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Home Eurosurveillance Weekly Release  2003: Volume 7/ Issue 36 Article 3
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Eurosurveillance, Volume 7, Issue 36, 04 September 2003

Citation style for this article: WHO reports that withdrawing antimicrobial growth promoters in animals in Denmark has reduced threat of antimicrobial resistance to human health. Euro Surveill. 2003;7(36):pii=2287. Available online:

WHO reports that withdrawing antimicrobial growth promoters in animals in Denmark has reduced threat of antimicrobial resistance to human health

Editorial team (, Eurosurveillance editorial office

An international review panel has concluded that Denmark’s termination of the use of antimicrobial growth promoters seems to have achieved its desired public health goal and has had no major consequences, and that countries with similar animal production conditions could see similar benefits if they follow suit (1).

The World Health Organization (WHO) convened the independent and international panel in November 2002. The panel evaluated the impact that withdrawal of antimicrobial growth promoters in Denmark has made on the efficiency of food animal production, animal health, food safety, and consumer prices.

Denmark’s termination programme is consistent with WHO Global Principles, which call on governments to adopt a proactive approach to reduce the need for antimicrobials in animals and ensure their prudent use (2). Antimicrobial growth promoters were withdrawn both as a public health measure, and to ensure consumer confidence. Their use ceased in Denmark in 1999. The concern was that resistance to these antimicrobials in the food animal reservoir would lead to clinical problems in humans, although these were rare in Denmark both before and after termination. The quantity of antimicrobials used in food animals in Denmark has declined 54% from peak use between 1994 and 2001.

Before the programme began, most pigs and broiler chickens in Denmark were given antimicrobials, such as avilamycin, avoparcin, tylosin and virginiamycin, for most of their lives. After withdrawal, average use declined to 0.4 days in broiler chickens (with life span of around 42 days) and 7.9 days in pigs (with life span of around 170 days). Pork production in Denmark has continued to increase, and effects on poultry production were small.

Data from the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP, see for more information) showed that ending the use of the above antimicrobials has greatly reduced the reservoir of resistant Enterococcus faecium in the food animal reservoir, thus reducing the reservoir of resistance genes. For example, resistance to avilamycin, avoparcin and streptogramins in Enterococcus faecium isolates from broiler chickens declined from 60-80% before withdrawal of antimicrobials to only 5-35% after. The panel considered that the threat of antimicrobial resistance to human health has been reduced.

The panel concluded that use of antimicrobials for the sole purpose of growth promotion can be ended in countries which have similar conditions to Denmark, that is, where animal farming methods are intensive, and animals have a relatively high health status, and where a high level of infrastructure and capacity to monitor antimicrobial use and resistance exist. In July 2003, the European Parliament adopted a regulation on feed additives which completes a ban on antibiotic growth promoters in feed, and the European Union’s Scientific Steering Committee has recommended that the use of these antimicrobials be progressively phased out (3 and

  1. WHO. Impacts of antimicrobial growth promoter termination in Denmark. WHO/CDS/CPE/ZFK/2003.1. Geneva: World Health Organization; 2003. ( [accessed 4 September 2003]
  2. WHO. WHO Global Principles for the Containment of Antimicrobial Resistance in Animals Intended for Food. Geneva: World Health Organization; 2001. ( [accessed 4 September 2003]
  3. European Commission. Council and Parliament prohibit antibiotics as growth promoters: Commissioner Byrne welcomes adoption of Regulation on feed additives. Press release IP/03/1058, 22 July 2003. (|0|RAPID&lg=EN&display=) [accessed 4 September 2003]

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