Preventing antibiotic resistance: the next step.

There is universal agreement that the emergence of antibiotic-resistant bacteria is a significant health problem, leading to preventable morbidity and mortality. Kaiser Permanente (KP) has made great strides in improving the antibiotic-prescribing behavior of its physicians, thereby limiting the emergence of antibiotic resistance in the clinical setting. This, however, is only a beginning. Greater than 70% of the antibiotics used in the United States are for nontherapeutic purposes in animal feed. The resulting emergence of resistant bacteria that cause human disease is described. I propose a campaign throughout KP to broaden our prevention efforts by phasing out meat, dairy, poultry, and fish products raised using antibiotic feed additives.