Antimicrobial Stewardship and One Health Perspectives: A Narrative Review

Background. Antimicrobial resistance (AMR) poses a significant global health challenge, threatening the effectiveness of life-saving antimicrobial therapies, and requires a multifaceted approach for its mitigation. Methods. This article explores the One Health (OH) framework as a comprehensive strategy that integrates human, animal, and environmental health to combat AMR. Key aspects of antimicrobial stewardship across various sectors are analyzed, including hospital-based interventions, community initiatives, and veterinary practices. Environmental contributors, including antibiotic water and soil contamination, are addressed through mitigation strategies, such as advanced waste management technologies and sustainable agricultural practices. Wildlife's role in transmitting resistance is discussed, emphasizing the need for conservation efforts and environmental monitoring. This paper also reviews global success stories and collaborative programs, in Africa, Europe, and North America, illustrating the importance of integrated surveillance and policy harmonization. Results. Challenges to implementing the OH strategy, including regulatory discrepancies, communication barriers, and cultural resistance, are acknowledged. However, opportunities for progress, such as global partnerships, interdisciplinary education, and innovation, offer hope for mitigating AMR. The role of technological innovations, such as artificial intelligence, advanced data analysis, and cutting-edge antibiotic research, is explored, alongside the importance of vaccines in preventing infections with resistant pathogens. Conclusions. By fostering collaboration, promoting sustainable practices, and leveraging advanced technologies, the OH framework provides a pathway to address AMR and safeguard public, animal, and environmental health for future generations.