scholarly journals Use of Monitoring Indicators in Hospital Management of Antimicrobials

2020 ◽  
Author(s):  
Ravena Silva ◽  
Ravena Silva ◽  
Simonize Mendonça ◽  
Ingrid Leão ◽  
Quesia Santos ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Management Program ◽  
Hospital Environment ◽  
Antimicrobial Use ◽  
Medical Clinic ◽  
National Data ◽  
Duration Of Therapy ◽  
Stewardship Program ◽  
Great Relevance ◽  
Surgical Clinic

Abstract Background: It is described in the literature that between 25% to 50% of antimicrobial prescriptions, in the hospital environment, are unnecessary or inadequate, directly impacting antimicrobial resistance. The National Health Surveillance Agency launched the “Brazil Stewardship Project” to assess the national panorama of antimicrobial use management programs, therefore, it is expected that managers will be encouraged to implement the antimicrobial use management program, with the publication of the results, enabling the comparison of national data. In this context, measures and indicators of antimicrobial use will be particularly important. We demonstrate the application of the indicators DOT, LOT e DOT/LOT ratio to explore and monitor antimicrobials use. Methods: This is an observational, analytical and prospective study conducted in a teaching hospital, with 94 active beds, distributed between the intensive care unit (ICU), the surgical clinic (SUR), the medical clinic (MED), the pneumology/infectology (PNE/INF) and pediatrics (PED). Results: During the study period, a total of 11,634 patient-days were followed up and an average of 50.4% of patients were exposed to some antimicrobial, showing significant reduction throughout the year. In 376 days, for every 1,000 days of hospitalization, patients were receiving antimicrobial therapy (LOT = 376/1000pd). Overall, the 1st generation cephalosporins and fluoroquinolones were highlighted both in the number of prescriptions and in the duration of therapy. The calculated global DOT / LOT ratio showed that each patient received an average of 1.5 antimicrobials during the hospital stay. The incidence of antimicrobial resistance, globally, for both Methicillin R and Carbapenem R , was 1 per 1000 patient-days. Conclusions: The indicators addressed in this study proved to be of great relevance for obtaining data regarding the use of antimicrobials, contributing to the initiatives to be taken by the Stewardship program. This study is expected to encourage other hospitals to monitor the use of antimicrobials, allowing comparison of data.

scholarly journals Application of Monitoring Indicators in The Management of Hospital Use of Antimicrobials

2020 ◽  
Author(s):  
Ravena Silva ◽  
Ravena Silva ◽  
Quesia Santos ◽  
Alessandra Batista ◽  
Matheus Melo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Management Program ◽  
Health Surveillance ◽  
Hospital Environment ◽  
Antimicrobial Use ◽  
Medical Clinic ◽  
National Data ◽  
Stewardship Program ◽  
Great Relevance ◽  
Surgical Clinic

Abstract Background It is described in the literature that between 25–50% of antimicrobial prescriptions, in the hospital environment, are unnecessary or inadequate. The National Health Surveillance Agency launched the “Brazil Stewardship Project”, in order to assess the national panorama of antimicrobial use management programs, therefore, it is expected that managers will be encouraged to implement the antimicrobial use management program, with publication of the results, enabling the confrontation of national data.Methods This is an observational, analytical and prospective study conducted in a teaching hospital, with 94 active beds, distributed between the intensive care unit (ICU), the surgical clinic (SUR), the medical clinic (MED), the pneumology/infectology (PNE/INF) and pediatrics (PED).Results During the study period, a total of 11,628 patient-days were followed up and an average of 58.3% of patients were exposed to some antimicrobial. In 376 days, for every 1,000 days of hospitalization, patients were receiving antimicrobial therapy (LOT = 376/1000pd). The calculated global DOT / LOT ratio showed that each patient received an average of 1.5 antimicrobials during hospital stay.Conclusions The indicators addressed in this study proved to be of great relevance for obtaining data regarding the use of antimicrobials, contributing to the initiatives to be taken by the Stewardship program. This study is expected to encourage other hospitals to monitor the use of antimicrobials, allowing comparison of data.

scholarly journals Use of monitoring indicators in hospital management of antimicrobials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ravena Melo Ribeiro da Silva ◽  
Simonize Cunha B. de Mendonça ◽  
Ingrid Novaes Leão ◽  
Quesia Nery dos Santos ◽  
Alessandra Macedo Batista ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Analytical Study ◽  
University Hospital ◽  
Medical Clinic ◽  
Carbapenem Resistant ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Length Of Therapy ◽  
Surgical Clinic ◽  
Gathering Data

Abstract Background According to the literature, 25% to 50% of antimicrobials prescribed in hospitals are unnecessary or inappropriate, directly impacting antimicrobial resistance. Thus, the present study aimed to evaluate the use of antimicrobials in a university hospital in Northeast Brazil, using days of therapy (DOT) and length of therapy (LOT) indicators in accordance with the latest national and international recommendations for monitoring the use of antimicrobials. Methods This is an observational, prospective analytical study conducted in a teaching hospital, with 94 active beds, distributed between the intensive care unit (ICU), the surgical clinic (SUR), the medical clinic (MED), the pneumology/infectology department (PNE/INF) and pediatrics (PED). The duration of the study was from the beginning of January to the end of December 2018. Results During the study period, a total of 11,634 patient-days were followed up and 50.4% of the patients were found to have received some antimicrobial, with a significant reduction in use of 1% per month throughout the year. Patients were receiving antimicrobial therapy for 376 days in every 1000 days of hospitalization (LOT = 376/1000pd). Overall, the 1st-generation cephalosporins and fluoroquinolones were the most used in respect of the number of prescriptions and the duration of therapy. The calculated global DOT/LOT ratio showed that each patient received an average of 1.5 antimicrobials during the hospital stay. The incidence of antimicrobial resistance, globally, for both methicillin-resistant Staphylococcus aureus (methicillin R), Carbapenem-resistant Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii (Carbapenem R), was 1 per 1000 patient-days. Conclusions The results obtained from the analyses revealed that half of the patients admitted to the hospital who took part in the study were exposed to the use of antimicrobials at some point during their stay. Although moderate, it is noteworthy that there was a decline in the use of antimicrobials throughout the year. The indicators used in this study were found to be very effective for gathering data on the use of antimicrobials, and assessing the results of the initiatives taken as part of the Stewardship program.

Perception, Attitude, and Knowledge Regarding Antimicrobial Resistance, Appropriate Antimicrobial Use, and Infection Control Among Future Medical Practitioners: A Multicenter Study

2016 ◽  
Vol 37 (5) ◽  
pp. 603-605 ◽  
Author(s):  
Nuttagarn Chuenchom ◽  
Visanu Thamlikitkul ◽  
Romanee Chaiwarith ◽  
Rawisut Deoisares ◽  
Pinyo Rattanaumpawan
Keyword(s):  
Medical Students ◽  
Antimicrobial Resistance ◽  
Infection Control ◽  
Multicenter Study ◽  
Control Unit ◽  
Antimicrobial Use ◽  
Antimicrobial Stewardship Program ◽  
Medical Practitioners ◽  
Stewardship Program ◽  
Appropriate Antimicrobial Use

A questionnaire-based study was conducted among final-year Thai medical students. The problem of antimicrobial resistance is well recognized, but their knowledge of antimicrobial resistance, appropriate antimicrobial use, and infection control was substantially limited. Only half of these students recognized existence of an antimicrobial stewardship program or infection control unit in their hospitals.Infect Control Hosp Epidemiol 2016;37:603–605

scholarly journals Percepção de pacientes sobre a comunicação de médicos clínicos e cirurgiões em hospital universitário

2021 ◽  
Vol 45 (2) ◽  
Author(s):  
Milena Regina Dos Santos Perez ◽  
Mirele Cristine Santos de Oliveira ◽  
Danielle Bispo Vieira Ortiz ◽  
Stela Souza Peña ◽  
Jose Roberto Pretel Pereira Job ◽  
...  
Keyword(s):  
University Education ◽  
Hospital Environment ◽  
Medical Clinic ◽  
Cross Sectional ◽  
Good Communication ◽  
Doctor Patient Communication ◽  
Patient Dissatisfaction ◽  
Hospitalization Period ◽  
General Communication ◽  
Surgical Clinic

Abstract: Introduction: The way information is transmitted is of crucial importance in the doctor-patient relationship, as good communication reduces complaints about inadequate practices and patient concerns and improves treatment adherence and health recovery. However, patient dissatisfaction on this subject is not unusual. Objectives: The objective of this work was to evaluate the perception of patients admitted to a Hospital Complex about the communication of clinical doctors and surgeons during the hospitalization period. Method: Cross-sectional, descriptive, analytical inquiry study, with the application of a questionnaire with questions about physicians’ general communication. The instrument was built by the researchers and was answered by 120 adult patients. The sample was defined by convenience and stratified by medical and surgical clinic. Frequency and statistical analyses were performed on the obtained results. Results: Of 120 patients, 53.33%(n=64) were admitted to the Surgical Clinic and 46.67%(n=56) to the Medical Clinic. Of this total, 57.5%(n=69) had high school to college/university education. Patients reported more negative than positive responses to the following questions: information about the side effects of medications (66%), advice on post-surgical procedures (68.75%) and information on health promotion and prevention in the hospital environment (63.33%). The surgical clinic had significantly lower proportions of positive responses for: The doctor said their name (p <0.01; crude OR: 0.33; 95% CI 0.15-0.76); The patient was informed about how their treatment would be conducted (p=0.02; crude OR: 0.38; 95% CI 0.17-0.87); and the patient was informed about the need to undergo tests (p=0.02; crude OR 0.40; 95% CI 0.18-0.90), which remained significant after adjustment for certain confounding factors. There were no significant differences regarding the other questions. When analyzing the question: “What grade would you give to the doctor’s general communication?” a significantly higher value (p=0.007) was given to the Medical Clinic (average 4.46±0.76) when compared to the Surgical Clinic (average 4±1.19). Conclusion: The doctor-patient communication showed significant deficits. Therefore, it is necessary for medical schools to offer students the development of this competence. Additionally, for an adequate generalization of the obtained results, new studies need to be carried out at different levels of medical care.

scholarly journals Patient’s perception of the communication of clinical doctors and surgeons in a university hospital

2021 ◽  
Vol 45 (2) ◽  
Author(s):  
Milena Regina Dos Santos Perez ◽  
Mirele Cristine Santos de Oliveira ◽  
Danielle Bispo Vieira Ortiz ◽  
Stela Souza Peña ◽  
Jose Roberto Pretel Pereira Job ◽  
...  
Keyword(s):  
University Education ◽  
University Hospital ◽  
Hospital Environment ◽  
Medical Clinic ◽  
Cross Sectional ◽  
Good Communication ◽  
Patient Dissatisfaction ◽  
Hospitalization Period ◽  
General Communication ◽  
Surgical Clinic

Abstract: Introduction: The way information is transmitted is of crucial importance in the doctor-patient relationship, as good communication reduces complaints about inadequate practices and patient concerns and improves treatment adherence and health recovery. However, patient dissatisfaction on this subject is not unusual. Objectives: The objective of this work was to evaluate the perception of patients admitted to a Hospital Complex about the communication of clinical doctors and surgeons during the hospitalization period. Method: Cross-sectional, descriptive, analytical inquiry study, with the application of a questionnaire with questions about physicians’ general communication. The instrument was built by the researchers and was answered by 120 adult patients. The sample was defined by convenience and stratified by medical and surgical clinic. Frequency and statistical analyses were performed on the obtained results. Results: Of 120 patients, 53.33%(n=64) were admitted to the Surgical Clinic and 46.67%(n=56) to the Medical Clinic. Of this total, 57.5%(n=69) had high school to college/university education. Patients reported more negative than positive responses to the following questions: information about the side effects of medications (66%), advice on post-surgical procedures (68.75%) and information on health promotion and prevention in the hospital environment (63.33%). The surgical clinic had significantly lower proportions of positive responses for: The doctor said their name (p <0.01; crude OR: 0.33; 95% CI 0.15-0.76); The patient was informed about how their treatment would be conducted (p=0.02; crude OR: 0.38; 95% CI 0.17-0.87); and the patient was informed about the need to undergo tests (p=0.02; crude OR 0.40; 95% CI 0.18-0.90), which remained significant after adjustment for certain confounding factors. There were no significant differences regarding the other questions. When analyzing the question: “What grade would you give to the doctor’s general communication?” a significantly higher value (p=0.007) was given to the Medical Clinic (average 4.46±0.76) when compared to the Surgical Clinic (average 4±1.19). Conclusion: The doctor-patient communication showed significant deficits. Therefore, it is necessary for medical schools to offer students the development of this competence. Additionally, for an adequate generalization of the obtained results, new studies need to be carried out at different levels of medical care.

scholarly journals Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Poultry Drug and Feed Sellers in Bangladesh

2021 ◽  
Vol 8 (6) ◽  
pp. 111
Author(s):  
Md. Abul Kalam ◽  
Md. Abdul Alim ◽  
Shahanaj Shano ◽  
Md. Raihan Khan Nayem ◽  
Md. Rahim Badsha ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Current Knowledge ◽  
Rank Order ◽  
Antimicrobial Use ◽  
Poultry Production ◽  
Attitudes And Practices ◽  
12Th Grade ◽  
Study Results ◽  
Knowledge Attitudes And Practices ◽  
Drug Sellers

Poultry production has boomed in Bangladesh in recent years. The poultry sector has contributed significantly to meet the increased demand for animal source proteins in the country. However, increased use of antimicrobials and antibiotics appeared to be a significant threat to food safety in the poultry sector. The poultry drug and feed sellers are at the frontline position involving selecting and delivering the antimicrobials to the poultry farmers. Studies assessing the poultry drug and feed sellers’ knowledge, attitudes, and practices (KAPs) are limited. The current study aimed to assess the community poultry drug and feed sellers’ KAPs of antimicrobial use (AMU) and antimicrobial resistance (AMR) in some selected areas of Bangladesh. We determined the respondents’ (drug and the feed sellers) KAPs of AMU and AMR using a tested and paper-based questionnaire. The study demonstrated that most respondents have insufficient knowledge, less positive attitudes, and inappropriate practices regarding AMU and AMR. The factor score analysis further showed that the type of respondents and their years of experience, level of education, and training on the drug were the significant factors impacting the current knowledge, attitudes, and practices of AMU and AMR. The adjusted logistic regression analysis revealed that the drug sellers who completed their education up to 12th grade and had training on the drug had adequate knowledge of AMU and AMR. The data also showed that the drug sellers belong to the age group 31–35 and 36–40 years and who completed 12th grade had good attitudes on the same. Likewise, the analysis further determined that drug sellers belonging the age category 18–25 and 26–30 years, and interestingly, the respondents who completed education up to 12th grade, had better practices. Spearman’s rank-order correlation revealed a positive association between each pair of the KAPs scores for the respondents. The correlation was fair between knowledge–attitudes, knowledge–practices, and attitudes–practices. Based on the current study results, we recommend educational interventions and appropriate training for the poultry drug and feed sellers to raise awareness and to upgrade their current knowledge on the appropriate use of antimicrobials. This will ultimately lead to reducing the chances of developing AMR in the poultry sectors of the country.

Antimicrobial Use Control Measures to Prevent and Control Antimicrobial Resistance in US Hospitals

2006 ◽  
Vol 27 (10) ◽  
pp. 1088-1095 ◽  
Author(s):  
Alan J. Zillich ◽  
Jason M. Sutherland ◽  
Stephen J. Wilson ◽  
Daniel J. Diekema ◽  
Erika J. Ernst ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antimicrobial Resistance ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Veterans Affairs ◽  
Control Measures ◽  
Antimicrobial Use ◽  
Cross Sectional ◽  
Term Care ◽  
Recommended Practices

Objective.Clinical practice guidelines and recommended practices to control use of antibiotics have been published, but the effect of these practices on antimicrobial resistance (AMR) rates in hospitals is unknown. The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals.Design.Cross-sectional, stratified study of a nationally representative sample of US hospitals.Methods.A survey instrument was sent to the person responsible for infection control at a sample of 670 US hospitals. The outcome was current prevalences of 4 epidemiologically important, drug-resistant pathogens, considered concurrently: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, ceftazidime-resistant Klebsiella species, and quinolone (ciprofloxacin)-resistant Escherichia coli Five independent variables regarding hospital practices were selected from the survey: the extent to which hospitals (1) implement practices recommended in clinical practice guidelines and ensure best practices for antimicrobial use, (2) disseminate information on clinical practice guidelines for antimicrobial use, (3) use antimicrobial-related information technology, (4) use decision support tools, and (5) communicate to prescribers about antimicrobial use. Control variables included the hospitals' number of beds, teaching status, Veterans Affairs status, geographic region, and number of long-term care beds; and the presence of an intensive care unit, a burn unit, or transplant services. A generalized estimating equation modeled all resistance rates simultaneously to identify overall predictors of AMR levels at the facility.Results.Completed survey instruments were returned by 448 hospitals (67%). Four antimicrobial control measures were associated with higher prevalence of AMR. Implementation of recommended practices for antimicrobial use (P< .01) and optimization of the duration of empirical antibiotic prophylaxis (P<.01) were associated with a lower prevalence of AMR. Use of restrictive formularies (P = .05) and dissemination of clinical practice guideline information (P<.01) were associated with higher prevalence of AMR. Number of beds and Veterans Affairs status were also associated with higher AMR rates overall.Conclusions.Implementation of guideline-recommended practices to control antimicrobial use and optimize the duration of empirical therapy appears to help control AMR rates in US hospitals. A longitudinal study would confirm the results of this cross-sectional study. These results highlight the need for systems interventions and reengineering to ensure more-consistent application of guideline-recommended measures for antimicrobial use.

scholarly journals Effects of a Paediatric Antimicrobial Stewardship Program on Antimicrobial Use and Quality of Prescriptions in Patients with Appendix-Related Intraabdominal Infections

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Sílvia Simó ◽  
Eneritz Velasco-Arnaiz ◽  
María Ríos-Barnés ◽  
María Goretti López-Ramos ◽  
Manuel Monsonís ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Case Fatality ◽  
University Hospital ◽  
Antimicrobial Use ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Length Of Therapy ◽  
Intraabdominal Infections

The effectiveness of antimicrobial stewardship programs (ASP) in reducing antimicrobial use (AU) in children has been proved. Many interventions have been described suitable for different institution sizes, priorities, and patients, with surgical wards being one of the areas that may benefit the most. We aimed to describe the results on AU and length of stay (LOS) in a pre-post study during the three years before (2014–2016) and the three years after (2017–2019) implementation of an ASP based on postprescription review with feedback in children and adolescents admitted for appendix-related intraabdominal infections (AR-IAI) in a European Referral Paediatric University Hospital. In the postintervention period, the quality of prescriptions (QP) was also evaluated. Overall, 2021 AR-IAIs admissions were included. Global AU, measured both as days of therapy/100 patient days (DOT/100PD) and length of therapy (LOT), and global LOS remained unchanged in the postintervention period. Phlegmonous appendicitis LOS (p = 0.003) and LOT (p < 0.001) significantly decreased, but not those of other AR-IAI diagnoses. The use of piperacillin–tazobactam decreased by 96% (p = 0.044), with no rebound in the use of other Gram-negative broad-spectrum antimicrobials. A quasisignificant (p = 0.052) increase in QP was observed upon ASP implementation. Readmission and case fatality rates remained stable. ASP interventions were safe, and they reduced LOS and LOT of phlegmonous appendicitis and the use of selected broad-spectrum antimicrobials, while increasing QP in children with AR-IAI.

Fluoroquinolone- and Methicillin-Resistant Staphylococcus Aureus: Insights from the Antimicrobial Resistance Management Program

2005 ◽  
Vol 21 (3) ◽  
pp. 123-128 ◽  
Author(s):  
John G Gums ◽  
Benjamin J Epstein
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Methicillin Resistance ◽  
Resistance Management ◽  
Multidrug Resistant ◽  
Management Program ◽  
Methicillin Resistant ◽  
The North ◽  
The Us ◽  
Northeast Us

Background: Staphylococcus aureus is a frequent cause of infections involving the bloodstream, skin and soft tissue, and lungs in hospitalized patients. These isolates are often multidrug resistant and represent a major therapeutic challenge. Objective: To explore the susceptibilities of S. aureus to nafcillin/oxacillin, a surrogate for methicillin resistance, and the fluoroquinolones and determine whether a relationship might exist between fluoroquinolone use and the prevalence of methicillin-resistant S. aureus (MRSA). Methods: To date, 353 institutions throughout the US and Puerto Rico have enrolled in the Antimicrobial Resistance Management (ARM) Program, and data have been submitted on nearly 5 million isolates of S. aureus. Isolates submitted from 1990 through 2002 were reviewed for sensitivity to nafcillin/oxacillin, clindamycin, erythromycin, and the fluoroquinolones ciprofloxacin and levofloxacin. Results: From 1990 through 2002 inclusive, susceptibility to nafcillin/oxacillin nationally was 64.9% (n = 360,460), ranging from 62.2% in the North Central and Northeast US to 72.8% in the Southwest. Nationally, S. aureus isolates were more resistant to levofloxacin (41.4%, n = 123,868) than ciprofloxacin (38.7%, n = 256,178). The greatest change in susceptibility of S. aureus to nafcillin/oxacillin and ciprofloxacin occurred concurrently from 1998 to 2002, which may implicate fluoroquinolone use with increasing rates of MRSA infection. Conclusions: Resistance to methicillin and the fluoroquinolones has increased in concert during the past 5 years. Collectively, data from the ARM Program, along with several other investigations, support a role of fluoroquinolone use in the emergence of MRSA. These observations, along with increasing resistance among gram-positive and gram-negative pathogens, underscore the need for judicious use of fluoroquinolones.

scholarly journals Antimicrobial Use, Residues, Resistance and Governance in the Food and Agriculture Sectors, Tanzania

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 454
Author(s):  
Robinson H. Mdegela ◽  
Elibariki R. Mwakapeje ◽  
Bachana Rubegwa ◽  
Daniel T. Gebeyehu ◽  
Solange Niyigena ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Crop Production ◽  
Growth Promotion ◽  
Penicillin G ◽  
Animal Origin ◽  
Antimicrobial Use ◽  
Food And Agriculture ◽  
Food Of Animal Origin ◽  
Food Animals

All infections are potentially curable as long as the etiological agents are susceptible to antimicrobials. The increased rate at which antimicrobials are becoming ineffective is a global health risk of increasing concern that threatens withdrawal of beneficial antimicrobials for disease control. The increased demand for food of animal origin, in particular eggs, meat and milk has led to intensification and commercial production systems where excessive use and misuse of antimicrobials may prevail. Antimicrobials, handled and used by farmers and animal attendants with no formal education, may be predisposed to incorrect dosages, misuse, incorrect applications and non-adherence to withdrawal periods. This study was conducted to assess the regulatory roles and governance of antimicrobials, establish the pattern and extent of their use, evaluate the antimicrobial residues and resistance in the food animals and crop agriculture value chains, and relate these findings to existing strategies in place for combating the emergence of antimicrobial resistance in Tanzania. A multimethod approach (desk review, field study and interviews) was used. Relevant establishments were also visited. High levels of resistance to penicillin G, chloramphenicol, streptomycin and oxytetracycline have been reported, especially for Actinobacter pyogenes, Staphylococcus hyicus, Staphylococcus intermedius and Staphylococcus aureus from dairy cattle with mastitis and in humans. Similar trends were found in poultry where eggs and meat are contaminated with Escherichia coli strains resistant to amoxicillin + clavulanate, sulphamethoxazole and neomycin. An increasing trend of emerging multidrug resistant E. coli, Klebsiella pneumoniae, Staphylococcus aureus and Salmonella was also found in food animals. An increase in methicillin resistant Staphlococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) in the livestock sector in Tanzania have been reported. The pathogens isolated in animals were resistant to ampicillin, augmentin, gentamicin, co-trimoxazole, tetracycline, amoxicillin, streptomycin, nalidixic acid, azithromycin, chloramphenicol, tylosin, erythromycin, cefuroxime, norfloxacin and ciprofloxacin. An increased usage of antimicrobials for prophylaxis, and therapeutics against pathogens and for growth promotion in livestock, aquaculture and crop production were observed. A One Health strategic approach is advocated to combat antimicrobial resistance (AMR) in the food and agriculture sectors in Tanzania. Practical recommendations include (a) legislation review and implementation; (b) antimicrobial use (AMU), AMR and antimicrobial residue (AR) awareness and advocacy among stakeholders along the value chain; (c) strengthening of surveillance and monitoring programs for AMU, AMR and AR; (d) enhanced development and use of rapid and innovative diagnostic tests and the promotion of biosecurity principles; and (e) good husbandry practices. The utilization of this information to improve public health policies and reduce the burden of AMR will be beneficial.

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