Antimicrobial stewardship from a One Health perspective.

Area of Science:

• One Health
• Public Health
• Infectious Disease Management

Background:

• Antimicrobial resistance (AMR) is a significant global threat to human, animal, and environmental health.
• Overuse and misuse of antimicrobials have accelerated AMR, necessitating immediate, multisectoral interventions.
• Antimicrobial stewardship (AMS) is a vital strategy for managing AMR through coordinated, responsible antimicrobial use.

Purpose of the Study:

• To explore Antimicrobial Stewardship (AMS) within a One Health framework.
• To examine the drivers of antimicrobial use and implementation challenges, particularly disparities between high-income and low-income settings.
• To advocate for equity-focused strategies to ensure global access to antimicrobials and mitigate AMR.

Main Methods:

• Review of existing literature and strategies for AMS.
• Analysis of clinical, economic, sociocultural, and environmental factors influencing antimicrobial use.
• Examination of governance, financing, digital innovation, surveillance, and behavioral science in AMS.

Main Results:

• Identified disparities in antimicrobial use and AMS implementation challenges between high-income and low-income countries.
• Highlighted the importance of integrated governance, financing, digital tools, surveillance, and behavioral science for sustainable AMS.
• Emphasized the need for context-aware interventions and policy integration for effective AMS.

Conclusions:

• Effective AMS programs require equity-focused strategies that address structural barriers and support marginalized populations.
• Scaling AMS globally necessitates aligning political will, funding, and scientific innovation to preserve antimicrobial efficacy and enhance global health security.
• Embedding AMS across sectors is essential for a sustainable response to the growing threat of AMR.