Responsible antibiotic use tackles resistance issues

An American health policy called One Health takes a look at the connections that exist between people, animals and their environment

AMES, Iowa — Physicians and veterinarians have known antibiotic use directly contributes to the emergence of resistant bacteria.

Educating the public on prudent use could save people from nasty infections like pneumonia and gonorrhea that are showing resistance to commonly used drugs.

“We have known antimicrobial resistance has been around since antibiotics came into market. From the 1930s and ’40s on we have seen antimicrobial resistance in patients,” said Dawn Sievert, senior office for antimicrobial resistance co-ordination at the Center for Disease Control in the United States.

The CDC has adopted what it calls a One Health policy that looks at the connections between people, animals and their environment.

“We look at antimicrobial resistance for being in the perfect spot because we know we need antibiotics for humans, animals and for our crops. We know any time antibiotics are used they can lead to resistance,” she said at the National Institute for Animal Agriculture antibiotic symposium held last fall in Ames, Iowa.

The CDC works with public health agencies on infection prevention, antimicrobial stewardship and zoonotic outbreaks and responds to foodborne pathogens related to illness.

Detecting and preventing drug resistance must be done across all sectors domestically and with international partners.

A CDC threats report released in 2013 was pivotal and got the attention of governments. The report provided full information on pathogens that were causing the most illnesses, infections and deaths, as well as showing resistance.

The report ranked the 18 bacterial and fungal threats into three categories based on level of concern to human health: urgent, serious, and concerning.

Resistance is appearing in cases of tuberculosis, gonorrhea, respiratory, enteric and fungal infections.

Governments started to pay attention to the dangers of antimicrobial resistance after that report was distributed.

A National Strategy for Combating Antimicrobial Resistance was formed and in 2016 various government agencies started creating their own action plans to combat antibiotic resistance.

The United Nations general assembly put the issue of resistance on its agenda in 2016 and countries started to make commitments to combat the problem.

CDC formed an action plan for the next five years to combat resistance and brought people from different sectors together to combat the spread and changes in antibiotic resistance.

“We know that we need antibiotics and we know that we have not seen a lot of antibiotics come to market. We need more antibiotics that will work and take over and replace some of the antibiotics we have. That is not the only solution,” she said.

More data from around the world is needed to track infections and more effort is needed to encourage prudent use and to develop improved diagnostics and vaccines.

The CDC is part of an antibiotic resistance laboratory network that enables faster tracking and identification of resistance and works to stop the spread of these pathogens to protect people.

The CDC is also building a pathogens bank. Researchers look at the resistance patterns and save them and place them in a bank. Isolates can be requested for research to test a new drug or diagnostic tool.

Preliminary data shows prevention of infections is working but more work is needed, especially for global efforts because antimicrobial resistance has become an international conversation.

According to the Canadian Institute for Health Information, overuse and misuse of antibiotics is more common in Canada than in other Organization for Economic Co-operation and Development countries.

Respiratory infections account for the greatest amount of overuse in Canada and abroad.

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