Antimicrobial stewardship in companion animals: Welcome to a whole new era

Untreatable bacterial infections (“the post-antibiotic era”) are far more likely to emerge in companion animals than in food animals, and have already arrived in the form of the multi-drug resistant (MDR) ESKAPE pathogens, the scourge of hospitals. These highly resistant, and in some cases hospital-adapted pathogens, are Enterococcus faecium, methicillin-resistant Staphylococcus pseudintermedius (and S. aureus), Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and Enterobacter species. There has however been a general increase in extendedspectrum beta-lactamase (ESBL) producing E. coli in companion animals which, like the ESKAPE pathogens, can be shared with their owners and escape into the veterinary clinic and hospital. We are moving rapidly from the antimicrobial era through the antimicrobial resistance (AMR) era into the era of antimicrobial stewardship (AMS). This shifting paradigm in our relationship with antibiotics is part of the global responsibility that all users have to preserve for the long term the rather small range of antimicrobial drugs available to treat bacterial infections.