Antimicrobial stewardship through a one health lens

Abstract

Purpose – Antibiotic resistance (AR) is a global health crisis that is attracting focussed attention from healthcare, public health, governmental agencies, the public, and food producers. The purpose of this paper is to describe the work in Washington State to combat resistance and promote antimicrobial stewardship from a one health perspective. Design/methodology/approach – In 2014, the Washington State Department of Health convened a One Health Steering Committee and two workgroups to focus on AR, the One Health Antimicrobial Stewardship work group and the One Health Antimicrobial Resistance Surveillance work group. The group organized educational sessions to establish a basic understanding of epidemiological factors that contribute to resistance, including antibiotic use, transmission of resistant bacteria, and environmental contamination with resistant bacteria and antibiotic residues. Findings – The authors describe the varied uses of antibiotics; efforts to promote stewardship in human, and animal health, including examples from the USA and Europe; economic factors that promote use of antibiotics in animal agriculture; and efforts, products and next steps of the workgroups. Originality/value – In Washington, human, animal and environmental health experts are working collaboratively to address resistance from a one health perspective. The authors are establishing a multi-species resistance database that will allow tracking resistance trends in the region. Gaps include measurement of antibiotic use in humans and animals; integrated resistance surveillance information; and funding for AR and animal health research.

Clostridium difficile colitis and zoonotic origins—a narrative review

“…It aims to achieve optimal health outcomes, recognizing the interconnection between people, animals, plants and their shared environment. This has led to further initiatives to improve antibiotic stewardship [ 128 ].…”

Opportunities and challenges to improving antibiotic prescribing practices through a One Health approach: results of a comparative survey of doctors, dentists and veterinarians in Australia

“…This limits the range and comparability of information needed to support the development of policies that target multiple prescriber groups. 13 In addition, no surveys have compared prescribers’ understanding of the interconnected nature of AMR across human, animal and environmental sectors. Given that One Health is central to international and national efforts to manage AMR, the response of prescribers to this new approach has implications for whether it will be accepted.…”

Minnesota One Health Antibiotic Stewardship Collaborative: A Reproducible Approach to Facilitate Antimicrobial Stewardship Progress

“…In 2015 and 2016, respectively, the United States (US) National Action Plan for Combating Antibiotic-Resistant Bacteria [ 4 ] and the United Nations General Assembly [ 5 ] advocated for a OH approach and stated that AS should be a collaborative cross-discipline effort. However, a literature search revealed just 1 published report of US state-level initiatives promoting AS across OH [ 6 ]. Minnesota's approach aligns with priorities set forth by the US government and United Nations [ 4 , 5 ], and its design could be replicated by other jurisdictions.…”