That was one of the questions that was tackled, wrestled with and given a beat-down at the November National Institute for Animal Agriculture’s (NIAA) One Health Approach to Antimicrobial Use & Resistance: A Dialogue for a Common Purpose symposium.

And the answer? Well, all of us are responsible, which makes it a huge issue to contend with. Livestock producers, companion and food-animal veterinarians, human physicians, consumers, regulatory agencies, crop and produce farmers, etc. all have a role to play in the use of antimicrobials and antimicrobial resistance.

What tends to bog down the dialogue is an ongoing finger-pointing battle between the human medical community’s use of antibiotics and the animal health use. What makes it difficult in comparing apples to apples is that in humans, antimicrobials can be used for treatment or prevention, and the physician determines the indication, route, dose, frequency and duration. “There are no restrictions on extralabel or off-label use of human antimicrobials,” explained Ron DeHaven, DVM, MS, American Veterinary Medical Association.

In food animals, however, only drugs approved for specific indications, and under specific dose, duration, frequency and route of administration can be used, and extralabel uses are heavily regulated. So the conversations on human and animal use can be frustrating when trying to compare them.

And the debate does not just include humans and animals. Did you know that streptomycin and tetracycline are used in apple and pear production to control a bacterial disease called fire blight? At the NIAA conference plant pathologist George Sundin, PhD, Michigan State University, discussed antimicrobial use in plant agriculture, its issues with resistance and antimicrobials in the environment, bringing a whole new perspective to the conversation.

In a post-conference press release, NIAA said presenters and participants agreed on numerous points:

• Antibiotics dramatically improve human, animal and plant health, and increase life expectancy.

• Antimicrobial resistance is not going to go away. A historical look at antimicrobial resistance shows antimicrobial resistance is not a new phenomenon but existed before mankind.

• The topic of antimicrobial resistance can be subtle, complex, difficult and polarizing. It is more than science and evidence. It’s about politics, be havior, economics and conflicting opinions.

• Antimicrobial resistance is not merely a consequence of use; it’s a consequence of use and misuse—and each community—animal health, human health or environmental health—is responsible for antibiotic stewardship.

• The finger pointing and blame for antimicrobial resistance need to end. The time has come to work together.

Antimicrobial resistance occurs without antibiotic use, with judicious use, but especially with misuse and/or overuse, said Lonnie King, DVM, MS, MPA, Dipl. ACVP, dean of the Ohio State University College of Veterinary Medicine. “It can be a polarizing issue adding to difficulty in finding resolution. Society seems to be at a major impasse on this issue, and the costs of inaction are unacceptable.”

This one conference can’t solve the divisive issues surrounding antimicrobial use in humans, animals and the environment, but these discussions open more doors for dialogue and trying to find common ground on what we do know, and what we need to do to find out the things we don’t know about antimicrobial use and resistance.

For more information, visit NIAA’s website at