The 2050 AMR Crisis: Why Veterinary Stewardship Can’t Wait
Every prescription decision veterinarians make today shapes the antibiotics available tomorrow
The clock is ticking. By 2050, antimicrobial resistance (AMR) is projected to kill 10 million people annually² — more than cancer kills today. What started as isolated pockets of resistant bacteria has exploded into a global health crisis that demands immediate action from every corner of healthcare, including veterinary medicine.
“We’re not just considering that specific patient,” explains Dr. Lauren Forsythe, veterinary pharmacist and antimicrobial stewardship expert. “We have to consider the impact that our treatment choice has on a wide variety of humans and animals across the world potentially.”
This isn’t a distant threat. The numbers are already staggering: in 2019 alone, 1.27 million deaths were directly attributable to antimicrobial resistance¹, with nearly 5 million additional deaths associated with drug-resistant infections. Yet many veterinary practices continue prescribing patterns that accelerate this crisis.
The Veterinary Medicine Reality Check
Consider this sobering statistic: at one veterinary teaching hospital — supposedly the gold standard of evidence-based medicine — 38% of antibiotic prescriptions had no documented evidence of infection³. If this represents our best practices, what’s happening in the broader veterinary community?
Dr. Forsythe notes that “drug development has not and cannot keep up with the pace that we’re seeing bacteria resistance develop.” Since 2000, fewer than 20 new antibiotics have been approved, with only four featuring novel mechanisms of action. Meanwhile, bacteria continue evolving resistance faster than pharmaceutical companies can develop solutions.
The mathematics are brutal: we’re running out of effective antibiotics while simultaneously creating more resistant pathogens through inappropriate use.
One Health, One Crisis
The interconnected nature of human and animal health means veterinary prescribing decisions directly impact human medicine. Resistant bacteria don’t respect species boundaries. When we select for resistance in animal patients, those mechanisms can transfer to bacteria affecting humans.
This reality has sparked urgent action at veterinary teaching hospitals. Dr. Forsythe reports that institutions like Ohio State, Texas A&M, and Illinois have recently implemented antimicrobial stewardship committees with restrictions on high-priority antibiotics like fluoroquinolones and third-generation cephalosporins.
But teaching hospitals represent a fraction of veterinary practice. The real battleground exists in community practices where most animals receive care.
The Path Forward
Antimicrobial stewardship doesn’t mean denying patients effective treatment. It means making informed decisions about the right antibiotic, at the right time, at the right dose, for the right duration. This requires:
Diagnostic Confirmation: Moving beyond “it might be bacterial” to “this is bacterial” through appropriate diagnostics.
Culture and Sensitivity Testing: Understanding what specific bacteria we’re fighting and which antibiotics will actually work.
Local Resistance Patterns: Recognizing that resistance varies by geographic region and adjusting empirical therapy accordingly.
Treatment Documentation: Recording why specific antibiotics were chosen to build institutional knowledge and ensure continuity of care.
The alternative is stark. Without immediate improvements in stewardship practices, we face a future where routine infections become untreatable, surgical procedures carry unacceptable risks, and veterinary medicine returns to a pre-antibiotic era.
Where This Leaves Us
Antimicrobial resistance is already affecting clinical outcomes in veterinary practice, and the trajectory is clear. The good news is that stewardship doesn’t require dramatic overhauls. Diagnostic confirmation before prescribing, culture-guided therapy when possible, and narrower-spectrum first-line choices are incremental steps that add up across a profession. The tools and guidelines exist. Implementation is the remaining challenge.
Learn evidence-based antimicrobial stewardship strategies from leading experts. Join our upcoming live session on antimicrobial resistance and stewardship practices.
Register for Event 33: Advanced Antimicrobial Stewardship →
References
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Kim C, et al. Global and regional burden of attributable and associated bacterial antimicrobial resistance avertable by vaccination. BMJ Glob Health. 2023;8(7):e011341.
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Pulingam T, et al. Antimicrobial resistance: Prevalence, economic burden, mechanisms of resistance and strategies to overcome. Eur J Pharm Sci. 2022;170:106103.
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Wayne A, et al. Therapeutic antibiotic use patterns in dogs: observations from a veterinary teaching hospital. J Small Anim Pract. 2011;52(6):310-8.