Food Protection Trends - September/October 2016 - 393

Consumers Many consumers in the United States today are not touched by infectious disease directly and do not think of infectious diseases as a problem anymore. Consumers should be aware that part of the concern about antibiotic resistance is the possibility of returning to a pre-antibiotic era, where many infectious diseases were untreatable. In order to personally reduce their contribution to that possibility, consumers can use medically prescribed antibiotics responsibly. That means not demanding antibiotics from their health care provider when these drugs are not indicated. It means taking antibiotics, if prescribed, as prescribed, and not sharing them. Handle food safely Consumers should do everything reasonably possible to reduce microbial contamination when handling food in the home. Safe food handling includes washing hands and utensils, separating cooked from raw foods, cooking to a safe internal temperature (using a food thermometer to assure it has reached the proper temperature), and storing food quickly and properly. These strategies will help reduce the risk of foodborne illness. Reducing foodborne illness means fewer humans will need to be treated with antibiotics, further reducing use. Become informed about antibiotic-free meat According to the 2015 IFIC Foundation Food & Health Survey, approximately one-quarter, or 25 percent, of Americans regularly purchase foods labeled as "raised without antibiotics" (13). However, most people agree that it is appropriate to use antibiotics to treat a sick cow or chicken, and when companies produce antibiotic-free meat, it means they use no antibiotics. There is even more controversy in using antibiotics for disease prevention, both in food animals and humans. However, if one administers a small dose of antibiotics to chicks in the first week of life, one can avoid larger doses of antibiotics to treat infected chickens later on. The roundtable concluded that a complete elimination of antibiotic use in animals intended for food is likely too extreme to serve the ultimate purpose of reducing the risk of antibiotic resistance. Some antibiotic use to treat and prevent disease in agricultural animals is appropriate. However, current food labeling practices make it almost impossible for consumers to identify companies attempting to use antibiotics responsibly. Place pressure on industry Companies are addressing the issue of antibiotic use in meats because consumers are demanding it (5, 13). When consumers demand meat from animals raised without antibiotics, companies will meet the demand. Buy foods produced in the United States Whenever possible, consumers should opt to purchase foods produced domestically. Domestic food continues to be safe, abundant, and high in quality. Some, although not all, imported food products are less likely than domestic products to be produced in ways that will reduce or minimize the global threat of antibiotic resistance (19). RECOMMENDATIONS Given today's environment and efforts currently under way to address antibiotic resistance, such as the President's Task Force on Antibiotic Resistance, our roundtable proceedings reflect a necessary and critical first step toward raising awareness and effecting change. Our goal is that readers will go to their respective professional organizations and affiliates and spread the word, helping to identify strategies within a community to combat antibiotic resistance. Leading organizations such as IFIC Foundation could form an interdisciplinary task force to engender more discussion among stakeholders. It will be important to enlist the aid of influential food producers already proactive on food safety issues. We suggest including an animal health company that takes a stand against antibiotics for growth promotion in food animals but encourages their use to treat sick animals. Medical organizations in addition to the veterinary and public health communities should also be included. The goal of this task force would be to identify ways to drive change. The hope is that the representatives from multiple interested communities can galvanize around a strategy and carry that message to their communities. These stakeholder organizations, along with IFIC, could also facilitate engagement with the One Health initiative. The One Health Initiative is a worldwide strategy for expanding interdisciplinary collaborations in all aspects of health care for humans, animals, and the environment (15). The goal of this platform is to develop equal, allinclusive collaborations between physicians, osteopaths, veterinarians, dentists, nurses, and other scientific-health and environmentally related disciplines. One Health is a venue that can foster conversations about antibiotic protection among the many users and stakeholders involved. Another possibility is for IFIC to develop an action plan on the basis of which others might act. IFIC might convene more small roundtables. This dynamic area of science can benefit from ongoing dialogue of all kinds. It is important for IFIC to support long-term collaboration with the CDC's NARMS program, as we must carefully track trends in resistance. It is urgent for stakeholders to begin by taking whatever small steps they can. The medical and agricultural communities are robust and will adapt to the changes we need to combat antibiotic resistance. ACKNOWLEDGMENTS The International Food Information Council (IFIC) Foundation acknowledges the following people for their insights, reviews, comments and guidance through the process of publishing this article: Mitchell Cohen, M.D., RADM, U.S. Public Health Service (Ret.); James Hughes, M.D., Emory University; Brenda Jones, M.D., University of Southern September/October Food Protection Trends 393

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