Pleuromutilins: use in food-producing animals in the European Union, development of resistance and impact on human and animal health
Investigation article published in The Journal of Antimicrobial Chemotherapy
August 1st, 2014
Pleuromutilins (tiamulin and valnemulin) are antimicrobial agents that are used mainly in veterinary medicine, especially for swine and to a lesser extent for poultry and rabbits. In pigs, tiamulin and valnemulin are used to treat swine dysentery, spirochaete-associated diarrhoea, porcine proliferative enteropathy, enzootic pneumonia and other infections where Mycoplasma is involved. There are concerns about the reported increases in the MICs of tiamulin and valnemulin for porcine Brachyspira hyodysenteriae isolates from different European countries, as only a limited number of antimicrobials are available for the treatment of swine dysentery where resistance to these antimicrobials is already common and widespread. The loss of pleuromutilins as effective tools to treat swine dysentery because of further increases in resistance or as a consequence of restrictions would present a considerable threat to pig health, welfare and productivity. In humans, only one product containing pleuromutilins (retapamulin) is authorized currently for topical use; however, products for oral and intravenous administration to humans with serious multidrug-resistant skin infections and respiratory infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA), are being developed. The objective of this review is to summarize the current knowledge on the usage of pleuromutilins, resistance development and the potential impact of this resistance on animal and human health
van Duijkeren E., Greko C., Pringle M., Baptiste K., Catry B., Jukes H., Moreno MA., Matias-Ferreira MC., Pyorala S., Rantala M., Ruzauskas M., Sanders P., Teale C., Threlfall EJ., Torren-Edo J. and Torneke K.
 | National Institute for Public Health and the Environment (RIVM). Ministry of Health, Welfare and Sport. Government of the Netherlands. |
| Danish Health and Medicines Agency. | |
| Scientific Institute of Public Health, Epidemiology Unit. European Programme for Intervention Epidemiology Training (EPIET). | |
| Veterinary Medicines Directorate (VMD). | |
 | Departamento de Sanidad Animal. Facultad de Veterinaria. Universidad Complutense (UCM). |
| Servicio de Zoonosis de Transmisión Alimentaria y Resistencia a Antimicrobianos (ZTA). Centro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense (UCM). |
| Faculdade de Medicina Veterinária. Universidade Técnica de Lisboa (UTL). | |
| Faculty of Veterinary Medicine. University of Helsinki. | |
| Veterinary Academy. Lithuanian University of Health Sciences (LSMU). | |
 | Veterinary Laboratories Agency. Department for Environment, Food and Rural Affairs (Defra). |
| Health Protection Agency Microbiology Services Colindale London. | |
| European Medicines Agency (EMEA). | |
| Läkemedelsverket Medical Products Agency. | |
