engleski

One Health: the importance of prudent and responsible use of antimicrobial medicines

The extensive use of antimicrobials in human and veterinary medicine has increased the emergence and spread of antimicrobial resistance. European Centre for Disease Prevention and Control and European Medicines Agency (EMA) estimate that each year, drug-resistant infections result in at least 25 000 patient deaths and cost the EU 1, 5 billion euros in healthcare costs and through loss of productivity. The first Antimicrobial Advice ad hoc Expert Group Categorisation, published in 2014., considered the risk to public health from antimicrobial resistance due to the use of antimicrobials in veterinary medicine. In 2019, EMA published updated guidelines regarding the categorisation of antimicrobials considering new experience gained and research. It categorised antimicrobial into following groups: Category A (avoid ; should not be used in food-producing animals, may be given to companion animals under exceptional circumstances), Category B (restrict ; critically important in human medicine, use based on antimicrobial susceptibility testing and only when there are no clinically effective antibiotics in Categories C or D), Category C (caution ; should be considered only when there are no clinically effective antibiotics in Category D), and Category D (prudence ; use as first line treatments, but only when medically needed). For antibiotics in all categories, unnecessary use, overly long treatment periods, and under-dosing should be avoided. Also, group treatment should be restricted to situations where individual treatment is not feasible and using an antimicrobial agent of as narrow-spectrum as possible is encouraged. Responsible, rational, and targeted use of antimicrobials should maximise the therapeutic effect and minimise the development of antimicrobial resistance.

antimicrobial resistance, guidelines, one health

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