Antimicrobial use in food animals and human health: time to implement ‘One Health’ approach

go back to reference O’Neill J. Tackling Drug-Resistance Infections Globally: Final Report and Recommendations; 2016. https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf. O’Neill J. Tackling Drug-Resistance Infections Globally: Final Report and Recommendations; 2016. https://​amr-review.​org/​sites/​default/​files/​160518_​Final%20​paper_​with%20​cover.​pdf.

go back to reference Pokharel S, Raut S, Adhikari B. Tackling antimicrobial resistance in low and middle income countries. BMJ Glob Heal. 2019;4:e002104. https://doi.org/10.1136/bmjgh-2019-002104.CrossRef Pokharel S, Raut S, Adhikari B. Tackling antimicrobial resistance in low and middle income countries. BMJ Glob Heal. 2019;4:e002104. https://​doi.​org/​10.​1136/​bmjgh-2019-002104.CrossRef

go back to reference Kimera ZI, Mshana SE, Rweyemamu MM, Mboera LEG, Matee MIN. Antimicrobial use and resistance in food-producing animals and the environment: an African perspective. Antimicrob Resist Infect Control. 2020. https://doi.org/10.1186/s13756-020-0697-x%0A.CrossRefPubMedPubMedCentral Kimera ZI, Mshana SE, Rweyemamu MM, Mboera LEG, Matee MIN. Antimicrobial use and resistance in food-producing animals and the environment: an African perspective. Antimicrob Resist Infect Control. 2020. https://​doi.​org/​10.​1186/​s13756-020-0697-x%0A.CrossRefPubMedPubMedCentral

go back to reference Van Boeckel TP, Glennon EE, Chen D, Gilbert M, Robinson TP. Reducing antimicrobial use in food animals. Science (80–). 2017;357(6358):1350–2. https://doi.org/10.1126/science.aao1495.CrossRef Van Boeckel TP, Glennon EE, Chen D, Gilbert M, Robinson TP. Reducing antimicrobial use in food animals. Science (80–). 2017;357(6358):1350–2. https://​doi.​org/​10.​1126/​science.​aao1495.CrossRef

go back to reference US Food and Drug Administration. Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals; 2017. https://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM588085.pdf. US Food and Drug Administration. Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals; 2017. https://​www.​fda.​gov/​downloads/​ForIndustry/​UserFees/​AnimalDrugUserFe​eActADUFA/​UCM588085.​pdf.

go back to reference European Medicines Agency. Sales of Veterinary Antimicrobial Agents in 30 European Countries in 2015; 2017. https://www.ema.europa.eu/docs/en_GB/document_library/Report/2017/10/WC500236750.pdf. European Medicines Agency. Sales of Veterinary Antimicrobial Agents in 30 European Countries in 2015; 2017. https://​www.​ema.​europa.​eu/​docs/​en_​GB/​document_​library/​Report/​2017/​10/​WC500236750.​pdf.

go back to reference Carrique-mas JJ, Choisy M, Van CN, Thwaites G, Baker S. An estimation of total antimicrobial usage in humans and animals in Vietnam. Antimicrob Resist Infect Control. 2020;7:1–6. https://doi.org/10.1186/s13756-019-0671-7.CrossRef Carrique-mas JJ, Choisy M, Van CN, Thwaites G, Baker S. An estimation of total antimicrobial usage in humans and animals in Vietnam. Antimicrob Resist Infect Control. 2020;7:1–6. https://​doi.​org/​10.​1186/​s13756-019-0671-7.CrossRef

go back to reference Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, Vlieghe E, Hara GL, Durand CG, Aires B. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2014;13(December):1057–98. https://doi.org/10.1016/S1473-3099(13)70318-9.CrossRef Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, Vlieghe E, Hara GL, Durand CG, Aires B. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2014;13(December):1057–98. https://​doi.​org/​10.​1016/​S1473-3099(13)70318-9.CrossRef

go back to reference Chantziaras I, Boyen F, Callens B, Dewulf J. Correlation between veterinary antimicrobial use and antimicrobial resistance in food-producing animals: a report on seven countries. J Antimicrob Chemother. 2014;69:827–34. https://doi.org/10.1093/jac/dkt443.CrossRefPubMed Chantziaras I, Boyen F, Callens B, Dewulf J. Correlation between veterinary antimicrobial use and antimicrobial resistance in food-producing animals: a report on seven countries. J Antimicrob Chemother. 2014;69:827–34. https://​doi.​org/​10.​1093/​jac/​dkt443.CrossRefPubMed

go back to reference Roth N, Käsbohrer A, Mayrhofer S, Zitz U, Hofacre C, Domig KJ. The application of antibiotics in broiler production and the resulting antibiotic resistance in Escherichia coli: a global overview. Poult Sci. 2019;98(4):1791–804. https://doi.org/10.3382/ps/pey539.CrossRefPubMed Roth N, Käsbohrer A, Mayrhofer S, Zitz U, Hofacre C, Domig KJ. The application of antibiotics in broiler production and the resulting antibiotic resistance in Escherichia coli: a global overview. Poult Sci. 2019;98(4):1791–804. https://​doi.​org/​10.​3382/​ps/​pey539.CrossRefPubMed

go back to reference Looft T, Johnson TA, Allen HK, Bayles DO, Alt DP, Stedtfeld RD. In-feed antibiotic effects on the swine intestinal microbiome. Proc Natl Acad Sci USA. 2012;109(5):1691–6. https://doi.org/10.1073/pnas.1120238109.CrossRefPubMed Looft T, Johnson TA, Allen HK, Bayles DO, Alt DP, Stedtfeld RD. In-feed antibiotic effects on the swine intestinal microbiome. Proc Natl Acad Sci USA. 2012;109(5):1691–6. https://​doi.​org/​10.​1073/​pnas.​1120238109.CrossRefPubMed

go back to reference World Helalth Organization. Global and regional food consumption pattern and trends. https://www.who.int/nutrition/topics/3_foodconsumption/en/index4.html. Accessed November 7, 2019. World Helalth Organization. Global and regional food consumption pattern and trends. https://​www.​who.​int/​nutrition/​topics/​3_​foodconsumption/​en/​index4.​html. Accessed November 7, 2019.

go back to reference Graham JP, Boland JJ, Silbergeld E. Growth promoting antibiotics in food animal production: an economic analysis. Public Heal Rep. 2007;122(February):79–87. https://doi.org/10.1177/003335490712200111.CrossRef Graham JP, Boland JJ, Silbergeld E. Growth promoting antibiotics in food animal production: an economic analysis. Public Heal Rep. 2007;122(February):79–87. https://​doi.​org/​10.​1177/​0033354907122001​11.CrossRef

go back to reference Jonathan R, Ferreira JP, Stark KDC. Antimicrobial resistance: the use of antimicrobials in the livestock sector. Paris. 2014. https://doi.org/10.1787/5jxvl3dwk3f0-en%0A.CrossRef Jonathan R, Ferreira JP, Stark KDC. Antimicrobial resistance: the use of antimicrobials in the livestock sector. Paris. 2014. https://​doi.​org/​10.​1787/​5jxvl3dwk3f0-en%0A.CrossRef

go back to reference Pornsukarom S, Thakur S. Horizontal dissemination of antimicrobial resistance determinants in multiple Salmonella serotypes following isolation from the commercial swine operation environment after manure application. Appl Environ Microbiol. 2017;83(20):1–14. https://doi.org/10.1128/AEM.01503-17.CrossRef Pornsukarom S, Thakur S. Horizontal dissemination of antimicrobial resistance determinants in multiple Salmonella serotypes following isolation from the commercial swine operation environment after manure application. Appl Environ Microbiol. 2017;83(20):1–14. https://​doi.​org/​10.​1128/​AEM.​01503-17.CrossRef

go back to reference Grenni P, Ancona V, Barra CA. Ecological effects of antibiotics on natural ecosystems: a review. Microchem J. 2018;136:25–39. https://doi.org/10.1016/j.microc.2017.02.006.CrossRef Grenni P, Ancona V, Barra CA. Ecological effects of antibiotics on natural ecosystems: a review. Microchem J. 2018;136:25–39. https://​doi.​org/​10.​1016/​j.​microc.​2017.​02.​006.CrossRef

go back to reference Thi V, Bich N, Thanh LV, Thai PD, Van PTT, Oomen M, Driessen C, Beuken E, Hoang TH, Van DHR, Penders J, Wertheim HFL. An exploration of the gut and environmental resistome in a community in northern Vietnam in relation to antibiotic use. Antimicrob Resist Infect Control. 2019;9:1–10. Thi V, Bich N, Thanh LV, Thai PD, Van PTT, Oomen M, Driessen C, Beuken E, Hoang TH, Van DHR, Penders J, Wertheim HFL. An exploration of the gut and environmental resistome in a community in northern Vietnam in relation to antibiotic use. Antimicrob Resist Infect Control. 2019;9:1–10.

go back to reference Bhandari G, Zomer P, Atreya K, Mol H, Yang X, Geissen V. Pesticide residues in Nepalese vegetables and potential health risks. Environ Res. 2019;172:511–21. https://doi.org/10.1016/j.envres.2019.03.002.CrossRef Bhandari G, Zomer P, Atreya K, Mol H, Yang X, Geissen V. Pesticide residues in Nepalese vegetables and potential health risks. Environ Res. 2019;172:511–21. https://​doi.​org/​10.​1016/​j.​envres.​2019.​03.​002.CrossRef

go back to reference Adhikari B, Pokharel S, Mishra SR. Shrinking urban greenspace and the rise in non-communicable diseases in South Asia: an urgent need for an advocacy. Front Sustain Cities. 2019;1(November):1–5. https://doi.org/10.3389/frsc.2019.00005.CrossRef Adhikari B, Pokharel S, Mishra SR. Shrinking urban greenspace and the rise in non-communicable diseases in South Asia: an urgent need for an advocacy. Front Sustain Cities. 2019;1(November):1–5. https://​doi.​org/​10.​3389/​frsc.​2019.​00005.CrossRef

go back to reference Balakrishnan K, Dey S, Gupta T, Dhaliwal RS, Brauer M, Cohen AJ, Stanaway JD, Beig G, Joshi TK, Aggarwal AN, Sabde Y, Sadhu H, Frostad J, Causey K, Godwin W, Shukla DK, Kumar GA, Varghese CM, Muraleedharan P, Agrawal A, Anjana RM, Bhansali A, Bhardwaj D, Burkart K, Cercy K, Chakma JK, Chowdhury S, Christopher DJ, Dutta E, Furtado M, Ghosh S, Ghoshal AG, Glenn SD, Guleria R, Gupta R, Jeemon P, Kant R, Kant S, Kaur T, Koul PA, Krish V, Krishna B, Larson SL, Madhipatla K, Mahesh PA, Mohan V, Mukhopadhyay S, Mutreja P, Naik N, Nair S, Nguyen G, Odell CM, Pandian JD, Prabhakaran D, Prabhakaran P, Roy A, Salvi S, Sambandam S, Saraf D, Sharma M, Shrivastava A, Singh V, Tandon N, Thomas NJ, Torre A, Xavier D, Yadav G, Singh S, Shekhar C, Vos T, Dandona R, Reddy KS, Lim SS, Murray CJL, Venkatesh S, Dandona L. The impact of air pollution on deaths, disease burden, and life expectancy across the states of India: the Global Burden of Disease Study 2017. Lancet Planet Heal. 2019;3(1):e26–39. https://doi.org/10.1016/S2542-5196(18)30261-4.CrossRef Balakrishnan K, Dey S, Gupta T, Dhaliwal RS, Brauer M, Cohen AJ, Stanaway JD, Beig G, Joshi TK, Aggarwal AN, Sabde Y, Sadhu H, Frostad J, Causey K, Godwin W, Shukla DK, Kumar GA, Varghese CM, Muraleedharan P, Agrawal A, Anjana RM, Bhansali A, Bhardwaj D, Burkart K, Cercy K, Chakma JK, Chowdhury S, Christopher DJ, Dutta E, Furtado M, Ghosh S, Ghoshal AG, Glenn SD, Guleria R, Gupta R, Jeemon P, Kant R, Kant S, Kaur T, Koul PA, Krish V, Krishna B, Larson SL, Madhipatla K, Mahesh PA, Mohan V, Mukhopadhyay S, Mutreja P, Naik N, Nair S, Nguyen G, Odell CM, Pandian JD, Prabhakaran D, Prabhakaran P, Roy A, Salvi S, Sambandam S, Saraf D, Sharma M, Shrivastava A, Singh V, Tandon N, Thomas NJ, Torre A, Xavier D, Yadav G, Singh S, Shekhar C, Vos T, Dandona R, Reddy KS, Lim SS, Murray CJL, Venkatesh S, Dandona L. The impact of air pollution on deaths, disease burden, and life expectancy across the states of India: the Global Burden of Disease Study 2017. Lancet Planet Heal. 2019;3(1):e26–39. https://​doi.​org/​10.​1016/​S2542-5196(18)30261-4.CrossRef

go back to reference Pirolo M, Visaggio D, Gioffrè A, Artuso I, Gherardi M, Pavia G, Samele P, Ciambrone L, Di NR, Spatari G, Casalinuovo F, Visca P. Unidirectional animal-to-human transmission of methicillin-resistant Staphylococcus aureus ST398 in pig farming: evidence from a surveillance study in southern Italy. Antimicrob Resist Infect Control. 2019. https://doi.org/10.1186/s13756-019-0650-z.CrossRefPubMedPubMedCentral Pirolo M, Visaggio D, Gioffrè A, Artuso I, Gherardi M, Pavia G, Samele P, Ciambrone L, Di NR, Spatari G, Casalinuovo F, Visca P. Unidirectional animal-to-human transmission of methicillin-resistant Staphylococcus aureus ST398 in pig farming: evidence from a surveillance study in southern Italy. Antimicrob Resist Infect Control. 2019. https://​doi.​org/​10.​1186/​s13756-019-0650-z.CrossRefPubMedPubMedCentral

go back to reference Lazarus B, Paterson DL, Mollinger JL, Rogers BA. Do human extraintestinal escherichia coli infections resistant to expanded-spectrum cephalosporins originate from food-producing animals? A systematic review. Clin Infect Dis. 2015;60(3):439–52. https://doi.org/10.1093/cid/ciu785.CrossRefPubMed Lazarus B, Paterson DL, Mollinger JL, Rogers BA. Do human extraintestinal escherichia coli infections resistant to expanded-spectrum cephalosporins originate from food-producing animals? A systematic review. Clin Infect Dis. 2015;60(3):439–52. https://​doi.​org/​10.​1093/​cid/​ciu785.CrossRefPubMed

go back to reference Vieira AR, Collignon P, Aarestrup FM, Mcewen SA, Hendriksen RS, Hald T, Wegener HC. Association between antimicrobial resistance in Escherichia coli Isolates from food animals and blood stream isolates from humans in Europe: An ecological study. Foodborne Pathog Dis. 2011;8:1. https://doi.org/10.1089/fpd.2011.0950.CrossRef Vieira AR, Collignon P, Aarestrup FM, Mcewen SA, Hendriksen RS, Hald T, Wegener HC. Association between antimicrobial resistance in Escherichia coli Isolates from food animals and blood stream isolates from humans in Europe: An ecological study. Foodborne Pathog Dis. 2011;8:1. https://​doi.​org/​10.​1089/​fpd.​2011.​0950.CrossRef

go back to reference Tang KL, Caffrey NP, Nóbrega DB, Cork SC, Ronksley PE, Barkema HW, Polachek AJ, Ganshorn H, Sharma N, Kellner JD, Ghali WA. Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis. Lancet Planet Heal. 2017;1(8):e316–27. https://doi.org/10.1016/S2542-5196(17)30141-9.CrossRef Tang KL, Caffrey NP, Nóbrega DB, Cork SC, Ronksley PE, Barkema HW, Polachek AJ, Ganshorn H, Sharma N, Kellner JD, Ghali WA. Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis. Lancet Planet Heal. 2017;1(8):e316–27. https://​doi.​org/​10.​1016/​S2542-5196(17)30141-9.CrossRef

go back to reference Mather AE, Reid SWJ, Maskell DJ, Parkhill J, Fookes MC, Harris SR. Distinguishable epidemics within different hosts of the multidrug resistant zoonotic pathogen salmonella typhimurium. Science (80–). 2013;341(6153):1514–7. https://doi.org/10.1126/science.1240578.CrossRef Mather AE, Reid SWJ, Maskell DJ, Parkhill J, Fookes MC, Harris SR. Distinguishable epidemics within different hosts of the multidrug resistant zoonotic pathogen salmonella typhimurium. Science (80–). 2013;341(6153):1514–7. https://​doi.​org/​10.​1126/​science.​1240578.CrossRef

go back to reference Wise R. An overview of the specialist advisory committee on antimicrobial resistance (SACAR). J Antimicrob Chemother. 2007;60:5–7. https://doi.org/10.1093/jac/dkm151.CrossRef Wise R. An overview of the specialist advisory committee on antimicrobial resistance (SACAR). J Antimicrob Chemother. 2007;60:5–7. https://​doi.​org/​10.​1093/​jac/​dkm151.CrossRef

go back to reference Grave K, Jensen VF, Odensvik K, Wierup M, Bangen M. Usage of veterinary therapeutic antimicrobials in Denmark, Norway and Sweden following termination of antimicrobial growth promoter use. Prev Vet Med. 2006;75(2):123–32. https://doi.org/10.1016/j.prevetmed.2006.02.003.CrossRefPubMed Grave K, Jensen VF, Odensvik K, Wierup M, Bangen M. Usage of veterinary therapeutic antimicrobials in Denmark, Norway and Sweden following termination of antimicrobial growth promoter use. Prev Vet Med. 2006;75(2):123–32. https://​doi.​org/​10.​1016/​j.​prevetmed.​2006.​02.​003.CrossRefPubMed

go back to reference World Health Organization. Global action plan on antimicrobial resistance. Geneva; 2015.ISBN 978 92 4 150976 3 World Health Organization. Global action plan on antimicrobial resistance. Geneva; 2015.ISBN 978 92 4 150976 3

go back to reference World Health Organization. WHO Guidelines on Use of Medically Important Antimicrobials in Food - Producing Animals. Geneva; 2017. https://apps.who.int/iris/bitstream/10665/258970/1/9789241550130-eng.pdf?ua=1. World Health Organization. WHO Guidelines on Use of Medically Important Antimicrobials in Food - Producing Animals. Geneva; 2017. https://​apps.​who.​int/​iris/​bitstream/​10665/​258970/​1/​9789241550130-eng.​pdf?​ua=​1.

go back to reference FAO. The FAO Action Plan on Antimicrobial Resistance 2016–2020. Rome; 2016. https://www.fao.org/3/a-i5996e.pdf%0Awww.fao.org/publications. FAO. The FAO Action Plan on Antimicrobial Resistance 2016–2020. Rome; 2016. https://​www.​fao.​org/​3/​a-i5996e.​pdf%0Awww.​fao.​org/​publications.

go back to reference OIE. The OIE Strategy on Antimicrobial Resistance and the Prudent Use of Antimicrobials; 2016. https://www.oie.int/fileadmin/Home/eng/Media_Center/docs/pdf/PortailAMR/EN_OIE-AMRstrategy.pdf. OIE. The OIE Strategy on Antimicrobial Resistance and the Prudent Use of Antimicrobials; 2016. https://​www.​oie.​int/​fileadmin/​Home/​eng/​Media_​Center/​docs/​pdf/​PortailAMR/​EN_​OIE-AMRstrategy.​pdf.

go back to reference The Fleming Fund. Request for Proposal for Regional Grants Round 2; 2019. https://www.flemingfund.org/wp-content/uploads/9b19bfbedc38ccd466b854871e109483.pdf. The Fleming Fund. Request for Proposal for Regional Grants Round 2; 2019. https://​www.​flemingfund.​org/​wp-content/​uploads/​9b19bfbedc38ccd4​66b854871e109483​.​pdf.

go back to reference Schrijver R, Stijntjes M, Rodriguex-Bano J, Tacconelli E, Babu Rajendran N, Voss A. Review of antimicrobial resistance surveillance programmes in livestock and their meat in Europe, with a focus on antimicrobial resistance patterns in humans. Clin Microbiol Infect. 2017;2:9. https://doi.org/10.1016/j.cmi.2017.09.013.CrossRef Schrijver R, Stijntjes M, Rodriguex-Bano J, Tacconelli E, Babu Rajendran N, Voss A. Review of antimicrobial resistance surveillance programmes in livestock and their meat in Europe, with a focus on antimicrobial resistance patterns in humans. Clin Microbiol Infect. 2017;2:9. https://​doi.​org/​10.​1016/​j.​cmi.​2017.​09.​013.CrossRef

go back to reference Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, Teillant A, Laxminarayan R. Global trends in antimicrobial use in food animals. Proc Natl Acad Sci. 2015;112(18):5649–54. https://doi.org/10.1073/pnas.1503141112.CrossRefPubMed Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, Teillant A, Laxminarayan R. Global trends in antimicrobial use in food animals. Proc Natl Acad Sci. 2015;112(18):5649–54. https://​doi.​org/​10.​1073/​pnas.​1503141112.CrossRefPubMed

go back to reference Pokharel S, Adhikari B. Antimicrobial resistance and over the counter use of drugs in Nepal. J Glob Helath. 2020;1:1. https://doi.org/10.7189/jogh.10.010360.CrossRef Pokharel S, Adhikari B. Antimicrobial resistance and over the counter use of drugs in Nepal. J Glob Helath. 2020;1:1. https://​doi.​org/​10.​7189/​jogh.​10.​010360.CrossRef

go back to reference European Centre for Disease Prevention and Control. Antimicrobial Consumption in the EU/EEA, Annual Epidemiological Report for 2018; 2019. https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-consumption-europe-2018. European Centre for Disease Prevention and Control. Antimicrobial Consumption in the EU/EEA, Annual Epidemiological Report for 2018; 2019. https://​www.​ecdc.​europa.​eu/​en/​publications-data/​surveillance-antimicrobial-consumption-europe-2018.

go back to reference ECDC. The European Surveillance System Antimicrobial Consumption (AMC) Reporting Protocol 2020; 2020. https://www.ecdc.europa.eu/sites/default/files/documents/ESAC-Net_Reporting_Protocol_2020.pdf. ECDC. The European Surveillance System Antimicrobial Consumption (AMC) Reporting Protocol 2020; 2020. https://​www.​ecdc.​europa.​eu/​sites/​default/​files/​documents/​ESAC-Net_​Reporting_​Protocol_​2020.​pdf.

go back to reference International Consultation Group on Antimicrobial Resisance (IACG). Surveillance and Monitoring for Antimicrobial Use and Resistance—IACG Discussion Paper; 2018. https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_Surveillance_and_Monitoring_for_AMU_and_AMR_110618.pdf?ua=1. International Consultation Group on Antimicrobial Resisance (IACG). Surveillance and Monitoring for Antimicrobial Use and Resistance—IACG Discussion Paper; 2018. https://​www.​who.​int/​antimicrobial-resistance/​interagency-coordination-group/​IACG_​Surveillance_​and_​Monitoring_​for_​AMU_​and_​AMR_​110618.​pdf?​ua=​1.

go back to reference Holloway KA, Kotwani A, Batmanabane G, Puri M, Tisocki K. Antibiotic use in South East Asia and policies to promote appropriate use: reports from country situational analyses. BMJ. 2017;358:9–13. https://doi.org/10.1136/bmj.j2291.CrossRef Holloway KA, Kotwani A, Batmanabane G, Puri M, Tisocki K. Antibiotic use in South East Asia and policies to promote appropriate use: reports from country situational analyses. BMJ. 2017;358:9–13. https://​doi.​org/​10.​1136/​bmj.​j2291.CrossRef