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Umair, M., et al., The Lancet Microbe 2023; 4,4:E264-276

International manufacturing and trade in colistin, its implications in colistin resistance and One Health global policies: a microbiological, economic, and anthropological study

The emergence of colistin-resistant Enterobacterales is a global public health concern, yet colistin is still widely used in animals that are used for food as treatment, metaphylaxis, prophylaxis, and growth promotion. Herein, we investigate the effect of colistin-resistant Enterobacterales in Pakistan, global trade of colistin, colistin use at the farm level, and relevant socioeconomic factors.

The use of human antibiotics in animal feeds is one of the largest drivers on antibiotic resistance globally. While many high-income countries have reduced their usage of antibiotics in farming, paradoxically, they are still exporting drugs like colistin to low-income and middle-income countries."

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