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An antibiotic amnesty can be a One Health tool to tackle antimicrobial resistance

Nature Medicine volume 29, pages 1046–1047 (2023)Cite this article

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The recent correspondence by Sjoberg et al.1 highlighted several commendable stewardship initiatives, developed for human medicine, that have been embraced by companion animal veterinarians and integrated into practice. Antibiotic use guidelines, including the PROTECT ME poster (see https://go.nature.com/3Hn7qcl), have been developed to encourage veterinarians to optimize their selection of the right drug, dose and duration2, mirroring resources widely available for prescribers of medicines for humans. Efforts in the UK and elsewhere have resulted in significant decreases in the agricultural use of antimicrobials (https://go.nature.com/3ABoA1X). However, a blind spot exists in both animal and human health systems relating to the oversight of medication once it is supplied to the patient.

Patients and pet owners are routinely provided with instructions to complete the prescribed treatment course. Leftover antibiotics should, therefore, be rare provided that adherence to the treatment protocol is high and intolerance of the medication (and the act of being medicated) remains low. Nonetheless, in a UK survey, 14% of patients reported having leftover antibiotics, with one-third of respondents storing them for potential future reuse, either for themselves or friends and family, and a further one-third disposing of unused antibiotics via household waste or down toilets and sinks3. These behaviors can exacerbate environmental pollution and antimicrobial resistance (AMR), increase the risk of drug adverse effects or delay instigation of proper care. The tendency to hoard antibiotics may be greater for pet owners, who must pay the full cost of antibiotics directly.

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Acknowledgements

The authors would like to thank the many individuals, organizations and businesses who supported the Antibiotic Amnesty.

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Authors and Affiliations

  1. Willows Veterinary Centre and Referral Service, Solihull, UK

    Fergus Allerton & Megan Work

  2. NHS England (Midlands), Birmingham, UK

    Conor Jamieson

  3. NHS Birmingham and Solihull Integrated Care Board, Birmingham, UK

    Rakhi Aggarwal & Angela Barker

  4. NHS Black Country Integrated Care Board, Birmingham, UK

    Donna Cooper

  5. University of Glasgow Small Animal Hospital, Bearsden, UK

    Ian Ramsey

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  1. Fergus Allerton
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Correspondence to Fergus Allerton.

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Allerton, F., Jamieson, C., Aggarwal, R. et al. An antibiotic amnesty can be a One Health tool to tackle antimicrobial resistance. Nat Med 29, 1046–1047 (2023). https://doi.org/10.1038/s41591-023-02334-3

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