The problem of antimicrobial resistance

Antimicrobial resistance (AMR) is a major global health concern, that weakens our ability to treat infections and increases the risk of disease spread, severe illness, disability, and death. AMR knows no borders and deeply affects the health of people, animals, and ecosystems. Antimicrobials include antibiotics, antifungals, antiparasitics, and antivirals and their inappropriate use in human healthcare, veterinary medicine, and agriculture accelerates resistance which can spread through water, soil, and food chain [1].

Under the One Health approach – which recognizes the link and interdependence between the health of humans, animals, and the environment – international efforts are being made to safeguard the effectiveness of treatments and ensure a sustainable future. Among these efforts are the design and implementation of guidelines for the responsible use of antimicrobials in food-producing animals [2,3].

What did the authors do?

This systematic review combines comprehensive searches and critical assessment of published guidelines on antimicrobial use in livestock (bovine, caprine, equine, ovine, and swine) across 49 OECD countries (members, partners, and candidates). The authors collected guidelines from official government websites, veterinary organizations, and international repositories, ensuring a broad and inclusive dataset. To evaluate the quality and consistency of these guidelines, the authors used the AGREE II instrument, a standardized tool that assesses multiple aspects of guideline development, such as clarity, rigor, and stakeholder involvement.

The authors aimed to:

• Identify guidelines’ main characteristics, strengths, and weaknesses.
• Assess guidelines’ compliance with international recommendations – published by the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (WOAH).

What did the authors find?

Of the 49 OECD countries, 37 of them presented a total of 82 guidelines for responsible antimicrobial use in food-producing animals (Figure 1), with guidelines targeting conditions in bovine and swine species being the most represented. The highest number of published guidelines was observed between 2017-2020. Also, the number of guidelines increased significantly after 2016, reflecting global efforts aligned with international initiatives, like the WHO's Global Action Plan on AMR [4].

Overall, countries recognize AMR as a major threat and are working diligently to promote responsible antimicrobial use in livestock. Nevertheless, some countries need further support for effective implementation of guidelines to strengthen global efforts against AMR.

What are the limitations of this study?

Despite providing valuable insights, this study relied on publicly available guidelines from official sources, which may not reflect actual practices or enforcement levels within countries. Moreover, the real-life impact of these antimicrobial use guidelines should be analyzed through data on antimicrobial use and/or sales and AMR prevalence. 

What are the implications?

This systematic review helps identify gaps that need to be addressed for better antimicrobial use and more sustainable agriculture practices. This work can inform policymakers and international agencies in designing more robust and evidence-based frameworks adapted to diverse national contexts and available resources. Barriers to implementation of guidelines should be addressed, international knowledge exchanged, and collaboration encouraged to fight AMR within the One Health approach.

References

[1] WHO. 10 Global health issues to track in 2021. 2020. https://www.who.int/news-room/spotlight/10-global-health-issues-to-track-in-2021. Accessed 15 Oct 2025.

[2] WHO. Fact sheet - One Health. 2023. https://www.who.int/news-room/fact-sheets/detail/one-health. Accessed 15 Oct 2025.

[3] WHO. Global call to action to address antimicrobial resistance: An appeal for keeping our medicines against infectious diseases effective to save lives. 2025. Available at: https://www.who.int/publications/m/item/global-call-to-action-to-address-antimicrobial-resistance. Accessed 15 Oct 2025.

[4] WHO. Global action plan on antimicrobial resistance. 2016. Available at: https://www.who.int/publications/i/item/9789241509763. Accessed 15 Oct 2025.