Programme no. 553-P
Public Health
Fighting Antibiotic Resistance - The one Health Approach in Human and Veterinary Primary Care to Increase Prudent use of Antibiotics for Urinary Tract Infection (UTI)
Anne Holm*1, Gloria Cordoba2, Lars Bjerrum3, Tina Møller Sørensen4, Lola Kathe Tolstrup Leihardt5, Jens Peter Nielsen6, Charlotte Bjørnvad7, Lisbeth Rem Jessen8
1Section of General Practice, Dept. of Public Health,Copenhagen University,Copenhagen,Denmark, 2Section of General Practice, Dept. of Public Health,Copenhagen University,Copenhagen,Denmark, 3Section of General Practice, Dept. of Public Health,Copenhagen University,Copenhagen,Denmark, 4Dept. of Veterinary Clinical & Animal Sciences,Copenhagen University,Copenhagen,Denmark, 5Dept. of Large Animal Sciences,Copenhagen University,Copenhagen,Denmark, 6Dept. of Large Animal Sciences,Copenhagen University,Copenhagen,Denmark, 7Dept. of Veterinary Clinical & Animal Sciences,Copenhagen University,Copenhagen,Denmark, 8Dept. of Veterinary Clinical & Animal Sciences,Copenhagen University,Copenhagen,Denmark
* = Presenting author
Objectives: WP4 aims to create new evidence regarding diagnosis and therapy of UTI in humans and animals and thereby establishing evidence-based diagnostic protocols and guidelines for rational use of antibiotics in the treatment of UTI.
Background: Antibiotic resistance is one of the most important threats to human health as resistance is rapidly spreading. Resistant strains can be selected for in both humans and animals, and antibiotic use is the most important factor for development of resistance. Clinical signs of urinary tract infection are a common complaint in both humans and dogs and in production animals, urogenital infections can cause lowered fertility and thereby economic loss. In 2013 a multi-disciplinary research center for control of antibiotic resistance in humans and animals (UC-CARE) was established at the University of Copenhagen. This poster describes the clinical work-package, WP4.
Results: The studies are on-going
Material/Methods: Mapping of 1500 human patients with suspected UTI recruited from 50 general practices followed by an intervention and re-mapping. Evaluation of a culture and susceptibility point of care test (POCT) in primary care, conducted as a multi-center randomized controlled trial (RCT).

Mapping of 800 dogs with suspected UTI recruited from100 small animal practices. Evaluation of a culture and susceptibility POCT in small animal practice, conducted as a multi-center RCT.

Examination of the prevalence of UTI in 185 slaughtered sows. The prevalence of UTI in live sows will be investigated on 5 different farms having reproductive problems, with UTI as the suspected cause. The most valid diagnostic test for detecting UTI in sows will be determined. The current procedures and attitudes toward treatment and prevention of UTI among pig veterinarians will be mapped.

Conclusion: Antibiotic resistance is a common problem in human and veterinary medicine. The collaboration has so far given an insight into common challenges as well as substantial differences between species. Hopefully, this study will inspire others to collaborate on confronting the increasing challenge of antibiotic resistance.
Points for discussion: Is a one health approach the way to go in order to combat the development of antibiotic resistant strains?

Where should interventions towards more prudent use of antibiotics be focussed, in the primary sector, the secondary sector or in veterinary medicine?