[Antibiotic consumption and resistance in human and veterinary medicine : where do we come from and where are we going ?]

Abstract

Antimicrobial resistance is now recognized as a major global public health threat. It results from a combination of interrelated factors : excessive or inappropriate use of antibiotics (ATB) in human and veterinary medicine, spread of bacteria and resistance genes across settings (hospitals, the community, farms, and the environment), and international circulation. In human medicine, despite ambitious European and national targets to reduce ATB consumption, progress remains limited. Although some qualitative indicators are encouraging, overall consumption remains high. In addition, resistance among key bacteria, such as Escherichia coli, continues to be a concern. In animals, the historical use of ATB, particularly as growth promoters, has contributed to the emergence of resistance. However, recent European and Belgian regulations have led to a marked reduction in sales, especially of antibiotics considered critically important for human health. Given the scarcity of new antimicrobial molecules, coordinated and sustained actions are mandatory to preserve ATB effectiveness and enable the achievement of the targets set for 2030.