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Clearly, antibiotic resistance (AR) in microbial ecosystem is a complex issue. Although the ultimate concern of AR is infections by antibiotic resistant pathogens no longer treatable by existing antibiotics, scientific discoveries in the past decade have demonstrated that multiple risk factors contributed to the AR problem seen today.  The food chain plays a key role in AR ecology due to the dominant commensal microflora, and conventional food intake serves as a critical avenue impacting AR in human and animal gut microbiota. Oral drugs disturb normal gut microbiota and lead to the rapid rise of AR in the microbial population. It is critically important to recognize that prudent use of antibiotics does not simply mean a ban of, but most importantly what, when, and how to use the antibiotics. While bacterial infections can be easily managed by the proper use of antibiotics at early stages, delayed therapy may lead to the development of biofilm-associated infections or other complicated health conditions in both humans and animals and, subsequently, the need for more-extensive treatments. Recent findings identified oral drugs as a key risk factor leading to the rapid rise of AR and disturbed gut microbiota; simply changing antibiotic administration route has already led to effective AR mitigation up to 5 logs to almost non-detectable, and protected gut microbiota diversity in animal models. The results provide a solution to the dilemma of AR and the usage of antibiotics in disease prevention and treatment. From removing problematic starter cultures and probiotics to proper manure and waste processing, innovative efforts have delivered more convincing outcomes on AR mitigation. These new data justify the urgent needs to support innovative research and to re-evaluate the causes of AR and diseases, the strategy on AR mitigation,  the direction of investigation and investment, as well as related policies and practices, for the best interest of the human society (see key publications for detail).

Hua Wang, Ph.D.

Professor, Food Science and Technology, Microbiology, Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University

Team Leader, U.S.-UK Global Innovation Initiative Project on Antibiotic Resistance Mitigation in the Global Ecosystem

Founder, ICARM