> Antibiotics that are crucial in human medicine should not be used in livestock.
> So, (and I ask as a layman), is it OK to use antibiotics that are not (yet perhaps?) crucial in human medicine?

Actually, that is the thinking in the US. Tylosin was developed as an alternative to oxytetracycline, when AFB started to exhibit resistance to it. It seemed wise at that point that if a new drug was going to be used against AFB, it should be one that isn't widely used in human medicine. On the other hand, chloramphenicol is prohibited because it is no longer approved for human use, and should not be used in food production. In plain language, we should have three categories. Human use only, animal use only, not to be used at all. 


> Antibiotics should not be used except where needed to control actual disease, not merely as stimulants to boost production.
> This seems so blindingly obvious that one wonders why it has to be stated or debated.

Well that may be so, but it is common practice. The FAO/OIE/WHO report states:

The non-human use of antimicrobials (which includes use in food animals, companion animals,
aquaculture and horticulture) can be divided into therapeutic, prophylactic, metaphylactic and growth
promoting use. Therapeutic antimicrobial use is the treatment of established infections.

Growth promotion use is when an antimicrobial agent is used as feed supplement in food animals to
promote growth and enhance feed efficiency. Growth promoters are usually administered in
relatively low concentrations, ranging from 2.5 to 125 mg/kg (ppm), depending on the drug and
species treated. Such levels that are usually less than therapeutic concentrations are commonly
referred to as subtherapeutic doses.

The societal benefits of therapeutic antimicrobial use in animals are assumed and unchallenged and
have not been subjected to economic analysis. 

The economic benefits of antimicrobial growth promoters have been estimated and are debated and
uncertain. Some estimates, based on targeted studies, suggest that the animal production benefits are
in the order of 1-11%, while other evidence, notably the review of Denmark’s programme of
antimicrobial growth promoter termination in swine and poultry production, suggests that the
production gains are considerably less.

Options include:

 Avoid group medication by feed or water wherever possible.

 Restrict the use of antimicrobials to prescription only.

 Remove antimicrobial use as growth promoters.

 Restrict off-label use.

 Reduce profit from sales of antimicrobials by veterinarians.

SOURCE:
Joint FAO/OIE/WHO Expert Workshop on Non-Human Antimicrobial Usage and Antimicrobial Resistance: Scientific assessment

* * *

But in the context of this debate, the key question remains: is the use of fumagillin against Nosema ceranae justified given the uncertainty of its efficacy. Are we using it to treat a diagnosed condition, or merely employing it as a temporary growth promoter? I have not heard these questions answered by anyone with any degree of certitude. Nor can I answer them myself. 

PLB

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