (UTC)

Merging content

All articles which have sections describing the subject of this article should have that section summarized, have their unique content moved here, and then they should link to this article. Here are some articles which need this:

• Antibiotic_resistance#Role_of_other_animals
• Antibiotic_misuse#Antibiotics_in_livestock
• Subtherapeutic antibiotic use in swine

Blue Rasberry (talk) 20:29, 27 August 2013 (UTC)

Wow! New history article

Scientific American just published on the history of the practice. I will incorporate this information soon. Blue Rasberry (talk) 11:53, 5 September 2013 (UTC)

This is a good source. Why is it not incorporated already? (real question) Jytdog (talk) 23:25, 4 November 2013 (UTC)

Resolved

It is in the article now. There was no reason for not doing it sooner, although now (as of November 2013) the book covering this more thoroughly has been published and probably it is preferable to cite the book over this blog post.

• Ogle, Maureen. In meat we trust : an unexpected history of carnivore America. ISBN 978-0151013401.

I started adding this information in the history section. The notice that this information exists is unnecessary now; anyone checking the history section will know that there is more to see. Blue Rasberry (talk) 11:44, 5 November 2013 (UTC)

Support for continued use of antibiotics in livestock

Lots of critics say that antibiotics should not be used in livestock. Almost all sources in this article take the view that there is some problem. However, this is a widespread practice and so some people must be taking the position that this is a good thing. I am unable to find anyone publishing contemporary detailed positive statements about this practice. If anyone finds one then please share. Blue Rasberry (talk) 11:41, 17 September 2013 (UTC)

I would suggest calling a university extension office in a state where they raise a lot of cattle, like Nebraska http://www.extension.unl.edu//animalagriculture and asking them what written material exists. Jytdog (talk) 23:27, 4 November 2013 (UTC)

Whenever you want to take a technology away you have to ask what the consequences would be - who would bear them and what they would think about that. I would ~guess~ that what you will find, is a) that consumers in America want (relatively) inexpensive meat, and use of antibiotics is a key tool in keeping meat cheap, as per the scientific american article you found above; and b) margins in all of agriculture are very thin, and giving antibiotics helps improve margins for livestock producers.Jytdog (talk) 23:32, 4 November 2013 (UTC)

just a few sources (search term is "antibiotic feed additives" which is what farmers call them) there are plenty more

http://extension.missouri.edu/p/G2353 (advice for farmers)

http://www.aasv.org/shap/issues/v17n5/v17n5p270.pdf (advice for farmers)

http://www.thepoultrysite.com/articles/contents/CERVANTES.pdf (this one is pretty darn argumentative) Jytdog (talk) 00:40, 5 November 2013 (UTC)

Thanks for these. Share more as you find them. This third paper seems like it was self-published. I would prefer to cite papers which are not self published, but I will look it over anyway. Blue Rasberry (talk) 11:52, 5 November 2013 (UTC)

 In progress These need to go into the article. Also the papers they themselves reference need to be checked because maybe they cite something bigger. Blue Rasberry (talk) 12:27, 5 November 2013 (UTC)

Problems with current article

The article has some serious neutrality issues and it is all about resistance. Where is the mention of what drugs are not allowed in food production animals (AMDUCA] laws in US and EU), meat and milk antibiotic withdraw times and classes of antimicrobials?

• I probably wouldn't rely on the press and individual blogs to give a balanced portrayal of the issue. As with human science articles, all sources should follow WP:MEDRS guidelines.
• "non-medicinal"? Ionophores are used as coccidiostats in animals and prevent animals from developing diarrhea, so they are used for a medicinal purpose.
• Are we talking enteric pathogens (Salmonella, E. coli, Campylobacter) or skin flora such as Stapylococcus or Streptococcus? There are definitely ab-resistant bacteria in the animal population and environment, but the link between these bacteria and clinical disease or drug resistance in humans is tenuous as best, especially enteric pathogens. "Bacteria" can mean many different things and the issue is not simple. Now transmission of MRSA and MRSP between people and their dogs and cats (and vice versa!) does happen and is another matter.
• "The biological mechanism by means of which antibiotics stimulate growth is not understood by science"- um, citation needed. Most have been studied for about 50 years now. Again, all bacteria are not the same and there are different classes of drugs that shouldn't be lumped together.
• Might benefit from discussion of what antimicrobials (that's what they are really) are feed to livestock, not just vague generic term "drugs". Most are not traditional antibiotics and are usually ionophores in ruminants/poultry (useful for feed efficiency and as a coccidiostat) which may indirectly lead to development of resistant bacteria in people, but it is not a primary, direct function of ionophores to kill bacteria.
• Treating sick animals also has the potential to cause resistance (use of wrong drug for bacteria that are not susceptible to it or bystander effect on other bacteria).
• The article would benefit from inclusion of the Denmark (where the practice is banned) statistics [1]. There was no difference in the incidence of drug-resistant bacterial strains in humans after the ban.
• It is the AVMA's own stance that there is not enough data to support ban of antimicrobials for livestock feed efficiency.
• A large amount of resistance in human bacterial populations may come from people and physicians that inappropriately use antimicrobials [2].

Prebiotics [3]

• I'm not denying that Ab-resistance exists, just that the link between livestock resistance its influence on human disease has not been proven.

Froggerlaura ^ribbit 04:49, 19 September 2013 (UTC)

Use of term "subtherapeutic"

Thanks. I am glad to have your attention. If you have other sources presenting viewpoints not given in this article then please share. Do you have a fundamental text explaining the practice of using subtherapeutic antibiotics to increase animal size? You mentioned withdrawal times for classes of antibiotics - where can I see such things? Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

There is a problem with the way your question is phrased. 'Subtherapeutic' is highly inaccurate, as it implies that there is no effect from the use of the drugs. Depending on the use, 'prophylactic' may be a better term. It depends on the drug. Also, the purpose is NOT to 'increase animal size' but to allow better health that allows a growning animal to mature without the deterimental effects of illness or parasites. Animals so treated are larger than those not so treated because the untreated ones are stunted.Kerani (talk) 14:30, 25 October 2013 (UTC)

• "Non-medicinal" is not a good term because subtherapeutic antibiotics do prevent illness. What is the preferred term for using medicine to encourage animal growth? How should this sentence be stated? I see that AVMA dislikes the term "nontherapeutic" (in that FAQ you just linked) but they also provide no preferred term or give advice about how to convey this. Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

I have heard 'growth permitants' used, but 'growth promotants' have traditionally been used.

This dates from the times when ranchers and vets assumed that 'naturally' grown animals were 100% healthy and that the drugs somehow promoted greater growth. It now appears that (like people) the animals are under a constant level of stress/attack by pathogens, and removing some of this by antibiotics allows the animals better health.Kerani (talk) 14:30, 25 October 2013 (UTC)

Lane, some antibiotics do crazy stuff, completely unrelated to killing bugs, like increase motility of the gut. See this page from the merck manual in the very first section above. For instanct monensins can "modify the movement of monovalent (sodium and potassium) and divalent (calcium) ions across biologic membranes, modify the rumen microflora, decrease acetate and methane production, increase propionate, may improve nitrogen utilization, and can increase dry matter digestibility in ruminants." Jytdog (talk) 00:47, 5 November 2013 (UTC)

I am not sure what to do with this information but thank you for finding some relevant content from the Merck Manual. I will have to think about this, but to get started, I at least added a table derived from the information you shared. I see this content also talks about that Danish study again - I am still thinking about that also. Blue Rasberry (talk) 03:16, 5 November 2013 (UTC)

Two things that I hope you take away. My sense is that the antibiotics that people are worried about (especially when they talk about the big quantities used) are those given in feed, like monensin and other ionophores. (Don't know if you have looked at any actual labels but here is one for one for monsensin from Lilly http://elms.xh1.lilly.com/rumensin_90_label.pdf.) The other is that I hope you get the sense that the purpose of using antibiotics in feed is economic -- to increase feed efficiency (in other words, less feed leads to same growth, which is a money saver on inputs) or increased growth (bigger cattle for same amount of feed, which means more money coming in when animal is sold) ... which is all about improving margins for livestock farmers and keeping the price of meat lower for consumers. It is "subtherapeutic" in that it is not killing bacteria. If you dig a bit more, it works rather by its "effect on the fermentation waste products in the digestive tract" (http://www.journalofanimalscience.org/content/43/3/670.full.pdf p676). How does it do that? http://www.ag.auburn.edu/~chibale/an03microbiology.pdf "About 8% of total digestible dietary energy is lost as methane. Thus, suppressing methane-producing bacteria would reduce the waste.e.g., Monensin: Affects electrolyte transport across the cell walls of methanogenic & other bacteria, while not affecting, e.g., propionate-producing bacteria." Not only more bang for your buck, but less methane (greenhouse gas). Monensin modulates the gut microflora when used subtherapeutically. Just to be clear, I am not advocating for or against the use of antibiotics in feed; it is just important to understand why they are being used, and how, and to present that in the article. Consumers and voters can't make rational decisions about what to buy and about policy if they don't understand the big picture - if they cannot weigh risks and rewards of staying with the current system or changing it. Jytdog (talk) 09:30, 5 November 2013 (UTC)

Where are sources?

You said you have WP:MEDRS sources. Please share any you like on this page. I do think that it is notable that newspapers report a perspective on this issue, but I would prefer that scientific consensus be presented more prominently. I would love to balance mass media claims with MEDRS sources. I tried to find them but failed. Please help me. Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

Try PUBMED or any animal industry journal. Kerani (talk) 14:30, 25 October 2013 (UTC)

• This article would greatly benefit from an overview of what antibiotics are fed to animals! Do you have one? Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

Failure to have this information in the basic article is a major weakness. You should also look into the different ways by which drugs can be given to animals, and why and when feeding (or water) might be more appropriate. Again, a basic veterinary medical text would be a good start. Also look at FARAD.org. Kerani (talk) 14:30, 25 October 2013 (UTC)

I looked at FARAD. What should I find here on their publications page? Nothing strikes me as relevant. It looks like these people make recommendations on when to cease administration of medicine to animals to make them safe for food to go to market, but I am not sure they are in the practice of writing review articles. I would have to look deeply - it seems like what they do is more specialized than the kind of overview I was hoping to find. Do you know of something good they have written? Blue Rasberry (talk) 17:11, 27 October 2013 (UTC)

• I have no idea what antibiotics are alleged to have gained resistance in this practice, so I am grouping all bacteria together just as the media does. I would love to see scientific papers you have looking at all bacteria or any specific bacteria. Can you direct me to any fundamental papers which name bacteria and which are necessary to understand this issue? Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

If you're not going by scientific papers then you're not increasing the knowledge of people reading the article. There are specific organisms of urgent, greater and lesser concern to scientists studying antibiotic resistance - you should learn those and apply that information to this article rather than lumping them all together.Kerani (talk) 14:30, 25 October 2013 (UTC)

Blue Rasberry - It's great that you're digging into this information and condensing it into an article for wider dissemination, but I have concerns about how you're going about it. You've already said that you're started with a biased group of sources and that you're finding it hard to understand the statements and positions put out by animal industry and animal medical groups. By attempting to narrow down the broader topic of 'animal medicine' down to 'animal medicine that people have said is bad' you may not be putting forth a quality article. "Lumping things together the way the media does" will not actually increase the understanding of anyone who comes here looking for greater understanding of the topic after reading an article in the media. I would suggest doing a lot more research into the actual science (the Danish study should have been one of the first ones you came across, and YES it is extremely relevant) before publishing an article like this. You can start with any basic animal medicine text.Kerani (talk) 14:12, 25 October 2013 (UTC)

There is a section called "sources". I just added a lot. There is also a section on the Danish study. I just made comments there also. After spending a few hours looking for information I am still finding biased sources in PubMed, Google scholar, and by scanning cited papers in articles I am finding. I am sure I need some help finding sources covering the other perspective. I am not sure what is best but whatever the solution is, I am sure it involves starting with sources. If I need to go to an animal medicine text then I will but I want to look at the scientific literature a bit more first. I am still thinking. Blue Rasberry (talk) 17:05, 27 October 2013 (UTC)

Biological mechanism of action

• Do you have a technical academic source which describes the biological mechanism by means of which antibiotics encourage growth? Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

This is not yet entirely understood, and likely is somewhat different depending on the drug and the species.Kerani (talk) 14:30, 25 October 2013 (UTC)

Danish study

I do not know how to interpret the Danish study. That AVMA FAQ also says that it is controversial and it seems that they do not agree with its methodology, but I do not immediately see the problems. It is not an academic paper and I am not immediately seeing conclusions; just data. Thanks for sharing it. I will look over it again. I fail to recognize why you would say, "There was no difference in the incidence of drug-resistant bacterial strains in humans after the ban." Why is this fact significant to you? Is this supporting evidence for some premise? Thanks a lot - I look forward to reading this more. Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

The Danish study shows that despite banning the use of some drugs - which resulted in a higher death rate among the animals and an increase in cost - there was no change in the rate of illness among people. This fact should be significant to anyone attempting to write about this.Kerani (talk) 14:30, 25 October 2013 (UTC)

It may show those facts, but such facts are not significant until they are interpreted. It seems that this "Danish study" is actually a annual updated information report, and that this report itself is not interpreted by the people who produce it. If it is just information, as it seems to be, then that makes it a WP:PRIMARY source and by Wikipedia guidelines one ought not do original research to interpret it. I did a Google Scholar search on DANMAP in hopes of finding people who have published interpretations of it, but no papers stood out to me as being highly cited. A confounding factor in this is that this is an annual report, and many papers interpret only a single year of it. I would really like to see a fundamental paper in which someone at sometime in the last 5 years has taken a position on trends in this report over years. How do I come to terms with this study? Do you know of a good paper covering it?

Here are some reviews I found on PubMed, but I think they are only good for discussing and validating DANMAP and do not actually interpret its findings.

• Fluit, A. C.; Van Der Bruggen, J. T.; Aarestrup, F. M.; Verhoef, J.; Jansen, W. T. M. (2006). "Priorities for antibiotic resistance surveillance in Europe". Clinical Microbiology and Infection. 12 (5): 410–417. doi:10.1111/j.1469-0691.2006.01406.x. PMID 16643516.
• Bager, F.; Aarestrup, F. M.; Jensen, N. E.; Madsen, M.; Meyling, A.; Wegener, H. C. (1999). "Design of a system for monitoring antimicrobial resistance in pathogenic, zoonotic and indicator bacteria from food animals". Acta veterinaria Scandinavica. Supplementum. 92: 77–86. PMID 10783720.
• Hammerum, A. M.; Heuer, O. E.; Emborg, H. D.; Bagger-Skjøt, L.; Jensen, V. F.; Rogues, A. M.; Skov, R. L.; Agersø, Y.; Brandt, C. T.; Seyfarth, A. M.; Muller, A.; Hovgaard, K.; Ajufo, J.; Bager, F.; Aarestrup, F. M.; Frimodt-Møller, N.; Wegener, H. C.; Monnet, D. L. (2007). "Danish Integrated Antimicrobial Resistance Monitoring and Research Program". Emerging Infectious Diseases. 13 (11): 1632–1639. doi:10.3201/eid1311.070421. PMC 3375779. PMID 18217544.
• Silley, P.; De Jong, A.; Simjee, S.; Thomas, V. R. (2011). "Harmonisation of resistance monitoring programmes in veterinary medicine: An urgent need in the EU?". International Journal of Antimicrobial Agents. 37 (6): 504–512. doi:10.1016/j.ijantimicag.2010.12.002. PMID 21295449.

Also - Just by scanning these, I am not sure that the outcomes you mentioned - higher animal death rate, cost increases, and no change in human illness (presumably short term; I only expect changes after 50 years or so) - are outcomes being considered here. Hmmm... these people were expecting those outcomes too, saying that they were the purpose of the ban, but I expected the outcomes you stated from less antibiotic use also and would have thought it was non-controversial and agreed by everyone that using less antibiotics should result in these things. There must be some fundamental miscommunication here. I need to think more about this because there are at least two perspectives here and I am not sure now what the points of contention are, but I suspect that the sides are not even discussing the same issues. Blue Rasberry (talk) 17:00, 27 October 2013 (UTC)

More sources on the Danish study -

• editors of Scientific American (30 March 2011). "Our Big Pig Problem: Scientific American". scientificamerican.com. Retrieved 29 October 2013. {{cite web}}: |author= has generic name (help)
• Rogers, Laura, Avoiding Antibiotic Resistance: Denmark's Ban on Growth Promoting Antibiotics in Food Animals (PDF), The Pew Charitable Trusts, retrieved 29 October 2013
• Couric, Katie (10 February 2010). "Denmark's Case for Antibiotic-Free Animals". CBS News. New York: CBS. Retrieved 29 October 2013.
• Chan, Margaret (14 March 2012). "Antimicrobial resistance in the European Union and the world". who.int. World Health Organization. Retrieved 29 October 2013.
• Grady, Denise (14 August 2003). "W.H.O. Finds Use of Antibiotics in Animal Feed Can Be Reduced". The New York Times. New York: NYTC. ISSN 0362-4331. Retrieved 29 October 2013.
• French, Aaron (8 February 2013). "The American Meat Institute Gets it Wrong on Antibiotic Resistant Superbugs". switchboard.nrdc.org. Natural Resources Defense Council. Retrieved 29 October 2013.
• Wegener, Henrik C. (2012 [last update]). "Antibiotic Resistance - Linking Human Health and Animal Health - Improving Food Safety Through a One Health Approach". ncbi.nlm.nih.gov. NCBI Bookshelf. National Center for Biotechnology Information. Retrieved 29 October 2013. {{cite web}}: Check date values in: |year= (help)CS1 maint: year (link)

Blue Rasberry (talk) 20:39, 29 October 2013 (UTC)

AVMA position

As Froggeraura said, AVMA's stance belongs here but I am not sure what you are citing to demonstrate their stance. AVMA may or may not support the ban of some antibiotics in some places - I am not seeing a strong position one way or the other and your link seems not to support as strong of a statement as you gave, but definitely their view should be incorporated. They qualify their position by saying that they do not support "broad bans" or one particular ban in the US. I am not clear on their official position. I need time to think about things. In the meantime I encourage you (talking to Froggerlaura) to change the article as you like. You know the material much better than me. If you do not want to work on the article at this time then please keep me in mind if you come across sources which ought to be incorporated. I really had trouble finding sources. Thanks. Blue Rasberry (talk) 13:47, 19 September 2013 (UTC)

PBS documentary

PBS just published a set of stories about antibiotic resistance. There is an interview, an audio conversation, and a video.

They also have a documentary on meat and antibiotics with related text interviews. Blue Rasberry (talk) 11:51, 23 October 2013 (UTC)

Having only opposition is a suboptimal way to go

So User:Bluerasberry started this article. Lane, as you disclosed above, you work for an organization that has a stance advocating against the topic of this article and you agree with that stance. And indeed, the descriptive part of this article (that actually describes the practice) is undeveloped and unsourced, but the part about how people don't like it, is well elaborated and sourced. Among the few sources in the descriptive part, not one is purely descriptive; every one of them is about opposition to the practice. This is not good, and is also a widespread problem in Wikipedia. People who care about X enough to create an article, do it with an ax to grind - to get their opposition to X stated clearly in Wikipedia - not to create a great article explaining what X is. (it may well be that the opposition to widespread use of antibiotics in raising livestock is well founded, but I am not going to believe a damn thing this article says because I don't judge something before I understand it. And this article gives neither me nor anyone else the basis for understanding the practice itself) Jytdog (talk) 23:01, 4 November 2013 (UTC)

Sorry, the point of my rant is that we should a) delete the "descriptive part" and rename to "Criticism of X" (in other words, let's drop the pretense that there was ever an intention to describe X); or b) we should pull this out of article space and put it in somebody's sandbox until there is at least decent and supported content about X; c) well yes, to blow off some steam. sorry about c) I just cannot keep up with the bullshit. And this article as it stands is bullshit with respect to its topic. Jytdog (talk) 23:11, 4 November 2013 (UTC)

You are completely correct that I have only provided information about opposition to the practice, and you are right that all perspectives should be included in this article. As you said, the scientific basis for understanding the subject of the article is lacking, and statements of support of the practice is lacking.

I do have an agenda in doing this but I dispute that I am operating under a "pretense that there was ever an intention to describe X" - I would like to present all sides. I also assert that I have not been unreasonable in seeking other perspectives - I posted all over this talk page requests for other perspectives, I cited 40 papers in the article text, and I listed about 25 other sources on the talk page. The content in the text right now represents Google searches for news and policy, and what is on the talk page are articles from PubMed and otherwise found by searching the journals. I have not selectively excluded alternative perspectives; I assert that searches in Google or in the journals for "livestock antibiotics" return a lot of critical content, and that publications in support of the practice are not easy to identify. I really appreciate the three sources you provided above, but as I stated there, one was self published and that weakens its legitimacy. The other two were from commercial trade journals which, while presenting a valid perspective and while they are peer reviewed, they are not science journals like the ones I searched. I am confident in saying that no one on this board has identified a non-trade science paper defending claims of antibiotic resistance resulting from livestock production. Even the two trade journals papers you provided say that antibiotic resistance is a real concern, so even what you give me is hardly an oppositional perspective because they only acknowledge but do not discuss the issue. I am sure that there are papers with a perspective in opposition to what I have added, but there are not lots of them and they are not readily found. I think that I have been reasonably diligent so far in seeking them and encouraging others to provide papers presenting alternative views, but no one has shared a defensive paper published in a science or medicine journal yet (trade journals are entirely legitimate; I just was not looking there first). It would not be reasonable for anyone to demand information from only these journals, but I do not think that I have been unreasonable in searching such journals in anticipation of finding content there, and frankly I am surprised that I did not. There are two doctors of veterinary medicine here and you also Jytdog, and among all of us I expect that eventually one of us will find something.

I am in opposition to sandboxing anything unless there are good sources presenting alternative perspectives listed on this talk page but not properly integrated into the article. Right now, I am asserting that everything I posted to this article has a citation, and that I have not been consciously overlooking research in opposition to my bias, and that before now there were not good sources (except the 2-3 trade papers I just mentioned) in queue on this talk page presenting alternative views.

Give me a chance; I have continually expressed my willingness to add alternative perspectives to this article and made a lot of requests for sources. The bias in this article is reflective of the bias on this topic which seems to exist in all media. It may be the case that I do not even understand what is lacking or what others would expect to see here; I may just be totally ignorant of what is important to include and am missing something major entirely, but please be patient with me. I hope that you can see that I am trying to collaborate with this. Blue Rasberry (talk) 12:26, 5 November 2013 (UTC)

Thank you for this long reply! As I wrote below I believe that you work in good faith. I also believe that our biases (and for you, the advocacy of your employer) get in the way of creating good NPOV articles when editors are not carefully reflective about checking their biases at the login page. This, I acknowledge, is very hard, since it is not just a question of Weltanshauung (your worldview), but goes much deeper to what Germans call Weltbild -- the picture of the world that you see, which is what you have a view on. None of Weltbild any of us carry around, is the same the actual world. Google searches are really dangerous to rely on, as they reflect what is most popular, not what is most real. I agree that the sources I provided are not great - they were just quick and easy to find with the right search terms (often I find with ag topics, that if you search with the actual terms used by farmers, you get real information quickly. In my experience activists tend to be ignorant of actual farming practices and don't use these terms) I agree that the self published source is not suitable for wikipedia; it is useful for background research is all. And please note that my complaint is not about "alternative views" - it is about actual farming practices not being part of the picture. I am also hopeful that together we can make this into a very useful article. I am planning on sticking around and working on this with you all. Jytdog (talk) 13:24, 5 November 2013 (UTC)

I think we are in agreement. The criticism you present is warranted; I just wanted to express that the problems are not permanent barriers and I hope that all criticism can be addressed. I will work to integrate other perspectives into this article. Blue Rasberry (talk) 14:33, 5 November 2013 (UTC)

reorganization

In the spirit of working instead of just bitching, today I reorganized the article to have the body discuss the actual use of antibiotics in livestock production, and separate out all the criticism and concern, so that readers can clearly see what the practice is, how it is done, and why. Before I did this, every section was smothered with concern and criticism. Still needs a lot of work. Jytdog (talk) 10:21, 5 November 2013 (UTC)

I never wanted it to turn out that way. I started the article by doing Google searches for every country and seeing what came up in the news. I would not have anticipated that there was so much criticism. Obviously the practice got established for the benefits it brings, but the people who enjoy the benefits seem to publish less than the people who have criticism.

I prefer not to have criticism sections but perhaps this is warranted for now. I wish that the content could be integrated with multiple perspectives in all places. Blue Rasberry (talk) 12:31, 5 November 2013 (UTC)

I see, and I do believe that everything you do here in in the best of faith. If you are OK with it, let's keep them separate now so the need for objective information about the practice itself is clear, and after it is well fleshed out we can re-integrate - would that be OK with you? It is so easy for the criticism to overwhelm, as you have lived through once, quite unintentionally.Jytdog (talk) 12:58, 5 November 2013 (UTC)

The separation is best for now. For as long as only one perspective is presented, and that is the case now, it is better to have that perspective cordoned so that readers will know that it is biased. I did not set out to create biased content but it is, and until it is mixed with the other perspectives, it should be as you put it. Blue Rasberry (talk) 14:30, 5 November 2013 (UTC)

scope

I think that this article should perhaps be focused on the use of antibiotics in animal feed to increase feed efficiency and promote growth (l'll call this "economic use" as opposed to "therapeutic use"), and we should perhaps explictly set aside actual therapeutic use of antibiotics in livestock. I'm writing this b/c there is a lot of content (unsourced) that addresses therapeutic uses and I am not sure it is relevant. I am still learning about this, but the sense I am getting is that it is the economic use that is the big concern among experts. I also ~wonder~ but am not sure yet, if there is a broad misconception out there in the animal rights community, that "factory farming" conditions lead to more infectious disease outbreaks and increased use of antibiotics. I know I have read that in a bazillion places. While there is logic to that story, I am not sure (and I really mean that) if this is true, or just a myth. The article currently doesn't provide information one way or the other on this. If it is true we should make that clear and explain to what extent crowding-drives-outbreaks-drives-overuse-of-antibiotics is part of the problem (a huge part, a small part?), and if it is a myth, we should make that clear. Once we know that, again we may be able to restrict the content to be more tightly focused on the economic use. Jytdog (talk) 10:38, 5 November 2013 (UTC)

I am not sure. This is discussed in Talk:Antibiotic_use_in_livestock#Name_of_this_article. I think that it would be ideal to have some article be the hub for all related topics, and then for subarticles to fork from that hub.

Just to disclose my own bias, I am not knowledgable about claims that "'factory farming' conditions lead to more infectious disease outbreaks and increased use of antibiotics" and I did not come here with intent to explore such claims, although now that I am more aware of them I want them integrated if they are notable perspectives. My own bias is a concern about long term effects of antibiotics in large populations over time, and I was surprised that User:Kerani above dismissed that. You also seem not to have perceived that to be my bias. If there are stories about short-term increases in disease outbreaks then that is another perspective, and I thought that the increased use of antibiotics claim was an industry claim defending the practice of blanket "subtherapeutic" treatments. Another perspective on this is residual antibiotics in food, and although I think I could find sources on that this is a criticism that I think both industry and activists agree is a real problem to be addressed and that there is collaboration here.

I am exploring this too. I am not sure what the correct answer is about scope. I am not opposed to content in this article being moved to other places because I am not yet sure how this information ought to be organized. Blue Rasberry (talk) 12:40, 5 November 2013 (UTC)

I wish there were some scientific paper which gave a history and overview over all aspects of this topic. If there were an outline identified somewhere then that could be adapted to outline this Wikipedia article. Blue Rasberry (talk) 12:44, 5 November 2013 (UTC)

Summary for October 2014

This short article gives links to other papers and I think it could be said to be a summary of the United States government's concerns about antibiotic resistance developing as a result of antibiotic use in livestock.

• Romm, Cari (3 October 2014). "The FDA Says Farmers Are Giving Animals Too Many Antibiotics - The Atlantic". theatlantic.com. Retrieved 6 October 2014.

Blue Rasberry (talk) 11:12, 6 October 2014 (UTC)

Investors calling for change

I am not sure how significant this is and cannot find the original statements but here are some news stories talking about investors requiring change in how antibiotics are used.

• Investors urge fast food and pub chains to act to reduce farm antibiotics
• Investor group launches campaign to curb antibiotic use in food

Blue Rasberry (talk) 15:26, 11 April 2016 (UTC)

I've been wondering about how to tackle this article on topics like this, and I'm not sure there's a clear answer right now. We can get into WP:FRINGE territory when it comes to public perception of antibiotic use vs. actual usage like we do in many agricultural topics. It's tricky to say the least. Kingofaces43 (talk) 20:34, 11 April 2016 (UTC)

This article needs good sources

Kingofaces43 you say above that you wish to help balance public perception versus actual use in this article. It stands out to me that this article mostly covers social issues and that the basic practice guidelines are not presented here.

Do you have any access to any expert in the field? This article is heavy on popular press because I have been unable to find the basic academic papers or industry guideline publications on the topic, and because no one else has offered them. I presume that any expert in the field ought to immediately be able to say, "Everyone in the field knows these papers..." but right now, this article is not even presenting the most basic sources on the topic.

I would love to see the industry guideline which says, "This is what industry does..." then the complementary academic publication which critiques that guideline and matches it to whatever evidence exists.

This is a dried-out article for lack of the basic information. If you can identify the most fundamental sources in the field, or if you can confirm that you also have been unable to find such sources, then that would be useful. Blue Rasberry (talk) 21:07, 11 April 2016 (UTC)

You've pretty much described my thinking on this. I've got a few vet friends on campus I can ask about the best way to tackle this article (I used to do veterinary entomology for awhile too). I have access sources to veterinary recommendations, farmer usage, and general regulatory information that I've been meaning to summarize, so we'll get something to cover the gap you described in due time. I've got to wait with really tackling anything major on Wikipedia until planting season settles down, but I'll put it on my to-do list and start making some headway on content sometime this summer.

To answer your questions for now though, there aren't any single great sources. There's a lot of subtopics and nuance that's handled almost too broadly in higher level secondary sources, while more pointed secondary sources tend to give better explanation suitable for a general reader. Organizing it and summarizing is where the work is, but I'll take that on. Kingofaces43 (talk) 22:35, 11 April 2016 (UTC)

This[4] is a UK government statement on the issue, although I am not sure when it was published. This[5] is a very recent secondary source of public/political situation here, although it is an industry magazine so might contain bias. DrChrissy ^(talk) 20:01, 13 April 2016 (UTC)

May 2016 updates

An IP editor just added a lot of content. The content seems in order. Some of the citations could be better, like for example, a book called Dominion: the power of man is cited without giving a page number and some articles are cited without presenting URLs, but overall everything complies with Wikipedia's demand for citations. The citations could be cleaned whenever the article is finally copyedited. Blue Rasberry (talk) 14:29, 9 May 2016 (UTC)

New World Health Organization guidelines

Hi

This article outlines new WHO guidelines to completely stop the use of antibiotics in healthy animals.

John Cummings (talk) 19:18, 7 November 2017 (UTC)

Edit 6/23/2018

New sections added: FDA risk assessment models - regulation

Concentrated animal feeding operations -manure -groundwater contamination -antibiotic usage -vectors -horizontal gene transfer

Effects in humans -spread to humans

The only completely new section I added was the CAFO section, as I felt it was necessary since this article is primarily focused on livestock.

I welcome feedback on these sections I have added. This can be pointing out redundant information, organizational criticism, and clarity of my writing. Thanks.

Content copied from user:Waltzer.l/sandbox

— Preceding unsigned comment added by Waltzer.l (talk • contribs) 19:57, 23 June 2018 (UTC) 

ionophores

The article says, twice, that ionophores are not used for human medicine; the first statement has no citation, the second has a citation but i don't see where the article cited says or implies that. Meanwhile, the gramicidin article says "It is used primarily as a topical antibiotic and is one of the three constituents of consumer antibiotic polysporin ophthalmic solution" (The gramicidin article doesn't say explicitly that gramicidin is an ionophore, although it discusses it as an ion channel, same thing; but the ionophore article does say explicitly that gramicidin is an ionophore). Clarification is required, I think. Thanks. Gzuckier (talk) 03:58, 9 April 2019 (UTC)

Worldwide view

This article (and especially the section on antibiotic excretion and environmental infiltration) is rather American-centric. I'll try to fix this by adding more global statistics and studies. MaryJohnson123 (talk) 19:15, 26 January 2020 (UTC)

Wiki Education assignment: Plagues and People

This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2023 and 11 December 2023. Further details are available on the course page. Student editor(s): Brays.world, Eweir1, Wafa AbuAlrob (article contribs). Peer reviewers: ExplorerRoxy, Brebre2719, F1287.

— Assignment last updated by MatthewBroadway (talk) 22:55, 2 October 2023 (UTC)