Abstract
Overuse and misuse of antibiotics in both human and veterinary medicine are key drivers for AMR. Previous observational studies analyzed the association of AMU and AMR as linear, which does not fully explain dynamic AMR selection. Longitudinal studies using time series analysis, could capture the underlying dynamic association between AMU and AMR, and provide insight into how changes in AMU lead to future changes in AMR. Such insights would allow us to build and to implement strategies to reduce the impact of AMR in humans and animals.
This thesis focused on two main objectives. In Chapter 2.1 we explored how non-clinical factors can influence antibiotic prescription patterns, and lead to inappropriate AMU. In Chapters 2.2 to 2.5 we explored the complex association of AMU and AMR by analyzing the trends and seasonality of AMU and how this could lead to future changes in AMR in the Netherlands.
Based on our results, future studies regarding the association of AMU and AMR should consider the dynamics between these two variables, including seasonal variations in both AMU and AMR. It is important to point out that most of the studies in this thesis used surveillance data that has been routinely collected for monitoring purposes, remarking the importance of using real-world evidence in contributing to knowledge and for implementing and monitoring strategies to reduce the impact of AMR. Therefore, this type of information should also be available in developing countries such as Ecuador, where a surveillance system of AMU and AMR in humans and animals has thus far not been fully implemented. It is important to consider our results regarding attitudes to AMU in food-producing animals in Ecuador, and note that it is pivotal to collect information to increase the knowledge of local AMR rates. This can help us in our aim to implement strategies to promote antibiotic stewardship inside a One Health concept in all countries.
This thesis focused on two main objectives. In Chapter 2.1 we explored how non-clinical factors can influence antibiotic prescription patterns, and lead to inappropriate AMU. In Chapters 2.2 to 2.5 we explored the complex association of AMU and AMR by analyzing the trends and seasonality of AMU and how this could lead to future changes in AMR in the Netherlands.
Based on our results, future studies regarding the association of AMU and AMR should consider the dynamics between these two variables, including seasonal variations in both AMU and AMR. It is important to point out that most of the studies in this thesis used surveillance data that has been routinely collected for monitoring purposes, remarking the importance of using real-world evidence in contributing to knowledge and for implementing and monitoring strategies to reduce the impact of AMR. Therefore, this type of information should also be available in developing countries such as Ecuador, where a surveillance system of AMU and AMR in humans and animals has thus far not been fully implemented. It is important to consider our results regarding attitudes to AMU in food-producing animals in Ecuador, and note that it is pivotal to collect information to increase the knowledge of local AMR rates. This can help us in our aim to implement strategies to promote antibiotic stewardship inside a One Health concept in all countries.
| Original language | English |
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| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 26 Sept 2024 |
| Place of Publication | Rotterdam |
| Publication status | Published - 26 Sept 2024 |
| Externally published | Yes |
