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ANTIMICROBIAL resistance has been identified by the World Health Organization (WHO) as one of the major threats to human health (WHO 2011). The emergence of resistance respects no borders and the problem must be solved internationally using a ‘One Health’ perspective. This involves the promotion of prudent antimicrobial use in all sectors. Promoting prudent use has been a major concern of international organisations such as the WHO, the World Organisation for Animal Health (OIE) and the European Medicines Agency (EMA) for years. The term ‘prudent’ implies both responsible use and continuing to reduce use, a strategy that may not always be appropriate in the clinical setting. In contrast, ‘responsible’ implies appropriate use whether or not this results in an overall reduction. Both prudent use and responsible use imply veterinary prescription of antimicrobials only when based on proper diagnostic work and selection of agents according to guidelines, and should consider resistance patterns in the target organism, optimum antibiotic and dosage regime, and the risk of resistance selection. Furthermore, prudent use must also take into account the One Health perspective; for example, the potential transmission of resistance to people.
Prudent use needs to balance regulatory and therapeutic needs. Legal restrictions can have an impact; for example, limiting the use of antimicrobials that are critically important for the treatment of people. Regulation of antimicrobial use overall is more complex, as veterinarians have to be able to treat sick animals. Therefore, strategies to reduce antimicrobial use must be targeted …
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