Associate Professor  with Habilitation Maria Teresa  Herdeiro
Department of Medical Sciences, University of Aveiro (UA),  Portugal

Title: Strengthening Education on Antimicrobial Resistance: A One Health Approach

Abstract:

Background: Antimicrobial resistance (AMR) is a major public health challenge that negatively impacts communities on a global scale [1]. Considering the interconnection between the health of humans, animals, and the environment, One Health actions are key to effectively mitigate AMR emergence and spread [2]. In this context, veterinarians are key public health agents, actively contributing to antimicrobial stewardship [3]. Several factors, including gaps in knowledge and lack of awareness, may influence antibiotic prescription and use. This may, in turn, hamper appropriate practices, compromising not only animal health and welfare, but also public health and food security. In this context and as part of the Edu4OneHealth project (2022.04568.PTDC), a previous cross-sectional study targeting Portuguese livestock veterinarians [4] allowed the identification of gaps in knowledge, key barriers to appropriate antibiotic use, and opportunities to promote antimicrobial stewardship.

Objectives: The aims of this research are to develop and implement multifaceted educational interventions to improve knowledge and to increase awareness on AMR and prudent antibiotic use in animals, encouraging the change of practices and attitudes of veterinarians. 

Methods: National experts from different fields were invited to develop educational materials, online training, and webinars on topics related to veterinary medicine, animal health and welfare, pharmacovigilance, market authorization, electronic prescription, One Health, and AMR. Developed educational resources were made available in the project’s website https://edu4onehealth.web.ua.pt/ and disseminated to Portuguese livestock veterinarians through social media platforms, the Portuguese Order of Veterinary Doctors (OMV), and the rectories of Universities with a Veterinary Medicine master’s degree program. Ethics approval was obtained from the Ethics Committee for Clinical Research of the University of Aveiro (reference 63-CEIC-UA2026-I). 

Results: A booklet, a flyer, and a bookmark were developed as educational materials, both in printed and digital formats. Veterinarians from the University of Trás-os-Montes and Alto Douro (UTAD) created the online training, with three modules: Module 1–Problems associated with the inappropriate use of antibiotics: Implications for animals, humans and the environment; Module 2–Antibiotic leftovers in animal farming: Impacts in antibiotic resistance from a One Health perspective; and Module 3–Bacterial resistance to antimicrobials: communication barriers between veterinarians and farmers. A final assessment of three clinical cases, with nine questions in total, was included. A total of four webinars were developed by national experts: (i) Antibiotic administration – Using formulas to estimate animal weight; (ii) Veterinary medicines: Regulatory framework – legal concepts and general provisions; (iii) Veterinary pharmacovigilance – importance in tackling AMR; and (iv) Electronic prescription and antibiotic resistance. This research is ongoing and the potential impacts of these educational interventions will be assessed via a cross-sectional study, with a questionnaire built in the University of Aveiro platform (https://forms.ua.pt/) and following a previously published methodology [4]. The number of accesses to the website will be recorded anonymously, allowing to assess engagement and overall interest in addressed topics.

Conclusions: Veterinarian-targeted educational resources have been successfully developed, with free and easy access. The implemented educational interventions are expected to address existing gaps in knowledge and attitudes, to promote prudent antibiotic use, and to increase awareness regarding AMR emergence and spread, its impacts in public health, and how a One Health vision is necessary to effectively tackle AMR.

Keywords: antimicrobial resistance; One Health; veterinary medicine; educational interventions; public health.

References: 1. WHO. Antimicrobial resistance - Key facts. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance. [Accessed on October 12, 2026]; 2. Van Puyvelde S, et al. Why the antibiotic resistance crisis requires a One Health approach. Lancet Infect Dis 2018; 18(2):132–134; 3. Pokharel S, et al. Antimicrobial use in food animals and human health: time to implement ‘One Health’ approach. Antimicrob Resist Infect Control 2020; 9:181; 4. Pinho JO, et al. Knowledge, attitudes, and practices of livestock veterinarians on antibiotic use and resistance: a cross-sectional study. Vet J. 2026; 320:106917. 

Funding: This work was supported by FCT – Fundação para a Ciência e a Tecnologia, I.P., FCT, grant numbers UID/04501/2025 (https://doi.org/10.54499/UID/04501/2025), 2022.04568.PTDC (https://doi.org/10.54499/2022.04568.PTDC), UIDB/04033/2020 (https://doi.org/10.54499/UIDB/04033/2020), LA/P/0126/2020 (https://doi.org/10.54499/LA/P/0126/2020), and UID/06407/2025 (https://doi.org/10.54499/UID/06407/2025). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the abstract.

Biography:

Degree (6 years) and Master in Pharmaceutical Sciences (University of Coimbra). PhD in Public Health, field of Pharmacoepidemiology and Post-Doc in Public Health (University of Santiago de Compostela). Master in Food Sciences and Engineering (University Católica Portuguesa). Specialist in Regulatory Affairs (Association of the Pharmacists, OF). European pharmacologist certificate (EuCP).

Member of World Health Organization (WHO) Advisory Committee on Safety of Medicinal Products (ACSoMP), Member of the Pharmacovigilance Risk Assessment Committee (PRAC) appointed by the European Commission and Member of the ENCePP of the European Medicines Agency, Member of the Technical Chamber of Pharmacovigilance (ANVISA), Brazil.