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Volume 10, Number 7—July 2004

Antimicrobial Resistance in Campylobacter

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To the Editor: We wish to rectify several errors in our commentary, Antibiotics in Animal Feed and Spread of Resistant Campylobacter from Poultry to Humans (1). The fluoroquinolone enrofloxacin was approved in 1996 for therapeutic use by addition to drinking water upon the decision of a licensed veterinarian “for the control of mortality in chickens associated with Escherichia coli organisms and control of mortality in turkeys associated with E. coli and Pasteurella multocida organisms” (2). This therapeutic use was withdrawn (3) but is now under appeal. Initial approval and subsequent efforts to withdraw use of enrofloxacin in the United States parallels the earlier trend in Europe and specifically Denmark, where the use of antimicrobial agentss as growth promoters has been banned (4).

Enrofloxacin is not approved for prophylactic or growth promotion use in poultry feed as stated in our commentary and in the first section of the flowchart (1). However, when enrofloxacin is added to the drinking water of poultry, large numbers of both ill and healthy animals are exposed to the agent (5). Although extra-label use of enrofloxacin is prohibited, microbiologic culture of either of the cited bacteria is not required before administration (2). Despite the restrictions on enrofloxacin use, emergence of fluoroquinolone-resistant Campylobacter species, with poultry as an important source, has been documented in the United States (5,6). Thus the decision to withdraw therapeutic use of enrofloxacin (3) was warranted. And our conclusion remains: use of enrofloxacin in poultry materially contributed to increase in human infection by fluoroquinolone-resistant Campylobacter species. Given the above, our commentary should have been entitled Use of Antibiotics in the Poultry Industry and Spread of Resistant Campylobacter to Humans. We regret the errors and hope we have clarified this issue.


Nicole M. Iovine* and Martin J. Blaser*†Comments to Author 
Author affiliations: *New York University School of Medicine, New York, New York, USA; †New York Harbor Department of Veterans Affairs Medical Center, New York, New York, USA



  1. Iovine  N, Blaser  MJ. Antibiotics in animal feed and spread of resistant Campylobacter from poultry to humans. Emerg Infect Dis. 2004;10:11589.PubMedGoogle Scholar
  2. Sundlof  S. Enrofloxacin for Poultry; Opportunity for Hearing. Department of Health and Human Services, Food and Drug Administration, Center for Veterinary Medicine. Fed Regist. 2000;65:6495465.
  3. Davidson  D. In the matter of enrofloxacin for poultry: withdrawal of approval of Bayer Corporation's new animal drug application 1 (NADA) 140-828 (Baytril). FDA Docket No 00N-1571 2004.
  4. DANMAP 2002. Use of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from food animals, foods and humans in Denmark. Copenhagen Danish Zoonosis Center, Danish Veterinary Institute. 2003.
  5. Gupta  A, Nelson  JM, Barrett  TJ, Tauxe  RV, Rossiter  SP, Friedman  CR, Antimicrobial resistance among Campylobacter strains, United States, 1997–2001. Emerg Infect Dis. 2004;10:11029.PubMedGoogle Scholar
  6. Smith  KE, Besser  JM, Hedberg  CW, Leano  FT, Bender  JB, Wicklund  JH, Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998. Investigation Team. N Engl J Med. 1999;340:152532. DOIPubMedGoogle Scholar


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DOI: 10.3201/eid1007.040580

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Table of Contents – Volume 10, Number 7—July 2004


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Martin J. Blaser, Department of Medicine, NYU School of Medicine, 550 First Avenue, OBV-606, New York, NY 10016, USA; fax: 212-263-3969

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