title: Antimicrobial resistance: A global emerging threat to public health systems.
abstract: Antimicrobial resistance (AMR) became in the last two decades a global threat to public health systems in the world. Since the antibiotic era, with the discovery of the first antibiotics that provided consistent health benefits to human medicine, the misuse and abuse of antimicrobials in veterinary and human medicine have accelerated the growing worldwide phenomenon of AMR. This article presents an extensive overview of the epidemiology of AMR, with a focus on the link between food producing-animals and humans and on the legal framework and policies currently implemented at the EU level and globally. The ways of responding to the AMR challenges foresee an array of measures that include: designing more effective preventive measures at farm level to reduce the use of antimicrobials; development of novel antimicrobials; strengthening of AMR surveillance system in animal and human populations; better knowledge of the ecology of resistant bacteria and resistant genes; increased awareness of stakeholders on the prudent use of antibiotics in animal productions and clinical arena; and the public health and environmental consequences of AMR. Based on the global nature of AMR and considering that bacterial resistance does not recognize barriers and can spread to people and the environment, the article ends with specific recommendations structured around a holistic approach and targeted to different stakeholders.
authors.affiliation: a Veterinary Service, ASL Pescara , Pescara , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ferri
authors.affiliation: b Public Hospital , Pescara , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Ranucci
authors.affiliation: c Veterinary Service, ASL C , Rome , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Romagnoli
authors.affiliation: d Department of Animal Medicine , Veterinary School, Padua University , Padua , Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Giaccone
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents; D001424:Bacterial Infections / Q000188:drug therapy* / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D006801:Humans; D011634:Public Health; D015047:Zoonoses
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents
keywords: Antimicrobial resistance; EU reduction strategy; food safety; international cooperation; public health; surveillance networks