Antibiotic prophylaxis – using antibiotics to prevent disease – has long been extensively used in humans and animals. After penicillin was introduced in 1928, it became apparent that administering antibiotics could reduce wound infection rates in many surgical procedures.[1] At first, prophylaxis was prescribed in a way that lacked organization. As antibiotic use increased, resistance to antibiotics and hospital-acquired infections caused by bacteria became an increasing problem. In livestock production, farmers use antibiotics to prevent the loss of animals and, in some countries, to promote growth in healthy animals. 

Today, less antibiotics are used for prophylaxis is less used than ten years ago. The current use of antibiotics has led to a rise in resistance, changes in bacteria that cause infections, and advances in technology to detect bacterial infections.

Professional guidelines still recommend using antibiotics before major surgery with a high risk of bacterial infection, but in most cases, only suggests only a single dose of antibiotics is recommended at the time of surgery. The WHO recommends against the prolongation of antibiotics after surgery to prevent infection.[2] Antibiotic prophylaxis is also no longer recommended before dental procedures unless the patient has artificial heart valves or rheumatic heart disease. 

In 2017, the WHO strongly recommended an overall reduction in the use of all classes of medically important antibiotics in food-producing animals, including complete restriction of these antibiotics to promote growth and prevent disease without a prior diagnosis.[3] Healthy animals should not receive antibiotics to prevent disease, only if there has been a diagnosis of sick animals in the same flock, herd, or fish.

It is noteworthy that countries promoting the campaign to stop using antibiotics as growth promoters may find that farmers respond by increasing antibiotic prophylaxis – causing the total amount of antibiotics used in animal agriculture to remain the same or even increase.[4] Therefore, it is crucial to follow the WHO recommendation to restrict antibiotic prophylaxis without a diagnosis.

Alternative options to using antibiotics for disease prevention in animals include improving hygiene, better use of vaccination, and changes in animal housing and husbandry (farming) practices.

References

1 Westerman, E. L. (1984). Antibiotic prophylaxis in surgery: Historical background, rationa1e, and relationship to prospective payment. American Journal of Infection Control,12(6), 339-343. doi:10.1016/0196-6553(84)90007-5

2 WHO. (2018). Global guidelines for the prevention of surgical site infection, second edition (2nd ed.). Geneva, Switzerland: World Health Organization. ISBN 978 92 4 155047 5

3 WHO. (2017, November 7). Stop using antibiotics in healthy animals to preserve their effectiveness. Retrieved from https://www.who.int/news-room/detail/07-11-2017-stop-using-antibiotics-in-healthy-animals-to-prevent-the-spread-of-antibiotic-resistance

4 Mevius, D., & Heederik, D. (2014). Reduction of antibiotic use in animals “let’s go Dutch”. Journal Für Verbraucherschutz Und Lebensmittelsicherheit,9(2), 177-181. doi:10.1007/s00003-014-0874-z