The RATIONAL USE focus area of the Toolbox outlines practical steps to improve antibiotic stewardship in health care and food animal production. It also provides case examples, resources, and tools that can be adapted locally.
Why rational use?
Any antibiotic use, even correct use, can drive resistance development in pathogenic and commensal bacteria. Antibiotics are finite resources and their benefits must be weighed against risks for patients and society. The goal is not simply to reduce antibiotic use, but to ensure that use is appropriate. In other words, that the right antibiotic at the right dose, is given to the right person or animal at the right time. Rational use also includes ensuring sustainable access to effective antibiotics. This supports patient safety, quality of care, and equity.
In human medicine
Unlike most drugs, antibiotics act on bacteria, not the patient directly. Because resistant bacteria spread between hosts, the main burden of inappropriate use is often on public health rather than the individual. Still, with increasing resistance levels and spread of resistant bacteria in healthcare and society, more and more people are at risk of getting hard-to-treat infections. Also, misuse poses safety risks such as allergic reactions, Clostridium difficile infection, and antibiotic-associated colitis. See also UNDERSTAND: Why should I care?
In the food animal sector
Antibiotics are widely used to treat, prevent and even promote growth in livestock, often without proper guidelines or diagnosis. Resistant bacteria are frequently found in farm animals and can spread between animals and to humans through contact, food, water, air, or fertilized soils. High antibiotic pressure also drives multidrug-resistance. In animals, resistance can cause therapy failures, harming health and welfare, as well as productivity. Any future antibiotics will likely be reserved for human medicine, highlighting the need for implementing alternative approaches and infection prevention.
A coordinated response
Appropriate use is essential to preserve the effectiveness of antibiotics and protect health outcomes. Coordinated action is needed within and across the human, animal, and environmental sectors.