Responsible Use Of Antimicrobials Research Articles

Antimicrobial Resistance in Lactococcus spp. Isolated from Native Brazilian Fish Species: A Growing Challenge for Aquaculture

Lactococcus spp. has emerged as a pathogen that is affecting global aquaculture, with L. garvieae, L. petauri, and L. formosensis causing piscine lactococcosis. While antimicrobials are commonly used to treat diseases in aquaculture, reports of antimicrobial resistance in fish isolates are increasing. However, little is known about the susceptibility patterns of Lactococcus spp. strains isolated from native fish species in Brazil. This study aimed to assess the antimicrobial susceptibility of these strains and establish a provisional epidemiological cutoff value for L. garvieae using the normalized resistance interpretation approach. A total of 47 isolates were tested: 17 L. garvieae, 24 L. petauri, and 6 L. formosensis. The isolates were classified as wild-type (WT) or non-wild-type (NWT) based on inhibition zone diameters. Isolates classified as NWT for three or more antimicrobial classes were considered multidrug-resistant, and the multiple antibiotic resistance (MAR) index was calculated. The results revealed heterogeneity in antimicrobial resistance profiles, with higher resistance to trimethoprim/sulfamethoxazole and norfloxacin. Resistance to other antimicrobials, including florfenicol and oxytetracycline (approved for use in Brazil), varied according to the bacterial species. Lactococcus petauri (87.5%) and L. formosensis (66.7%) showed the highest multidrug resistance, compared to L. garvieae (11.7%), along with higher MAR index values. These findings suggest that multidrug-resistant strains could pose future challenges in the production of native species, underscoring the need for ongoing monitoring of antimicrobial resistance and responsible use of antimicrobials in aquaculture.

Evaluation of the Knowledge, Attitudes and Practice of Veterinary Professionals and Senior Animal Health Students in Central Gondar Zone, Gondar, Ethiopia: Antimicrobial Use and Resistance Perspectives.

Antimicrobial resistance (AMR) poses a worldwide challenge to the well-being of animals and humans. The emergence of AMR is largely attributed to the improper utilization and overuse of antimicrobials. In order to combat this issue and promote responsible antimicrobial use (AMU), it is imperative for veterinary professionals and graduating students to possess extensive knowledge, maintain positive attitudes, and adhere to good practices regarding AMU and AMR. To assess the knowledge, attitude and practices (KAPs) of veterinary professionals and senior animal health students' towards veterinary AMU and AMR. A cross-sectional study design was conducted on purposefully selected 200 participants (60 of them were veterinary professionals from the districts and towns, and the remaining 140 were senior animal health university students). A self-administered, structured questionnaire was used to collect the necessary data, and descriptive statistics were used to summarize the data. The study revealed that, overall, study participants' KAP were not satisfactory. From veterinary professionals, about 56.7% of respondents scored average knowledge, whereas 66.7% and 61.66% of them had negative attitudes and poor practices, respectively, on AMU and AMR. The study found that 56% of the participants' think the previous knowledge they acquired regarding AMU and AMR was not sufficient, and the internet was used as a source of drug information by the majority of participants. The majority (72%) of them were not taking special training on AMU and AMR. Regarding senior animal health students, this study indicated that 52% and 69.2% of the respondents had poor knowledge and a negative attitude, respectively, towards AMU and AMR. Overall, veterinary professionals in the central Gondar zone have average knowledge, a negative attitude and poor practices. Poor knowledge and a negative attitude were also observed among senior animal health students towards AMU and AMR. Therefore, to fill the observed gaps, activities that enhance the skills of veterinary professionals and students should be implemented. Ingreted measures with animicrobial stewardship program and Nationwide studies are highly suggested to evaluate the overall status of veterinary professionals towards AMU and AMR.

Study on knowledge, attitudes and behavioral practices of antimicrobial usage and resistance in animals and humans in Bahir Dar City, Northwest Ethiopia

Antimicrobial resistance has emerged as one of the foremost global public health challenges. While not a new issue, AMR has gained increasing attention due to the rise of multi-resistant pathogenic organisms, leading to higher mortality rates and significant economic burdens. To assess the knowledge, attitudes, and practices of the Bahir Dar City community regarding human and animal antimicrobial use and AMR, a community-based cross-sectional study was conducted from February to June 2023. The study area was selected purposively, and a simple random sampling approach was used to select kebeles, households, and individual participants. A total of 400 participants were enrolled in the study, with 63.25% being male and 31.25% having graduated from secondary school. Additionally, 61.5% of respondents were married, and the majority (46.5%) owned two species of animals. The findings revealed that 48.5% of the participants had moderate knowledge, 57.5% had positive attitudes, and 52.75% demonstrated good practices regarding antimicrobial resistance and usage. Chi-square analysis revealed statistically significant associations (p < 0.05) between respondents’ knowledge level and their educational level, marital status, and position in the house. Attitude level were significantly associated (p < 0.05) with educational level, marital status, occupation, house ownership, and position in the house. Practice level also showed significant association (p < 0.05) with position in the house and occupation. Furthermore, there were significant associations among knowledge, attitude, and practice: knowledge was significantly associated with attitude (χ2 = 209.91, p ≤ 0.001), knowledge with practice (χ2 = 160.43, p ≤ 0.001), and attitude with practice (χ2 = 136.95, p ≤ 0.001). In conclusion, the study found a moderate level of knowledge, positive attitude, and good practice regarding antimicrobial usage and resistance among participants. It is recommended to promote responsible antimicrobial use across all sectors and encourage interdisciplinary collaboration.

The Short-Term Impact of Educational Programs on Knowledge and Attitudes Regarding Antimicrobial Stewardship among Veterinary Students in Serbia.

Effective antimicrobial stewardship (AMS) is crucial for combating the rise of antimicrobial resistance (AMR), particularly in veterinary medicine. Educational programs targeting veterinary students can play a significant role in shaping their knowledge and attitudes toward antimicrobial use and stewardship. This study aimed to evaluate the impact of educational programs on the knowledge and attitudes regarding AMS among veterinary students in Serbia. A structured educational program on AMS was implemented for veterinary students at the Faculty of Agriculture, University of Novi Sad. Pre- and post-symposium assessments were conducted to measure changes in students' knowledge and attitudes. The study employed a mixed-methods approach, including surveys and focus groups, to gather quantitative and qualitative data. The study resulted in significant short-term improvements in students' knowledge of AMS principles and their attitudes toward responsible antimicrobial use. Participants demonstrated a better understanding of the mechanisms of resistance and the importance of adhering to stewardship guidelines. Qualitative feedback indicated increased awareness of the consequences of inappropriate antimicrobial use and a stronger commitment to applying stewardship practices in their future careers. The educational programs effectively enhanced immediate veterinary students' knowledge and attitudes regarding AMS. These findings underscore the importance of integrating targeted educational programs into veterinary curricula to promote responsible antimicrobial use and combat resistance in veterinary practice.

An Overview of the Recent Advances in Antimicrobial Resistance.

Antimicrobial resistance (AMR), frequently considered a major global public health threat, requires a comprehensive understanding of its emergence, mechanisms, advances, and implications. AMR's epidemiological landscape is characterized by its widespread prevalence and constantly evolving patterns, with multidrug-resistant organisms (MDROs) creating new challenges every day. The most common mechanisms underlying AMR (i.e., genetic mutations, horizontal gene transfer, and selective pressure) contribute to the emergence and dissemination of new resistant strains. Therefore, mitigation strategies (e.g., antibiotic stewardship programs-ASPs-and infection prevention and control strategies-IPCs) emphasize the importance of responsible antimicrobial use and surveillance. A One Health approach (i.e., the interconnectedness of human, animal, and environmental health) highlights the necessity for interdisciplinary collaboration and holistic strategies in combating AMR. Advancements in novel therapeutics (e.g., alternative antimicrobial agents and vaccines) offer promising avenues in addressing AMR challenges. Policy interventions at the international and national levels also promote ASPs aiming to regulate antimicrobial use. Despite all of the observed progress, AMR remains a pressing concern, demanding sustained efforts to address emerging threats and promote antimicrobial sustainability. Future research must prioritize innovative approaches and address the complex socioecological dynamics underlying AMR. This manuscript is a comprehensive resource for researchers, policymakers, and healthcare professionals seeking to navigate the complex AMR landscape and develop effective strategies for its mitigation.

Awareness of Antimicrobial Resistance and Antimicrobial Drugs Prescription Pattern in Small Animal Clinical Practice in Ogun State, Nigeria

Antimicrobial resistance (AMR) is a global health challenge in veterinary and human health, leading to monitoring of resistance and promotion of responsible antimicrobial use. This survey assessed the use of antimicrobials among government veterinarians in Ogun state, Nigeria. Clinicians were requested to fill questionnaires designed to extract information on the frequency of antibiotics use, antibiotic prescription patterns and evaluation of perception on AMR and use of antibiotics with compromised efficacy in veterinary practice in the last three years. Fifty-two (52) questionnaires were administered and duly completed upon return. Data analysis showed 100% awareness of AMR with 80.8% (42/52) agreeing to have encountered AMR in the course of managing small animal cases. The tetracycline class of antibiotics 49(94.2%) was the most prescribed, followed by aminoglycosides 40(76.9%) and fluoroquinolones 35(67.3%). Empirical therapy (34/52) 65.4% is the most common treatment option among clinicians while 18 (34.6%) out of 52 clinicians performed antibiotic susceptibility testing along with laboratory diagnosis as treatment guide. Furthermore, 75.0% of the respondents affirmed administering antibiotics formulated for human use in small animal treatment. Thirty-three (63.5%) respondents administered human antimicrobials in animals according to the recommended dosage in humans. This survey identified that AMR was common in small animals in the state studied and this may be due to the irrational use of antibiotics. Promoting antimicrobial stewardship in small animal medicine therefore is paramount to mitigating antimicrobial resistance and data obtained from this study will contribute to developing evidence-based policy on the rational use of antibiotics in small animal practice in Nigeria.

Progress and Challenges: Implementation of the UK Antimicrobial Resistance National Action Plan 2019-2024 within the Beef Cattle Sub-Sector.

The five-year UK antimicrobial resistance (AMR) National Action Plan (NAP) was published in 2019 focusing on reducing the need for, and unintentional exposure to antimicrobials (AMs); optimising the use of AMs; and investing in innovation, supply and access of AMs. This study aimed to evaluate the progress made in the beef cattle sub-sector in addressing specific NAP commitments related to improving animal health and welfare and responsible antimicrobial use (AMU). A thematic analysis was conducted of 21 semi-structured interviews with stakeholders from government organisations, farms, veterinary practices, levy boards and livestock associations. The findings indicate substantial progress, with various initiatives implemented targeting data collection, farmer and veterinarian engagement, and herd health planning. However, there remain a number of challenges and barriers that need to be addressed in order to assess the impacts of these initiatives, such as the availability of AMU and AMR data. Ensuring the adequacy of resources was found to be critical for the sustainability of effective initiatives, considering competing demands on people's time. Additionally, the importance of other outcomes from these initiatives such as developing and strengthening the farmer-veterinarian relationship should not be underestimated since it is fundamental to successfully addressing issues such as AMR.

Módulo de promoción del uso responsable de antimicrobianos en odontología: diseño instruccional guiado por la teoría de carga cognitiva

IntroductionAproximately 30% to 50% of annual antimicrobial prescriptions are inappropriate or unnecessary, enhancing the development of bacterial resistance. It has been proposed that the responsible use of antimicrobials in undergraduate programs be emphasized. However, teachers usually do not manage effective strategies for this purpose. Aims1. Develop an instructional design, guided by the cognitive load theory, of a teaching and learning module to promote responsible use of antimicrobials 2. Evaluate the educational impact of the module on third-year Dental students. MethodsAction research and mixed methodology in four phases. i. Identification of learning needs and outcomes; ii. Instructional design guided by cognitive load theory; iii. Module implementation; iv. Educational impact on students was evaluated using satisfaction surveys, self-reports of learning outcomes achievement and a pre-post knowledge test. Descriptive and analytical statistical analysis (Wilcoxon test) and qualitative content analysis were used. ResultsThe antimicrobial module was designed in Canvas (LMS), allocating protected time for study and a classroom session. The educational impact was evaluated in 48 students. The satisfaction survey reported positive results on their 10 items (minimum 81.3%). The results of the self-reports of achievement of 7 learning outcomes and the pre-post test of 18 questions were statistically significant (p<0.001). ConclusionsThe design of this module could serve as a guide to promote the responsible use of antimicrobials while achieving greater satisfaction with students’ experience and learning outcomes.

Quantifying antimicrobial consumption in the Chilean salmon industry using standardized metrics and indicators: The case of florfenicol and oxytetracycline

The adoption of standardized metrics and indicators of antimicrobial use (AMU) in the food animal industry is essential for the success of programs aimed at promoting the responsible and judicious use of antimicrobials in this activity. The objective of this study was to introduce the use of standardized AMU metrics and indicators to quantify the use of florfenicol and oxytetracycline in the Chilean salmon industry, and in this way evaluate the feasibility of their use given the type of health and production information currently managed by the National Fisheries and Aquaculture Service (SERNAPESCA), the Chilean agency responsible for regulating aquaculture in Chile. The data available from SERNAPESCA allowed the construction and evaluation of the most data-demanding AMU metrics and indicators. Consequently, the use of florfenicol and oxytetracycline administered by oral and parenteral routes was quantified using the treatment incidence based on both animal defined daily dose (TIDDDvet) and animal used daily dose (TIUDDA). To that end, the study included information from 1320 closed production cycles from farms rearing Atlantic salmon, coho salmon and rainbow trout that were active between January 2017 and December 2021. By applying standardized AMU metrics and indicators, we were able to determine that the median of TIDDDvet for florfenicol was 75.1 (80 % range, 20.0–158.0) DDDvet per ton-year at risk for oral procedures and 0.36 (80 % range, 0.07–1.19) DDDvet per ton-year at risk for parenteral procedures. For oxytetracycline, the median TIDDDvet was 3.09 (80 % range, 0.74–42.8) and 0.47 (80 % range, 0.09–1.68) DDDvet per ton-year at risk for oral and parenteral procedures, respectively. The median TIUDDA for treatments with florfenicol was 45.6 (80 % range, 10.9–96.5) UDDA per ton-year at risk for oral treatments and 0.28 (80 % range, 0.05–0.80) UDDA per ton-year at risk for parenteral treatments. For oxytetracycline, the median TIUDDA was 2.63 (80 % range, 0.61–28.2) UDDA per ton-year at risk for oral treatments and 0.41 (80 % range, 0.08–1.29) UDDA per ton-year at risk for parenteral treatments. This study demonstrates that it is feasible to move from traditional AMU metrics and indicators to standardized ones in the Chilean salmon industry. This is possible because the competent authority requires salmon farms to report detailed health and production information at a high frequency. The use of standardized AMU metrics and indicators can help the authority to have a more comprehensive view of the antimicrobial use in the Chilean salmon industry.

Enteropathogenic and Multidrug-Resistant blaCTX-M-Carrying E. coli Isolates from Dogs and Cats.

Enteropathogenic Escherichia coli (EPEC) are pathogens associated with gastrointestinal illnesses. Dogs and cats can harbor EPEC, and antimicrobial resistance may impair necessary treatments. This study characterized E. coli strains from dogs and cats, focusing on phylogroup classification, virulence factors, and antimicrobial resistance profiles. Ninety-seven E. coli isolates from fecal samples of 31 dogs and 3 cats were obtained from a private diagnostic laboratory in Botucatu, Brazil, from March to October 2021. The antimicrobial susceptibility was assessed using the disk diffusion method. Polymerase chain reaction (PCR) was employed to screen for blaCTX-M and genes encoding virulence factors, as well as to classify the isolates into phylogroups. Twenty isolates were positive for intimin encoding gene eae and, consequently, these isolates were classified as EPEC (20.62%). Notably, 5.1% (5/97) of the isolates exhibited extended-spectrum β-lactamase (ESBL) production and 13.4% (13/97) were identified as multidrug-resistant bacteria. Phylogroups A and B2 were the most prevalent, comprising 29.9% (29/97) and 26.8% (26/97) of the bacterial isolates, respectively. This characterization highlights the prevalence of EPEC in domestic animals, emphasizing the potential risk they pose to public health and highlighting the urgency of responsible antimicrobial use in veterinary practices and the important role of laboratories in the surveillance of pathogenic multidrug-resistant bacteria.

Addressing residue and resistance in food animals: a policy imperative in Southeast Asia

SummaryResidue and resistance in food animals pose significant challenges to Southeast Asia's public health, animal welfare, agricultural productivity, and sustainability. This article emphasises the need for policy interventions to address these issues effectively. Residue, the presence of harmful substances in animal products, is a concern due to the misuse of veterinary drugs and pesticides. Robust surveillance programs, risk assessment, and enforcement of maximum residue limits are crucial to ensure food safety. Antimicrobial resistance (AMR) is another critical challenge in the region, driven by intensive animal production systems and disproportionate antimicrobial use. Responsible antimicrobial use, surveillance systems, and alternative production practices like vaccination, enhanced animal husbandry, and improved biosecurity a re essential to combat the menace. Addressing residue and resistance requires a comprehensive mindset and policy approach, including strengthening regulatory frameworks and inter‐agency collaboration, including a One Health approach. Governments, farms, veterinarians, and other stakeholders must work together to develop and enforce effective policies. Education and awareness campaigns can promote responsible practices throughout the food‐animal production chain. By prioritising the reduction of residue and resistance, Southeast Asian countries can safeguard public health, ensure sustainable agriculture, and contribute to global efforts in tackling AMR. Policymakers supported by academia, industry, and other stakeholders play a crucial role in effectively shaping and implementing policies to address these challenges.

Antimicrobial Stewardship in Ireland (2010-2021): a scoping review protocol

Background Antimicrobial stewardship programmes (ASP) are essential in promoting responsible antimicrobial use, reducing antimicrobial resistance (AMR) and health care-associated infections. In 2009 the Strategy for the Control of Antimicrobial Resistance in Ireland (SARI), Hospital Antimicrobial Stewardship Working Group published guidance on antimicrobial stewardship (AMS) in hospitals. This paper presents a protocol for a scoping review which aims to examine the current literature to evaluate progress related to the implementation of the SARI (2009) guidance on antimicrobial stewardship in hospitals in Ireland. Methods This scoping review will be conducted in line with the five-stage methodological framework by Arksey &amp; O’Mally 2005. We will search the following databases (PubMed, CINAHL, Embase, Web of Science) and targeted websites for articles and reports for possible inclusion in our review. Studies pertaining to AMS undertaken or related to the Republic of Ireland from January 2010 until December 2021 will be included. We will include all study designs. We will map all selected publications to the recommendations of the SARI (2009) guidance document. The protocol follows the guidance of Peters et al., 2022. Two reviewers will independently screen studies and reports to assess eligibility with any discrepancies resolved by consensus discussion with a third reviewer. Results These will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR)and this checklist will be included when the scoping review is published. Conclusion This scoping review will map studies and reports to evaluate AMS in relation to national guidelines without restriction on study design or outcomes in the Republic of Ireland. This information has the potential to provide a valuable resource for the implementation of future AMS research and interventions.

Risk Factor Analysis for Occurrence of Linezolid-Resistant Bacteria in the Digestive and Respiratory Tract of Food-Producing Animals in Belgium: A Pilot Study.

Linezolid is a critically important antimicrobial used in human medicine. While linezolid is not licensed for food-producing animals, the veterinary use of other antimicrobials, such as phenicols (e.g., florfenicol), could cross/co-select for linezolid-resistant (LR) bacteria. Such LR strains pose a great concern for public health due to their potential transfer between animals and humans. This study explored possible associations between epidemiological risk factors, including phenicol use, and the occurrence of LR bacteria, such as enterococci and staphylococci, in poultry, pigs, and veal calves in Belgium. Florfenicol use significantly increased the likelihood of harboring LR bacteria in veal calves, sows, and fattening pigs, particularly for the digestive tract (odds ratio (OR): [3.19-5.29]) and the respiratory tract (OR: [6.11-9.09]). LR strains from feces from fattening pigs were significantly associated with production type (OR: [3.31-44.14]) and the presence of other animal species (OR: 0.41). The occurrence of LR strains in the respiratory tract from sows was also significantly associated with using antimicrobials other than florfenicol (OR: 10.07) and purchasing animals (OR: 7.28). Our study highlights the potential risks of using certain veterinary antimicrobials, such as florfenicol, in food-producing animals and emphasizes the need for responsible antimicrobial use to safeguard both animal and public health.

Understanding Antimicrobial Prescription Practices: Insights from Small Animal Veterinarians in North Macedonia

Abstract Antimicrobial resistance (AMR) is an increasing global concern in small animal veterinary practices. The overuse and misuse of antimicrobials in companion animals can contribute to the spread of AMR between animals and humans. This study aimed to assess small animal veterinarians’ knowledge, attitudes, and behaviors towards antimicrobial use (AMU) and AMR in North Macedonia. A web-based questionnaire was developed, including questions addressing demographics, owner influence on antibiotic prescription and prescribing practices. The response rate of the small animal veterinarians was 47.50% (57/120), with most of them (84.20%) having 1-15 years of work experience. Pearson’s chi-square test of independence was used for contingency tables that met the chi-square assumption, and Fisher’s exact test was conducted for contingency tables that did not. Most veterinarians responded that they had perceived pressure and direct demands from pet owners to prescribe antimicrobials (35.09% frequently, 45.61% occasionally). In the survey, 50.77% of the veterinarians reported frequently administering antibiotics without conducting bacteriological or antimicrobial susceptibility testing. They typically resorted to these tests in cases with recurrent infections, such as skin infections (19.63%), or when empirical therapy is ineffective (14.72%). Based on the findings, it can be concluded that veterinarians play a crucial role in tackling the AMR in North Macedonia. The lack of stewardship programs or guidelines for responsible antimicrobial use in companion animals is a critical issue that requires urgent attention, emphasizing the vital role of veterinarians in combating AMR.

Voluntary optimisation of antimicrobial consumption in swine and poultry production in Thailand: a policy analysis.

Antimicrobial resistance (AMR) is a global health concern with significant implications on economies and health security, affecting humans, animals, food, and the environment. To tackle this issue, promoting responsible antimicrobial use in livestock production has emerged as a crucial intervention. In 2018, Thailand introduced the Voluntary Optimization of Antimicrobial Consumption (VOAC) programme, with the objective to encourage responsible antimicrobial use practises. This study aimed to analyse the context, content, process and actors of the VOAC programme. A qualitative method including document reviews and key informant interviews were applied. In-depth interviews were conducted with 18 key informants who are key stakeholders from public and private sectors involved in the policy formulation, design of policy contents and implementation of VOAC: policy makers or officers responsible for animal health (n = 12), animal producers (n = 2), animal product traders or retailers (n = 2), and farm veterinarians (n = 2). Interview transcripts were validated by informants for accuracy, and triangulated with document review findings. Deductive approach was applied for data analysis and interpretation based on Walt and Gilson's policy analysis framework. The VOAC farm certification comprises of Raised Without Antibiotics (RWA) and Reducing Antibiotic Use (RAU), both aiming to combat AMR in food animals. Global and national factors, including increased public awareness, policy commitments, export requirements from the European Union, and international organisation advocacies, influenced the development of the programme led by the Department of Livestock Development (DLD), under the Ministry of Agriculture and Cooperatives. Collaboration with the private sector facilitated policy clarity, with implementation primarily executed through regional, provincial, and district livestock officers. Integration of the programme with the pre-existing Good Agriculture Practise certification system enabled cost-effective implementation without additional resources. In 2022, DLD official data reported 214 RWA farms (112 pig and 102 broiler), and 230 RAU farms (83 pig and 147 broiler). Incentives for farms to participate in the programme include improving corporate image and demonstrating corporate responsibility addressing AMR in food products. Recommendations include optimising certification strategies, increasing consumer awareness of RWA and RAU products and strengthening monitoring and evaluation systems.

Antimicrobial use practices in canine and feline patients with co-morbidities undergoing dental procedures in primary care practices in the US.

This study aimed to investigate how the presence of co-morbid conditions influenced antimicrobial usage as presumptive prophylaxis for suspected bacteremia in dogs and cats undergoing dental treatments at primary care veterinary clinics in the United States. In 2020, data was collected from 1076 veterinary clinics across 44 US states. A total of 681,541 general anesthesia dental procedures were conducted on 592,472 dogs and 89,069 cats. This revealed that systemic antimicrobials were administered in 8.8% of dog procedures and 7.8% of cat procedures in the absence of concurrent periodontal disease or extractions. Cefpodoxime, clindamycin, and amoxicillin-clavulanate were the most frequently used antimicrobials in dogs, while cefovecin, amoxicillin-clavulanate, and clindamycin topped the list for cats. Dogs with cardiovascular, hepato-renal, and endocrine co-morbidities, as well as those undergoing concurrent removal of cutaneous or subcutaneous neoplasia, displayed higher antimicrobial use. Similarly, cats with endocrine or hepato-renal disease, retroviral infection (i.e., feline leukemia virus (FeLV), feline immunodeficiency virus (FIV)), and concurrent removal of cutaneous or subcutaneous neoplasia exhibited increased antimicrobial use. Dogs with hepato-renal abnormalities had longer treatment durations compared to those without (10.1 vs. 9.6 days). Conversely, cats with concurrent removal of cutaneous or subcutaneous neoplasia had shorter durations of treatment as compared to those that did not have this procedure performed (8.4 vs 9.2 days). The findings of this study underscore the necessity for further research and collaboration within the veterinary community to develop evidence-based guidelines, promoting responsible antimicrobial use, and advancing the field of veterinary dentistry for enhanced patient outcomes.

Antimicrobials Use by Smallholder Dairy Farmers in Peri-Urban Area of Nakuru Kenya: Knowledge, Attitudes and Practices

In dairy intensification, mastitis infections become prevalent and induce frequent Antimicrobial Use (AMU), sometimes inappropriately. This poses public health risks because of growing Antimicrobial Resistance (AMR), which calls for stewardship programs informed by Knowledge, Attitude and Practices (KAPs) about AMU and AMR to halt or reverse the worrying trend. Data was obtained in cross sectional survey conducted in four peri-urban wards around Nakuru city in Kenya. Randomly selected sample farmers (n=124) with free-grazing, semi-zero-grazing or zero-grazing dairy management, representing increasing dairy intensification levels provided data on the KAPs. Chi-square test statistics was fitted to establish associations between KAPs and dairy intensification levels. Among the sample farmers, six in ten (58.8 percent) had intensified dairy production, at least six in ten were marketing milk through informal outlets and were using antimicrobial drugs. Compliance with the withdrawal period was high and increased (p&amp;lt;0.05) with increasing intensification from free-grazing to zero-grazing. Within antibiotic withdrawal period, at least seven in ten farmers did not sell milk, fewer than four in ten consumed their milk at home and fewer than three in ten fed the milk to calves. Though independent of dairy intensification level (p&amp;gt;0.05), using antimicrobials for mastitis treatment increased while sourcing information on antimicrobial use from extension and veterinary officers decreased, with increasing intensification level. Farmers with some training on prudent antimicrobial use and with positive attitudes that milk from antimicrobial treated cows is unsafe, antimicrobial resistant pathogens and residues can be passed from milk to humans, mastitis can be treated without antimicrobial drugs, and antimicrobial residues can end up accumulating in the soils increased (p&amp;gt;0.05) with increasing dairy intensification levels. These results show that regarding AMU and AMR, farmers become more knowledgeable, with positive attitudes and good practices as they intensify their dairy management. The implication is that intensification of dairy management motivates farmers to gain more knowledge, acquire positive attitudes and apply good practices towards responsible prudent use of antimicrobials in livestock. Therefore, strengthening stewardship with targeted training and sensitization can foster prudent and responsible antimicrobial use.

ZOONOTIC DISEASES AND ANTIMICROBIAL RESISTANCE: A DUAL THREAT AT THE HUMAN-ANIMAL INTERFACE

With over 200 zoonotic diseases and the emergence of antimicrobial-resistant (AMR) microbes, a substantial threat looms over public health. If we are unable to cope with AMR, it suggests a potential of 10 million global fatalities by 2050. The evolving landscape of AMR transcends geographic boundaries and species, necessitating collaborative and multidisciplinary efforts. The interplay between humans, animals, and the environment highlights the profound significance of One Health in addressing these interconnected challenges. The imperative of multidisciplinary efforts to safeguard the health and well-being of our shared world, comprised of humans, animals, and the environment, can pave the way toward success. The role of surveillance, education, and public awareness in combating AMR and fostering responsible antimicrobial use is inevitable in addressing this global concern. Key Words: Antimicrobial resistance, Zoonoses, One health

Redefining on-farm practices: The perceived effect of a responsible antimicrobial use regulation on dairy farmers

The global food animal industry faces a growing concern regarding antimicrobial resistance (AMR), primarily driven by the use of antimicrobials (AM) for the treatment, control, and prevention of diseases. Addressing this challenge requires promoting responsible antimicrobial use (AMU) practices. In 2019, the province of Québec, Canada, took a significant step by implementing a regulation that limits the use of AM of very high importance for human medicine (category I AM as defined by Health Canada) in the food animal industry. However, the implementation of such regulation can significantly influence behavioral shifts among producers, contributing to the wider effort against AMR. Therefore, the objective of this observational study was to describe the perceived changes in dairy producers' knowledge and on-farm practices following the implementation of this regulation, using a cohort design. Data collection involved administering questionnaires to 87 dairy producers from 3 regions of the province of Québec (Estrie, Montérégie, Centre-Du-Québec) before (2017-2018) and after (2020-2021) the implementation of the regulation. The questionnaires explored the descriptive characteristics of farms, the knowledge of producers about the categorization of AM, the on-farm treatment practices, and the perceived effects of the regulation. Statistical analysis included t-tests and McNemar tests to compare the paired data obtained using the 2 questionnaires. The results indicated an increase in the knowledge score (the number of AM correctly categorized by the producers by their importance for human medicine) after the implementation of the regulation, suggesting an improved understanding of the categorization of AM based on their importance for human medicine. Trends in AMU practices for treating clinical mastitis and reproductive diseases suggested that category I AM were less likely to be reported as the primary treatment after the regulation, whereas category II AM were more often reported as primary treatment. Adoption of the selective dry cow therapy method significantly increased, whereas the use of teat sealants remained unchanged. Moreover, producers had divergent perceptions regarding the effect of the regulation on the cure rates and disease frequencies. This disparity emphasizes the need for comprehensive data collection to discern the risks associated with such regulatory shifts. The study acknowledges several limitations, including the potential for recall bias, confirmation bias, and desirability bias. Despite these limitations, this study shows that implementing regulations to encourage responsible AMU drives positive transformations in producers' knowledge and on-farm practices. This underscores the pivotal effect of proactive interventions in combating the escalating threat of AMR within the global food animal industry.

Antimicrobial Resistance: Stewardship and One Health in the Eastern Mediterranean Region.

Antimicrobial resistance (AMR) is a major threat in the Eastern Mediterranean region (EMR) due to factors such as the high prevalence of infectious diseases, weak health systems, and the misuse of antimicrobials. This paper aims to discuss how interdisciplinary action and collaboration, specifically through antimicrobial stewardship (AMS) and the One Health approach, can effectively address AMR in the EMR. The review focuses on successful AMS initiatives and the adoption of the One Health approach in countries within the EMR, including the Gulf Cooperation Countries (GCC), Egypt, Iran, Jordan, and Pakistan. The goal is to highlight the potential for progress in combating AMR and identify challenges and opportunities for strengthening interdisciplinary collaboration. The results showcase successful AMS programs and One Health initiatives in various EMR countries, demonstrating their potential to address AMR challenges. The paper also discusses the challenges faced by these nations, such as limited resources, fragmented health systems, and knowledge gaps. Additionally, opportunities for enhancing interdisciplinary action through regional cooperation, international partnerships, and research and innovation are outlined. In conclusion, this paper emphasizes the importance of a comprehensive and collaborative response to combat AMR in the EMR. It advocates for the One Health approach as a crucial framework to guide these efforts, promoting coordinated action, improved surveillance, responsible antimicrobial use, and enhanced interdisciplinary collaboration to effectively mitigate the threat of AMR.