External Societal Costs of Antimicrobial Resistance in Humans Attributable to Antimicrobial Use in Livestock

Author:

Innes Gabriel K.1,Randad Pranay R.1,Korinek Anton23,Davis Meghan F.14,Price Lance B.5,So Anthony D.6,Heaney Christopher D.167

Affiliation:

1. Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA;, , ,

2. Department of Economics and Darden School of Business, University of Virginia, Charlottesville, Virginia 22904, USA;

3. National Bureau of Economic Research, Cambridge, Massachusetts 02138, USA

4. Department of Molecular and Comparative Pathobiology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA;

5. Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA;

6. Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA;,

7. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA;

Abstract

Antimicrobial use (AMU) in animal agriculture contributes to antimicrobial resistance (AMR) in humans, which imposes significant health and economic costs on society. Economists call these costs negative externalities, societal costs that are not properly reflected in market prices. We review the relevant literature and develop a model to quantify the external costs of AMU in animal agriculture on AMR in humans. Parameters required for this estimate include ( a) the health and economic burden of AMR in humans,( b) the impact of AMU in animal agriculture on AMR in animals, ( c) the fraction of AMR in humans attributable to animal agriculture, and ( d) AMU in animals. We use a well-documented historic case to estimate an externality cost of about US$1,500 per kilogram of fluoroquinolones administered in US broiler chicken production. Enhanced data collection, particularly on the third and fourth parameters, is urgently needed to quantify more fully the externalities of AMU in animal agriculture.

Publisher

Annual Reviews

Subject

Public Health, Environmental and Occupational Health,General Medicine

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