A publication in September 2023’s edition of The Lancet about our work on optimising antimicrobial use in highly populated urban environments:
Antimicrobial resistance (AMR) is considered an increasing threat to public health and a cause of great concern worldwide.
AMR is a complex One Health issue, in which agriculture, livestock, companion animals, and the environment play roles. Transmission of organisms and resistance genes occurs across these pathways and antibiotics and their metabolites reach the environment via a range of routes, including directly from humans or through waste. The accumulation of antimicrobials within the environment can contribute to selective pressures for the acquisition or development of AMR.
The use of antimicrobials is a major driver of AMR, thus optimising the prescribing of antimicrobials is a potentially effective strategy to reduce AMR. The term “antimicrobial stewardship programme” (ASP) defines a set of actions that promote and enforce the adequate use of antimicrobials (ATM) to reduce selective pressure while improving patient outcomes.2 It focuses on avoiding ineffective prescriptions, finding the adequate moment to start treatment, the adequate choice of drugs, the adequate/short duration of treatment, deescalation once there is a diagnosis, and PK/PD optimisation of antimicrobial use.
