What does antimicrobial stewardship mean for One Health and animal health?

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Antimicrobial stewardship means the coordinated, system-wide effort to ensure antimicrobials are prescribed, administered and disposed of safely and responsibly, and it is inseparable from One Health because human, animal and environmental health are linked. For horse owners, veterinarians, trainers, breeders and animal-health businesses, antimicrobial stewardship is not a human-hospital issue alone. It is an operational, economic and welfare priority shaping how equine and livestock care is delivered in Australia in 2026.

What is antimicrobial stewardship and why does it matter in 2026?
How does the One Health approach connect human, animal and environmental health?
Why is antimicrobial resistance a serious threat to modern medicine?
What does Australia’s national approach to antimicrobial stewardship look like?
What are the key components of an effective antimicrobial stewardship program?
How is antimicrobial stewardship being applied in veterinary medicine and agriculture?
How can equine businesses build antimicrobial stewardship into their operations?
Key Takeaways
References

What is antimicrobial stewardship and why does it matter in 2026?

Antimicrobial stewardship is an organisational or healthcare-system-wide approach that fosters and monitors judicious use of antimicrobials, according to research published in Infection and Drug Resistance. It is also the term used to describe actions and policies that ensure the safe and responsible prescribing, administration and disposal of antimicrobials, as defined by SA Health.

Antimicrobials cover all antibiotics, antivirals, antifungals and antiparasitic agents, not just antibiotics. This matters because antimicrobial resistance, or AMR, occurs when microbes such as bacteria, viruses, fungi or protozoa adapt over time and no longer respond to the medicines used against them. Resistance develops in the microbes, not in the medications.

The stakes are high. People and animals with infections caused by antimicrobial-resistant microorganisms are more likely to experience ineffective treatment, recurrent infection, delayed recovery or death, according to the Australian Commission on Safety and Quality in Health Care. Resistant infections also carry high economic costs from the health care burden they create.

How does the One Health approach connect human, animal and environmental health?

The One Health concept holds that human health, animal health and the environment are interconnected, and that antimicrobial use in one sector influences another. This principle is central to understanding why stewardship in equine and livestock operations is not separate from public health protection.

The global significance of this connection was underscored in September 2016, when the General Assembly of the United Nations gathered to discuss antimicrobial resistance. According to the Doherty Institute, this was only the fourth time in history that a health issue had prompted such action.

Australia’s national research agenda and health policy identify a key objective as developing effective antimicrobial stewardship systems in all sectors where antimicrobials are primarily used. Those sectors include hospitals, community care settings, general practice, aged care, veterinary medicine and agriculture, according to Professor Karin Thursky of the National Centre for Antimicrobial Resistance.

For equine and livestock operations, the practical implication is direct. Every antimicrobial decision made on a broodmare farm, at a stud, or in a training stable carries One Health consequences that extend beyond the individual animal.

Why is antimicrobial resistance a serious threat to modern medicine?

Antimicrobial resistance is a serious threat because resistant pathogens undermine treatments that modern medicine depends on. The Doherty Institute names Clostridium difficile, carbapenem-resistant Enterobacteriaceae and methicillin-resistant Staphylococcus aureus as pathogens that pose a serious threat to modern medicine.

Infections with multidrug-resistant bacteria have substantial implications on clinical and economic outcomes, according to research published in Infection and Drug Resistance. These infections are harder to treat, require longer hospital stays and demand more expensive interventions.

The problem has been compounded by recent global events. Increased indiscriminate use of antibiotics during the COVID-19 pandemic will heighten bacterial resistance and ultimately lead to more deaths, according to the same research.

Antimicrobial resistance increases morbidity and mortality and is associated with high economic costs due to its health care burden. This burden is not confined to human hospitals; it ripples through veterinary medicine and agriculture as resistant organisms move across sectors.

What does Australia’s national approach to antimicrobial stewardship look like?

Australia has developed one of the most comprehensive national frameworks for antimicrobial stewardship in the world. Australia is one of a handful of countries to have developed comprehensive national guidelines for antibiotic prescribing in hospitals and general practice, according to the Doherty Institute.

In November 2016, Australia released an implementation plan to accompany its 2015 National Antimicrobial Resistance Strategy. This plan set the direction for coordinated action across human health, animal health and agriculture.

The Australian Commission on Safety and Quality in Health Care has introduced strong clinical standards that emphasise medication safety and infection prevention. Since 2013, all hospitals have been required to take action with regard to antimicrobial stewardship, according to the Doherty Institute.

An established antimicrobial stewardship program is now a requirement of the National Safety and Quality Healthcare Service Standards, third edition. The Antimicrobial Stewardship Clinical Care Standard supports quality improvement by health services and clinicians to help reduce antimicrobial resistance, as noted by SA Health.

What are the key components of an effective antimicrobial stewardship program?

An effective antimicrobial stewardship program is built on several core components. These include antimicrobial formulary management, guidelines on antimicrobial usage, education and feedback to the clinical workforce, and surveillance of antimicrobial usage and resistance, according to SA Health.

Stewardship activities also include auditing the use of antimicrobials, providing feedback and advice to health professionals on alternative options, overseeing and managing antimicrobials, monitoring prescribing patterns to identify trends, and raising awareness of antimicrobial resistance. These activities are outlined by the Australian Commission on Safety and Quality in Health Care.

The evidence for these programs is strong. Effective hospital, aged care and community antimicrobial stewardship programs have been shown to decrease inappropriate antimicrobial use, reduce the burden of multidrug-resistant organisms, and improve the safety and quality of patient care, according to SA Health.

The World Health Organization describes Antimicrobial Stewardship Programmes as one of the most cost-effective interventions to optimise the use of antimicrobial medicines, improve patient outcomes and reduce antimicrobial resistance and health care-associated infections.

How is antimicrobial stewardship being applied in veterinary medicine and agriculture?

Antimicrobial stewardship in veterinary medicine and agriculture is recognised as a national priority, but implementation remains a work in progress. A key objective of Australia’s national research agenda is developing effective stewardship systems in every sector where antimicrobials are primarily used, including veterinary medicine and agriculture, according to the Doherty Institute.

The primary care sector has an important role to play in improving the safe and appropriate use of antimicrobials and reducing patient harm and antimicrobial resistance risk in Australia, according to the Australian Commission on Safety and Quality in Health Care. This principle extends to primary animal care settings.

Reported barriers to implementing stewardship in veterinary medicine and agriculture include limited surveillance data, varying prescribing practices and the challenge of operationalising One Health across human, animal and environmental sectors. These barriers mean progress is uneven.

For equine practice, the implications are direct. Broodmare and stud farms, rehabilitation centres and training stables all make antimicrobial decisions that carry One Health consequences. Every course of antibiotics given to a horse has the potential to influence resistance patterns beyond that single animal.

How can equine businesses build antimicrobial stewardship into their operations?

Equine businesses can build stewardship into their operations by reducing reliance on medically important antibiotics where natural, non-invasive alternatives are appropriate. Equine Salt Therapy supports this goal through its patented dry salt aerosol delivery system, which creates favourable conditions for equine athletes and addresses day-to-day horse complaints.

Equine Salt Therapy offers Licensed Business Opportunities and Master Licenses for Equine, Poultry, Swine and Companion Animals, with territories sold under license and Master Licenses available for various modalities under US Patent; 11,497,593 and CA 3019046. Pricing ranges from $110,000 to $1,000,000.

Licensed Practitioners operate as local operators delivering natural, non-invasive treatment sessions to horse and animal clients known as Salties. The treatment protocol takes fifteen minutes and is recommended over three consecutive days.

This model offers veterinarians, trainers, breeders and investors a practical, business-ready way to participate in the stewardship conversation. By integrating non-pharmaceutical options into equine care, operations can reduce their pharmaceutical footprint while maintaining performance and welfare standards.

Key Takeaways

Antimicrobial stewardship is a system-wide approach to ensuring antimicrobials are prescribed, administered and disposed of safely and responsibly.
Antimicrobials include all antibiotics, antivirals, antifungals and antiparasitic agents, not antibiotics alone.
Resistance develops in the microbes, not in the medications used to treat them.
The One Health concept holds that human, animal and environmental health are interconnected, so antimicrobial use in one sector influences another.
In September 2016 the UN General Assembly met on antimicrobial resistance, only the fourth time a health issue had prompted such action.
Australia requires all health service organisations to have an Antimicrobial Stewardship program under the Preventing and Controlling Infections Standard.
The World Health Organization describes Antimicrobial Stewardship Programmes as one of the most cost-effective interventions to optimise antimicrobial use and reduce resistance.