One Health Approach to Antimicrobial Resistance: A Veterinary Perspective

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-08-11

Key Takeaways

• The One Health framework necessitates veterinary medicine's active role in antimicrobial resistance (AMR) control by integrating human, animal, and environmental health, with veterinarians contributing through surveillance of resistance in food, companion, and wildlife animals, and rigorous stewardship of antimicrobial use.
• Surveillance systems like EARS-Vet are crucial for evidence-based AMR management, monitoring specific bacterial species (e.g., Escherichia coli, Staphylococcus aureus) in multiple animal species (e.g., cattle, swine, poultry) and against key antimicrobials to inform clinical decisions and policy.
• Resistance determinants, such as carbapenemase genes (bla-NDM-1, bla-KPC) and ESBL-producing Enterobacterales, can persist in animal feces and transmit across the human-animal-environment interface, as demonstrated by genomic epidemiology studies in livestock and peri-urban settings.
• Clinical decision-making in veterinary AMR stewardship involves a diagnostic sequence prioritizing sample collection before antimicrobial administration, followed by empirical, targeted, and definitive therapy based on clinical stability, pathogen identification, and susceptibility results, with careful consideration of drug penetration and breakpoints.
• Implementation of One Health AMR policy is uneven, with significant gaps in environmental sector data and implementation studies, highlighting a research priority to connect veterinary policy to measurable environmental outcomes and resistance gene persistence.
• Alternative strategies to antimicrobials, including vaccination, microbiota modulation, bacteriophage therapy, and antivirulence approaches, are being explored to reduce selection pressure, though their field efficacy data remain limited and require careful evaluation for routine use.

Antimicrobial resistance is a biological phenomenon that crosses species boundaries, production systems, and geographical regions. For the veterinary researcher, the One Health framework provides the conceptual architecture for understanding how resistance determinants move between animal populations, human communities, and the shared environment. This article examines the veterinary contribution to that framework, the surveillance systems that support it, and the practical decisions clinicians make when antimicrobial use must be balanced against resistance selection pressure. The intended reader is a veterinary researcher or advanced clinician who requires a structured account of the scientific basis, current evidence, and operational realities of antimicrobial resistance management from the animal health side of the One Health interface.

The article addresses a specific question: what does the veterinary profession contribute to the global antimicrobial resistance response, and how should that contribution be organized? The answer involves surveillance design, stewardship protocols, alternatives to antimicrobials, and an honest appraisal of where the evidence base remains thin. Later sections in this series will address stewardship implementation, diagnostic strategies, and emerging technologies. This first part establishes the conceptual foundation and the surveillance architecture on which those practical elements depend.

At a Glance

The One Health Framework and Veterinary Responsibility

The World Health Organization defines One Health as an integrated approach that recognizes the interdependence of human, animal, and environmental health, with antimicrobial resistance among its priority concerns. The WHO One Health initiative positions veterinary medicine as one of three pillars, alongside human medicine and environmental science. The CDC One Health resources similarly frame zoonotic disease prioritization and cross-sector collaboration as core activities requiring veterinary input. For the clinician, this means that antimicrobial prescribing decisions in animals are not isolated clinical acts. They are events within a connected system where resistance genes selected in one compartment can become available to another.

The veterinary responsibility operates at several levels. At the individual animal level, the clinician must choose antimicrobials that are effective, appropriate, and least likely to select for resistance. At the population level, the veterinarian advises on herd health programs, vaccination, and biosecurity that reduce the need for antimicrobials altogether. At the societal level, the profession contributes resistance surveillance data, participates in policy development, and implements standards such as those in the WOAH Terrestrial Animal Health Code, which sets international expectations for animal health surveillance and disease control relevant to trade.

Antimicrobial Resistance as an Ecological Problem

Resistance is not a property of bacteria alone. It is an ecological outcome of selection pressure applied to bacterial communities within hosts and environments. Antimicrobial use in any sector creates conditions favouring resistant strains, and those strains can then move through food chains, water, soil, and direct contact. A study of fresh cow dung in Bangladesh detected multiple carbapenemase genes, including bla-NDM-1 and bla-KPC, in samples from commercial farms and individual households, demonstrating that resistance determinants of critical clinical importance can be present in livestock feces even without active infection in the animals. The qPCR detection of carbapenemase genes in cattle feces illustrates a broader principle: the food animal chain can serve as a reservoir of resistance genes that persists independently of clinical disease.

The same ecological logic applies to extended-spectrum beta-lactamase producing Enterobacterales. Genomic surveillance of peri-urban pig farms in Cameroon identified ESBL-producing Escherichia coli and Klebsiella pneumoniae across human, pig, and environmental samples, with whole-genome sequencing revealing shared sequence types and resistance determinants across compartments. The genomic epidemiology of ESBL-producing Enterobacterales in pig production provides direct evidence that resistance transmission operates at the human-animal-environment interface, particularly in settings where livestock and people live in close proximity.

Surveillance Architecture in Veterinary Medicine

Surveillance is the foundation of any evidence-based resistance management program. Without reliable data on which resistance phenotypes are emerging, in which species, and against which antimicrobials, stewardship decisions are guesswork. The European Antimicrobial Resistance Surveillance network in Veterinary medicine, known as EARS-Vet, represents a structured attempt to build this evidence base. The EARS-Vet scope definition was developed through consensus among 26 European experts using a bottom-up approach, surveying which combinations of animal species, production types, bacterial species, specimens, and antimicrobials were both relevant and feasible to monitor in diseased animals across 13 countries.

The resulting surveillance design covers six animal species: cattle, swine, broilers, laying hens, turkeys, cats, and dogs. Eleven bacterial species are monitored, including Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus pseudintermedius, and Streptococcus suis, among others. The selection of antimicrobials for monitoring was guided by treatment relevance in veterinary medicine, complemented by agents of specific public health concern. This design deliberately complements existing European monitoring systems coordinated by the European Center for Disease Prevention and Control and the European Food Safety Authority, so that veterinary data can be read alongside human and food safety data within a single analytical frame.

Policy Implementation and Evidence Gaps

Surveillance architecture must be supported by policy, and policy must be implemented to have effect. A scoping review of One Health antimicrobial resistance policy in Bangladesh mapped 91 policy documents and studies against the objectives of the Global Action Plan and the national action plan. The mapping of One Health AMR policy in Bangladesh found that human and animal sector policies were represented in similar proportions, with roughly one third each, while only 15 percent of policies addressed the environmental sector alone. Studies assessing implementation or compliance were predominantly from the human sector, with the animal sector accounting for about a quarter. No implementation studies were identified from the environmental sector.

This pattern is not unique to Bangladesh. It reflects a structural imbalance in how One Health is operationalised. Veterinary medicine has policy instruments and surveillance programs, but the translation of those instruments into measurable compliance data is uneven. The absence of environmental sector implementation studies is particularly notable, given that the environment is the compartment where resistance genes persist longest and where intervention is most difficult. For the veterinary researcher, this gap identifies a concrete research priority: generating implementation evidence that connects veterinary policy to environmental outcomes.

Foodborne Pathogen Resistance as a Veterinary Concern

Foodborne pathogens occupy a special position in the One Health resistance framework because they move directly from animals to humans through the food chain. A systematic review of antibiotic resistance in foodborne pathogenic bacteria in West Africa between 2010 and 2020 identified 149 eligible publications from 15 countries. The systematic review of foodborne pathogen resistance in West Africa found that poultry was the most studied food commodity, followed by ready-to-eat foods and meat and animal products. Escherichia coli was the most frequently reported resistant species across these commodities.

The concentration of studies on poultry reflects both the scale of poultry production in the region and the recognized role of poultry as a vehicle for resistant Enterobacterales. The review also documents the temporal trend of increasing publication volume in 2018, 2019, and 2020, suggesting growing research attention to foodborne resistance. For the veterinary reader, the practical implication is that food animal production systems, particularly poultry, are priority targets for resistance mitigation. The evidence base for intervention effectiveness in these systems, however, remains thinner than the evidence base for resistance prevalence, and this asymmetry should inform how research effort is allocated.

Clinical Decision-Making in Veterinary AMR Stewardship

The Diagnostic Sequence for Suspected Resistant Infections

The clinical approach to a suspected antimicrobial-resistant infection follows a defined sequence that balances patient welfare against antimicrobial stewardship obligations. The sequence begins with a thorough history that includes prior antimicrobial exposure, travel or movement history, herd or household contacts, and any previous culture results. This history determines the pretest probability of resistance and shapes the initial empirical choices while cultures are pending.

Sample collection precedes antimicrobial administration whenever the patient's condition permits. The specimen type must match the suspected infection site, and collection technique determines whether the laboratory result will be clinically meaningful. For respiratory disease in cattle, deep nasopharyngeal swabs or tracheal washes outperform superficial swabs. For urinary tract infections, cystocentesis avoids the contamination that makes voided samples unreliable. For skin infections in dogs, the lesion should be sampled from the leading edge after surface debridement, and the sample should be submitted in transport medium appropriate for the suspected pathogen.

The laboratory request should specify the suspected pathogen, the infection site, and any prior antimicrobial therapy, because this information guides the laboratory in selecting appropriate culture media and susceptibility panels. A request for a full identification and susceptibility profile is appropriate when the infection is recurrent, severe, or has failed previous therapy. A request limited to pathogen identification may be sufficient for first-episode infections with predictable susceptibility patterns, but this decision must be justified in the medical record.

Interpretation of susceptibility results requires attention to the breakpoints applied. Clinical breakpoints derived from pharmacokinetic and pharmacodynamic data for the target species differ from epidemiological cut-off values that distinguish wild-type from non-wild-type populations. The laboratory report should state which interpretive criteria were used, and the clinician must verify that the breakpoints correspond to the species and infection site under treatment. Where species-specific breakpoints do not exist, the clinician must extrapolate cautiously and document the rationale.

Selection Criteria for Antimicrobial Therapy

The choice between empirical, targeted, and definitive therapy depends on the clinical stability of the patient, the severity of the infection, and the availability of culture results. Empirical therapy is justified when the patient is systemically ill, when delay would compromise outcome, or when the infection site makes sampling impractical. The empirical choice should reflect local resistance patterns, the likely pathogen spectrum for the presenting syndrome, and the antimicrobial class with the narrowest spectrum that covers the probable organizms.

Targeted therapy follows identification of the pathogen but precedes susceptibility data. This stage allows narrowing from a broad empirical agent to a drug with activity against the identified species, even before the laboratory confirms susceptibility. Definitive therapy follows the susceptibility report and should be the most narrow-spectrum agent with proven activity, the lowest risk of collateral damage to the commensal microbiota, and the most favourable safety profile for the individual patient.

The table below summarizes the decision points and the factors that change the correct choice.

The decision to withhold antimicrobial therapy is as important as the decision to prescribe. Colonisation without clinical disease does not warrant treatment, and treating colonisation selects for resistance without benefiting the patient. This distinction matters in food animals, where group-level treatment decisions must account for the proportion of affected animals, the severity of disease, and the risk of transmission within the group.

Monitoring Parameters During and After Therapy

Clinical monitoring during antimicrobial therapy serves three purposes: confirming therapeutic response, detecting adverse effects, and identifying early treatment failure. The monitoring interval depends on the infection site and the severity of disease. For pneumonia in cattle, respiratory rate, rectal temperature, and appetite should be reassessed within 48 to 72 hours of treatment initiation. For pyoderma in dogs, pruritus and lesion appearance should be reassessed at 7 to 14 days. For mastitis in dairy cattle, the California Mastitis Test and somatic cell count provide objective measures of intramammary inflammation.

Treatment failure, defined as lack of clinical improvement within the expected interval, triggers a repeat evaluation instead of an immediate change of antimicrobial. The repeat evaluation should include re-examination of the infection site, repeat sampling for culture and susceptibility, and consideration of complications such as abscess formation, foreign bodies, or biofilm-associated infection. The original susceptibility result may no longer reflect the infecting population if resistance has emerged during therapy, and the laboratory should be informed that the sample represents a treatment failure.

Documentation in the medical record should include the indication for therapy, the drug selected, the dose and route, the expected duration, the monitoring parameters, and the criteria for stopping therapy. For food animals, the record must also include the withdrawal period applied and the basis for that determination. The MSD Veterinary Manual provides species-specific pharmacology and therapeutic monitoring guidance that supports these clinical decisions.

Antimicrobial Stewardship in Practice Settings

Stewardship in veterinary practice operates at three levels: the individual patient, the practice or herd, and the wider community. At the individual level, stewardship means prescribing only when indicated, selecting the narrowest effective agent, and using the shortest effective duration. At the practice level, stewardship requires a written antimicrobial policy, regular audit of prescribing patterns, and continuing education for all veterinary staff. At the community level, stewardship contributes to the preservation of antimicrobial efficacy for both animal and human health, as recognized in the WHO One Health initiative.

Practice-level stewardship programs benefit from a defined formulary that lists approved antimicrobials, their indications, and any restrictions on use. Restricted agents, typically those classified as critically important for human medicine, require justification and documentation before dispensing. The restriction process should be simple enough to avoid creating workarounds, and the practice should review restriction compliance at least annually.

Herd-level stewardship in food animal practice requires a different framework from companion animal practice. The herd health plan should include vaccination protocols, biosecurity measures, and management practices that reduce the need for antimicrobials. Alternatives to antimicrobials, including microbiota modulation, vaccination, and improved host genetics, can reduce antimicrobial use when implemented as part of a comprehensive disease control strategy, as reviewed in the institutional publication on alternatives to antibiotics in a One Health context. The veterinarian's role extends beyond prescribing to advising on these preventive measures and monitoring their impact on disease incidence and antimicrobial use.

Species-Specific and Production System Considerations

The correct antimicrobial choice and stewardship approach differ substantially across species and production systems. In companion animals, the close human contact and the potential for zoonotic transmission of resistant organizms increase the public health significance of resistance in pathogens such as methicillin-resistant Staphylococcus pseudintermedius and extended-spectrum beta-lactamase-producing Escherichia coli. The genomic epidemiology of ESBL-producing E. coli and K. pneumoniae across the human-animal-environment interface demonstrates that resistant clones circulate between humans, pigs, and the environment in peri-urban production systems, reinforcing the need for coordinated surveillance across sectors.

In food animals, the withdrawal period constrains therapeutic choices, and group-level treatment decisions must balance individual animal welfare against the risk of selecting resistance in the population. In dairy cattle, the choice between intramammary and systemic therapy for mastitis depends on the pathogen, the quarter affected, and the cow's lactation stage. In poultry, the absence of individual animal treatment means that therapy is administered at flock level, and the decision to treat must consider the proportion of affected birds, the expected response, and the economic threshold for intervention.

In wildlife and exotic species, antimicrobial therapy is often based on extrapolation from domestic species, and the evidence base for dosing and efficacy is limited. The clinician should document the basis for extrapolation and monitor the response closely, recognizing that pharmacokinetic parameters may differ substantially from those in domestic animals.

Documentation and Communication Across Sectors

The veterinary contribution to One Health AMR surveillance depends on accurate and standardized documentation of antimicrobial use and resistance findings. Clinical records should capture the antimicrobial, dose, route, duration, and indication in a format that can be aggregated for surveillance purposes. Where laboratory data are available, the records should link the susceptibility result to the clinical outcome, providing evidence of therapeutic success or failure.

Communication with human health and environmental health sectors requires a shared vocabulary and agreed data standards. The European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) illustrates how veterinary surveillance can be designed to complement human surveillance systems, using comparable bacterial species, antimicrobial panels, and interpretive criteria. Veterinarians who participate in such networks contribute clinical samples, interpret findings for their clients, and communicate resistance trends to the relevant authorities.

The AVMA practice resources and the WOAH terrestrial animal health standards provide guidance on professional responsibilities and international standards relevant to antimicrobial use and resistance surveillance. Veterinarians should be familiar with the standards applicable to their jurisdiction and should incorporate these requirements into their practice protocols.

Recognized Failure Modes in Veterinary AMR Stewardship

The most consequential failure in veterinary antimicrobial stewardship is the reflexive prescription of a broad-spectrum agent before culture and susceptibility results are available. This pattern is common in production animal practice where treatment cost and labor constraints favour immediate metaphylactic intervention. The corrective action is a two-step decision: first, determine whether antimicrobial therapy is indicated at all, and second, select the narrowest agent consistent with the suspected pathogen profile. Alternatives to antibiotics in a One Health context emphasize that improved understanding of host-pathogen interactions permits more targeted antimicrobial use, which reduces selection pressure without sacrificing clinical outcomes.

A second failure mode is the incomplete treatment course. Clinicians may discontinue therapy when clinical signs resolve, particularly in food animals nearing slaughter or in companion animals where owner compliance lapses. This selects for surviving subpopulations and promotes resistance amplification. Detection relies on structured re-examination at the end of the prescribed course, not on owner-reported improvement. The monitoring parameters described in earlier sections, including temperature, appetite, and production metrics, must be documented at the planned endpoint.

A third failure is the misclassification of colonisation as infection. Commensal organizms such as Escherichia coli or coagulase-negative staphylococci isolated from non-sterile sites do not warrant therapy. The discriminating question is whether the isolate is accompanied by local or systemic inflammatory signs. Genomic epidemiology of ESBL-producing E. coli and Klebsiella pneumoniae across the human-animal-environment interface demonstrates that resistant Enterobacterales are frequently present in healthy animals and environmental samples, which reinforces the distinction between carriage and disease.

Common Errors and Corrective Actions

Students and less experienced clinicians frequently over-interpret susceptibility reports. A laboratory report of susceptibility does not guarantee clinical efficacy, because breakpoints are derived from pharmacokinetic-pharmacodynamic modeling that may not reflect the tissue concentration achieved at the infection site. The corrective action is to integrate the susceptibility result with the drug's tissue distribution, the route of administration, and the severity of the infection. Consultation of the MSD Veterinary Manual for species-specific pharmacology is appropriate when tissue penetration is uncertain.

Another common error is the failure to collect diagnostic samples before initiating therapy. Once antimicrobials are administered, culture sensitivity declines and the likelihood of a false-negative result increases. The corrective action is to embed sample collection into the clinical protocol as a non-negotiable step preceding first-dose administration. This requires anticipating the need for culture before the examination begins.

A third error is the extrapolation of dosing and withdrawal information across species or production classes. The WOAH terrestrial animal health standards provide international reference points for responsible antimicrobial use, but national regulations and label claims vary. The corrective action is to verify every prescription against the current label and the relevant jurisdictional formulary before dispensing.

Limitations of the Current Evidence

The evidence base for veterinary AMR stewardship is uneven across species and regions. Surveillance networks such as EARS-Vet have defined monitoring scopes for cattle, swine, poultry, cats, and dogs, but the defining scope of EARS-Vet reflects consensus among European experts and may not transfer directly to other production systems or climatic regions. Data from low- and middle-income countries are particularly sparse. Mapping One Health antimicrobial resistance policy and implementation in Bangladesh found that environmental sector policies were nearly absent and that implementation studies were concentrated in human medicine, leaving veterinary compliance poorly characterized.

Expert opinion still differs on the role of bacteriophage therapy and other alternatives. Some authorities advocate phage cocktails as a replacement for antimicrobials in specific infections, while others regard them as adjunctive only. The review of alternatives to antibiotics identifies phage therapy and antivirulence strategies as promising but notes that field efficacy data remain limited. Clinicians should treat these modalities as experimental unless local regulatory approval and published efficacy data support routine use.

Referral, Consultation, and Reporting Triggers

Referral to a specialist or diagnostic laboratory is warranted when a resistant infection fails to respond to appropriately selected therapy, when the infection involves a site where tissue penetration is uncertain, or when the isolate displays an unusual resistance phenotype such as carbapenemase production. Detection of carbapenemase genes in livestock feces, as reported in qPCR identification of carbapenemase genes in fresh cow dung, signals a potential public health concern that exceeds routine clinical management. Such findings warrant escalation to the relevant veterinary authority and, where applicable, to public health agencies.

Regulatory reporting obligations vary by jurisdiction and by the antimicrobial class involved. Clinicians should report notifiable diseases, unusual resistance phenotypes, and treatment failures involving critically important antimicrobials to the appropriate national authority. The CDC One Health resources and the AVMA practice resources provide guidance on reporting pathways in the United States, while the WHO One Health initiative frames the international coordination context. When in doubt, the clinician should contact the diagnostic laboratory or the regulatory body directly instead of assume that reporting is unnecessary.

Troubleshooting Guide

Frequently Asked Questions

How Should I Prioritize AMR Stewardship When My Practice Faces Severe Budget and Staffing Constraints?

Prioritize interventions that require no additional equipment: treatment protocols, client communication scripts, and record templates. The WHO One Health framework positions veterinary stewardship as a core component of cross-sector resistance control, so even modest clinic-level changes contribute to the larger effort. Culture and susceptibility testing should be reserved for cases where treatment failure is likely or where critically important antimicrobials are being considered. If laboratory access is unavailable, use published resistance patterns from regional surveillance, such as the European Antimicrobial Resistance Surveillance network in Veterinary medicine, to guide empirical choices. Review your antimicrobial inventory quarterly and remove agents that are rarely indicated. Staff training can be delivered in existing meeting time using free resources from bodies such as the AVMA practice resources.

What Do I Do When the Recommended Diagnostic Equipment Is Not Available in My Setting?

Adapt the diagnostic sequence to what is available without abandoning its logic. If culture and susceptibility testing are unavailable, use clinical response to first-line therapy as a pragmatic indicator, but document the basis for that decision clearly. Where rapid molecular tools are absent, request that referral laboratories hold isolates for later genomic analysis, since genomic epidemiology across the human-animal-environment interface can reveal transmission links that phenotypic testing alone misses. For farm-level decisions, pooled sampling from affected animals can reduce cost while retaining useful information. When laboratory access is intermittent, collect and store appropriate specimens before starting therapy so that susceptibility data can be generated retrospectively if the animal fails to respond. Communicate these limitations to the owner or farm manager explicitly so that expectations match the diagnostic certainty achieved.

How Should I Approach AMR Concerns in Species Where Residue Data and Breakpoints Are Sparse?

Treat sparse data as a reason for increased caution, not for abandoning stewardship. Consult the MSD Veterinary Manual for species-specific pharmacology and withdrawal information, and confirm any extrapolated dose against current formulary references before use. For minor food-producing species, consider whether an alternative drug with established data in that species is available before using an extrapolated product. Document the rationale for extrapolation in the medical record, including the source of the dose and the basis for assuming comparable pharmacokinetics. Where possible, use susceptibility testing with breakpoints from the closest related species and interpret results conservatively. Flag these cases for follow-up so that any observed efficacy or failure contributes to the practice's local evidence base.

What Records Should I Keep to Support Both Clinical Care and Broader AMR Surveillance?

Record the antimicrobial agent, dose, route, duration, indication, and the basis for selection, including whether susceptibility testing informed the choice. Note the clinical response at scheduled rechecks and any adverse events. For food animals, record the withdrawal period applied and the owner's confirmation of compliance. These records support both individual patient care and veterinary AMR surveillance networks that depend on standardized data from clinical cases. Where possible, record the production type and age category using standardized definitions so that data can be aggregated across practices. Retain records for at least the period required by local regulations, and longer where litigation risk or herd-level investigations are plausible. Ensure records distinguish between confirmed infections, suspected infections, and prophylactic or metaphylactic use.

How Do I Explain Antimicrobial Resistance to a Client Who Expects Antibiotics for Every Case?

Frame the explanation around the individual animal's interests and the shared environment. Explain that antimicrobials kill susceptible bacteria but leave resistant ones behind, and that those resistant bacteria can spread to other animals and people through direct contact, food, or the environment. The CDC One Health resources describe zoonotic disease prevention as a shared responsibility across human and animal health, which provides a useful framing for clients who are concerned about household transmission. Use the specific case to illustrate: if the infection is viral or self-limiting, explain why antimicrobials would add risk without benefit. If antimicrobials are indicated, explain why a specific drug was chosen and why the full course must be completed. Offer a written care summary that includes the expected timeline for improvement and the criteria for re-examination.

When Should I Escalate a Suspected AMR Case to a Referral Laboratory or Public Health Authority?

Escalate when a zoonotic pathogen shows resistance to critically important antimicrobials, when a cluster of similar resistant infections appears within a herd or practice population, or when treatment failure occurs despite appropriate therapy and confirmed susceptibility. International animal health standards require notification of certain disease and resistance events, and your local authority can confirm which organizms and resistance patterns are reportable in your jurisdiction. Submit isolates from treatment failures to a reference laboratory for confirmation and possible genomic characterization, since whole-genome sequencing of resistant Enterobacterales can identify plasmids and clones that move between animals, humans, and the environment. Document the clinical history, prior antimicrobial use, and laboratory results before referral. Inform the owner that escalation is a routine part of resistance monitoring, not an accusation of mismanagement.

Related Clinical & Scientific Guides

• Wildlife Disease Surveillance: Designing and Implementing a One Health Program
• Biosecurity Risk Assessment for Livestock Operations: A Practical Framework
• Rabies Post-Exposure Prophylaxis in Veterinary Personnel

References and Further Reading

• Alternatives to antibiotics in a One Health context and the role genomics can play in reducing antimicrobial use.. 2020.
• Mapping One Health antimicrobial resistance policy and implementation in Bangladesh: A scoping review.. 2026.
• Defining the scope of the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet): a bottom-up and One Health approach.. 2022.
• A Systematic Review and Meta-analysis of Antibiotic Resistance of Foodborne Pathogenic Bacteria in West Africa Between 2010 and 2020.. 2023.
• Using Quantitative Polymerase Chain Reaction (qPCR) to Identify a Myriad of Carbapenemase Genes in Fresh Cow Dung in Bangladesh.. 2024.
• Genomic epidemiology of ESBL-producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> across the human-animal-environment interface in peri-urban pig farms in Yaounde, Cameroon. 2026.
• WHO One Health Initiative. WHO.
• CDC One Health and Zoonotic Disease Resources. CDC.
• MSD Veterinary Manual, Professional Edition. MSD Veterinary Manual.

Related Articles

• Antimicrobial Resistance in Wildlife: Environmental Reservoir and Public Health Risk
• One Health Approach to Emerging Zoonoses: Integrating Veterinary and Human Health Data
• Antimicrobial Resistance Surveillance in Wildlife: Methods and Gaps
• Veterinary Public Health and Food Safety: A Systems Approach
• Antimicrobial Resistance Surveillance in Food Animals: Sampling Strategies and Data Interpretation

This article is educational professional reference material for veterinary audiences. It is not a substitute for veterinary diagnosis, individual clinical judgment, current product labeling, or applicable regulatory requirements.