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Title: Antimicrobial stewardship through a one health lens: Observations from Washington State

item D'ANGELI, MARISA - Washington Department Of Health
item BAKER, JOE - Washington Department Of Agriculture
item CALL, DOUGLAS - Washington State University
item DAVIS, MARGARET - Washington State University
item KAUBER, KELLY - Washington Department Of Health
item MALHOTRA, UMA - Virginia Mason Medical Center
item MATSUURA, GREGORY - Yakima Valley Memorial Hospital
item MOORE, DALE - Washington State University
item PORTER, CHRIS - Virginia Mason Medical Center
item POTTINGER, PAUL - University Of Washington
item Stockwell, Virginia
item WAGNER, CAROL - Washington State Hospital Association
item WOHRLE, RON - Washington Department Of Health
item YODER, JONATHAN - Washington State University
item YOKE, LEAH - Fred Hutchinson Cancer Research Center
item RABINOWITZ, PETER - University Of Washington

Submitted to: International Journal of Health Governance Information
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/13/2016
Publication Date: 8/26/2016
Citation: D'Angeli, M., Baker, J., Call, D., Davis, M., Kauber, K., Malhotra, U., Matsuura, G., Moore, D., Porter, C., Pottinger, P., Stockwell, V.O., Wagner, C., Wohrle, R., Yoder, J., Yoke, L., Rabinowitz, P. 2016. Antimicrobial stewardship through a one health lens: Observations from Washington State. International Journal of Health Governance Information. 21(3):114-130. doi: 10.1108/IJHG-02-2016-0009.

Interpretive Summary: The continuing increase in antibiotic resistant bacteria is reducing our ability to control diseases of people and animals. The State of Washington used a 'One-Health' perspective to examine the impact of antibiotic uses on people, animals, and the environment. A multi-disciplinary team of experts was recruited. Through webinars and meetings, the One-Health workgroup gained an understanding of antibiotic use and antibiotic resistance across environmental settings, including humans, companion animals, agricultural animals, poultry, plants, and aquaculture. The group acknowledged that knowledge gaps on the interplay of antibiotic use and resistance are prevalent and persistent. The work group recommends developing tracking systems for accurate measurement of antibiotic use across sectors. Without accurate measurement of current use, it will be difficult to quantify the impact of stewardship programs. The paper describes the organization of the One-Health Washington group, the efforts undertaken to date and offers this as a model to other states that wish to establish similar groups to monitor and improve antibiotic use and minimize resistance.

Technical Abstract: Antibiotic resistance is a global health crisis that threatens patient care, public health, agriculture, economic growth and national security. It has recently attracted increasing attention from healthcare professionals, public health officials, federal governments, international agencies, the public, and food producers. Despite seven decades of warnings, antibiotic resistance continues to increase. It is clear that antibiotic resistance is a threat to all- healthy and vulnerable humans in high- and low-income nations, pets and animals raised for food- and that cooperative, collaborative global action is essential to mitigate this threat. the purpose of this article is to describe Washington's statewide effort to combat antibiotic resistant bacteria from a One-Health perspective, and to present our findings and observations about the challenges we face.