Increasing reliance on antibiotics of last resort to treat the rising numbers of multi-drug resistant bacterial infections in people has focused attention on how shared-use antibiotics are managed and regulated across human and animal health.

In The One Health stewardship of colistin as a antibiotic of last resort for human health in South Africa published in The Lancet Infectious Diseases, April 16, 2018, the authors outline the process, institution of governance with widespread stakeholder engagement, surveillance, and interventions that South Africa has taken towards optimizing the shared use of colistin.

The instigation of stewardship guided by the principles of the One Health concept for shared-use antibiotics at the country level is a crucial component of any action plan to combat antibiotic resistance, and is as relevant to other existing antibiotics and new chemical entities that will be forthcoming from an invigorated antibiotic pipeline as it is to colistin.  The authors write:

“We believe that our approach of convening intersectoral stakeholders across the One Health platform to develop a national strategy for the stewardship of antibiotics provides valuable lessons for future work in South Africa, and that such a method could be useful in other countries.”

Read the paper