Intended for healthcare professionals

Feature Antimicrobial Resistance

Doctors and vets working together for antibiotic stewardship

BMJ 2018; 362 doi: (Published 13 July 2018) Cite this as: BMJ 2018;362:k3014
  1. Ingrid Torjesen, freelance journalist, London, UK
  1. Ingrid_torjesen{at}

Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance. Ingrid Torjesen reports from an expert discussion jointly hosted by both The BMJ and Vet Record to identify ways to tackle it

In July 2014, David Cameron, then prime minister, commissioned economist Jim O’Neill to analyse the global problem of rising antimicrobial resistance and recommend how to tackle it. O’Neill recommended a One Health approach, covering humans and animals,1 and the UK government took action to reduce use of antibiotics in human and veterinary medicine.

The NHS has made efforts to ensure antibiotics are used judiciously. This is a delicate balancing act, explained Emmanuel Wey, consultant in infection at the Royal Free Hospital in London— because clinicians are concerned about not treating sick patients adequately, they may prescribe broad spectrum antibiotics if the right diagnostic tests are not available. He was speaking at a discussion on 26 June at BMA House in London hosted by The BMJ and Vet Record.

Hospitals in rich countries have fast molecular tests, but no cheap quick test can be used at the point of prescribing, said Peter Hawkey, professor of clinical and public health bacteriology at the University of Birmingham.

The most worrying resistant organisms are constantly changing, Tim McHugh, professor of medical microbiology at University College London, explained. “We need to manage infection control as a whole rather than focus on one particular group of organisms.”

Reduced use in agriculture

In agriculture, the Department for Environment, Food and Rural Affairs committed to reduce antibiotic use in livestock and fish farmed for food in the UK to 50 mg/kg by 2018.2 That target was achieved two years early, with a major reduction in antibiotic use, said Sandy Trees, Vet Record’s editor in chief and retired …

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