Antimicrobial resistance as a shared task for human and veterinary medicine
Antibiotics are indispensable in human and veterinary medicine. The more often and the less selectively they are used, however, the greater the selection pressure on bacteria. Antimicrobial resistance (AMR) therefore does not concern individual patients or disciplines alone, but people, animals and the environment together. This is where the One Health approach comes in.
What does One Health mean?
One Health regards the health of people, animals and the environment as closely linked. Resistant bacteria and their genes do not stop at these boundaries.
People and animals live closely together, share environments and surfaces, and in part the same microorganisms. Environmental factors such as wastewater and soil, along with residues of antibiotics and resistant bacteria, also influence the spread of resistance.
How does resistance arise?
Bacteria can become insensitive to certain antibiotics through mutation or by acquiring resistance genes. Selection pressure is decisive: susceptible bacteria are suppressed, while resistant ones survive and multiply.
This does not mean that every course of antibiotics leads to resistance. Antibiotics are important, and sometimes life-saving, medicines. What matters is targeted use that is appropriate to the indication. This is the core of antibiotic stewardship.
The role of veterinary medicine
Companion animals are part of the One Health system. They can carry certain bacteria, and exchange between people and animals has been described (Jin et al. 2023). Veterinary medicine itself also depends on effective antibiotics.
Antibiotic stewardship does not mean using antibiotics as rarely as possible. They should be used when they are needed: with a suitable agent, appropriate dosing and an appropriate duration. The WOAH recommendations on the responsible and prudent use of antimicrobial agents are one point of reference.
Stewardship starts before the prescription
The decision for or against an antibiotic comes at the end of a series of steps:
- careful clinical examination and targeted diagnostics (cytology, culture, susceptibility testing)
- consistent practice and hand hygiene
- investigation and management of underlying conditions
What veterinarians can do in practice
- Use antibiotics only when indicated
- Carry out targeted diagnostics where possible, for example susceptibility testing
- Apply hygiene measures consistently
- Inform animal owners about responsible antibiotic use
- Avoid unnecessary or repeated antibiotic courses
- Record usage within the practice and review it regularly
Conclusion
Resistance cannot be considered in isolation within human or veterinary medicine. A considered approach to antibiotics, sound diagnostics and consistent hygiene help preserve the efficacy of important antimicrobial agents.
References
- WOAH. Responsible and prudent use of antimicrobial agents in veterinary medicine.
- Jin et al. (2023). Evidence for the transmission of antimicrobial resistant bacteria between humans and companion animals.