3.2 Why does antimicrobial stewardship matter?

There are a host of reasons why antimicrobial stewardship matters, from the fact it is a true One Health issue (addressed in module I, Introducing a One Health approach to AMR), to our prescribing practices and food security. Figure 6 illustrates some of the key factors that help us understand why AMS is important. If we do nothing about the ways we use antimicrobials the outcomes will be tragic for future generations.

One of the first steps to take is to look closely at our motivations for using antimicrobials, both in people and animals.

Figure 6 Why does antimicrobial stewardship matter? (Source: Future Learn online course)

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An infographic showing seven reasons why antimicrobial stewardship matters. Each reason (depicted in seven separate text bubbles) is shown with an arrow pointing at a central bubble which has the question ‘Why does AMS matter?’ written within. The key words in the bubbles that cluster around are: ‘One Health’; ‘AMR’; Antimicrobial development’; ‘Treatment outcomes’; ‘Food security’; ‘Economics and Industry’; ‘Global and local’.

Figure 6 Why does antimicrobial stewardship matter? (Source: Future Learn online course)

Inappropriate prescribing and misuse of antimicrobials are critical problems – the more we use, the more we increase the burden of AMR. By far the biggest driver of AMR in people is prescribing in human healthcare. The same can be said for AMU and AMR in animals. But, when it comes to using antimicrobials in food animals, our actions can have an impact on human health, especially if the drugs we use are rated as critically important.

As veterinarians, paraprofessionals, farmers and regulators, we need to take up the challenge to minimise the impact of AMU in food animals as much as possible. Well thought-out and implemented AMS programmes are the means to achieve these goals.

You may have learned in other modules (The problem of AMR (module B) and Introducing AMR (module C)) that the pipeline for new antimicrobial products has dried up. Without new antimicrobials on the horizon and growing resistance to existing antimicrobials, we must be careful to preserve the resources we have left. To not do so means that more people will die from untreatable infections, which has been ominously projected to increase to 10 million people per year by 2050 (O’Neill, 2014). LMICs will most feel the impact of not managing our dwindling antimicrobial resources; they already carry the greatest burden of AMR and the loss of vulnerable people to untreatable infections.

Antimicrobial stewardship is a critical element in food security. Keeping animals healthy and free of disease while maintaining productivity and thinking about how AMU relates to these goals is an important element of stewardship. Other important elements include ensuring animal food products are free of harmful residues by following drug dosage recommendations, avoiding off-label use where possible and observing drug withdrawal periods.