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 “... The One Health Approach

Another notable topic on the table at the recent UN meeting was the need for a One Health approach, which recognizes that the health of people, animals, plants, and their environments are interdependent.

“Now we have all sectors that impact AMR—agriculture, animal, environmental—on board,” said Nyemazi, who leads a WHO AMR task force that includes UN agencies in these arenas. “We’re pushing them to improve on their practices.”

Improper use of antibiotics in the animal health sector has far-reaching implications, considering that a majority of infectious diseases are zoonotic—meaning transmissible between animals and humans.

Resistant bacteria can be spread through food contamination—by meat and animal byproducts not handled or cooked properly or by food crops sprayed with fertilizers that contain animal manure with the pathogens.

More than 11% of the World Organisation for Animal Health’s veterinary and animal industry members still use essential antibiotics for humans, like colistin, for growth promotion in animals, despite all of them pledging to ban the practice back in 2016. And beyond intentional misuse, some feed additives with unlabeled low doses of antibiotics are unknowingly administered by livestock workers, farmers, and veterinarians.

Environmental waste on both an individual and industrial level has also “upset the ecosystem,” Boucher said, noting that improperly disposed drugs can spill into the soil and water systems and emerge in ways that can infect the people, plants, and animals that encounter them.

Evidence exists that antibiotic stewardship—a crucial One Health effort that ensures antimicrobials are used appropriately and only when necessary—reduces antibiotic consumption, slows drug resistance, and can be done without sacrificing patient care. A recent multicountry study found a 7-day course of antibiotics to be equally effective against bloodstream infections as a 14-day regimen, for example.

“Proper diagnosis, which is still an issue, is key to safeguard medicines,” Nyemazi added. Boucher also recommended “shared decision-making” between doctors and patients. “It’s perfectly reasonable for patients to ask questions about what an antibiotic is for” and for physicians to encourage alternative options when a prescription isn’t vital, Boucher said. When patients do require antibiotics, they should be reminded to take them as prescribed. ...”

SEE: UN Meeting Highlights Antimicrobial Resistance “Epiphany”—Lack of Antibiotic Access Is a Key Driver | Infectious Diseases | JAMA | JAMA Network

https://jamanetwork.com/journals/jama/fullarticle/2826187