In order to protect and prolong the usefulness of existing antimicrobials, increasing cross-sectoral efforts are needed to rationalize their use and misuse in human and animal health and food production settings. Key measures to achieve this are to improve existing and implement new evidence-based control, prevention, stewardship and intervention strategies to reduce the risk of acquisition, development and transmission of antibiotic-resistant bacteria and infection caused by these pathogens, in hospitalized patients, outpatients, healthy people, animals and the environment.
Despite significant investments in research and increased knowledge about the development, acquisition, occurrence, and transmission pathways of AMR, little of this research has translated into interventions to significantly improve health care by reducing improper antibiotic usage or infections by resistant microbes. Furthermore, much of what has been recommended as interventions to control AMR has been based on experience, empiricism, and common sense, rather than strong evidence. Consequently, the evidence-base for key interventions including detection, screening, isolation, decolonization, environmental decontamination, and antibiotic stewardship remains weak. The lack of sufficient evidence-based research is a problem in veterinary and agriculture science too, which has limited prospects for new antibiotics and therefore, interventions to enable lowering antibiotic usage in animal husbandry are vital.
It is a formidable challenge to decrease the misuse of antibiotics as well as to implement measures to block transmission of AMR in humans and animals. Cultural, contextual and behavioral determinants influence antibiotics use and may also determine interventions which are most cost-effective and/or can be successfully implemented.
In summary, controlled integrated studies between human population, health care systems, and agricultural settings, multiple sectors are urgently needed to devise the optimal intervention strategies across diverse cultural settings and heterogeneous systems of human health and animal health and food production.
For more information, please consult the Joint Programming Initiative on Antimicrobial Resistance website.