Antimicrobial use and control of resistanceAn integrating vision

Resum

Antimicrobials, particularly antibiotics, represent one of the most important medical advancements that started in 1928 with the discovery of penicillin by Fleming, simultaneously to the appearance of the antimicrobial resistance (AMR). Several decades of antibiotic overuse and misuse in humans, animals (79%), and agricultural practices has led to a global critical situation in the absence of effective antibiotics, aggravated by the lack of discoveries of new agents. The policy on antibiotic stewardship promotes the prudent use of antibiotics to avoid the further emergence and spread of antibiotic (multi-)resistance. Some of the resistances are mediated by genes, some of them plasmidic and so transferable, but other are reversible chromosomal point mutations. The monitoring and identification of common multiresistance patterns circulating in the environment by joint efforts of clinicians, pharmacists and veterinarians, following an "One Health" approach, and using next generation sequencing will share a common goal to characterize the environmental transmission routes and to decide on the best control strategies that ultimately will improve the state of global alarm to face antibiotic ineffectiveness.