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Research comment
Balancing conflicting demands: factors influencing vets’ choice of antimicrobial agent
  1. Katherine Adam
  1. Innogen Institute, Science, Technology and Innovation Studies, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
  1. email: k.adam{at}

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Antimicrobial resistance (AMR) is a major threat to both human and animal health.1,2 Antimicrobial stewardship – also referred to as prudent or responsible antimicrobial use – by veterinary surgeons is a central strategy to prevent the development of AMR.3 In order to define responsible use, it is useful to identify the different stakeholder groups involved and their primary responsibilities in relation to antimicrobial use.

The phrase ‘as little as possible, as much as necessary’ is frequently used to summarise the conflict between public and private interests that lies at the heart of efforts to combat AMR, and can refer to the choice of antimicrobial agent as well as the quantity used. The primary responsibility at a population level is to protect human and animal health by restricting the use of antimicrobial agents, and selecting lower priority drugs where possible, in order to minimise the development of resistance (ie, as little as possible).4 Conversely, the primary responsibility of the vet is to safeguard the health, welfare and productivity of their clients’ animals (ie, as much as necessary).5 Prudent AMU in animals and people, therefore, involves a trade-off between these competing demands in order to select an antimicrobial that will be clinically effective while also minimising the risk of AMR.6,7

The factors influencing vets’ decisions regarding prescribing antimicrobial agents in pig production have been explored using both qualitative8–10 and quantitative11–13 approaches. In a paper summarised on p 798 of this issue of Vet Record, Eriksen and colleagues have built upon this existing knowledge by quantifying and comparing the influence of the factors identified …

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