Integration of a multi-pronged standardized methodology to identify key diseases and prioritized antimicrobial alternatives in production animals - PROJECT SUMMARY Antimicrobial resistance (AMR) is recognized as a significant threat to the health of animals, humans and plants, leading to calls to improve antimicrobial stewardship in all sectors. In order to assure the best utilization of limited resources, there is a critical need to identify the diseases and associated alternative strategies that, if implemented, would lead to the greatest impact on improving antimicrobial stewardship. This proposal seeks to address this critical gap with an approach that integrates evidence-based and decision-making methods such as scoping reviews, structured expert elicitations (informed in some cases by proprietary large- scale data and experience), and multi-criteria decision analysis (MCDA) across four livestock groups. This approach provides a comprehensive, systematic, and transparent framework to identify and prioritize the most important disease, and then the most promising alternative approaches to reduce the use of medically important antimicrobials in food animals, while maintaining animal health and wellbeing. The proposed project is significant in that, in contrast to the present situation, successful completion of the project will generate comprehensive and nuanced assessments of the disease drivers and recommendations on how to mitigate antimicrobial use in chickens, beef cattle, dairy cattle and swine. This integrated methodology, combined with application to four major food producing species, allows for a consistent and innovative approach to addressing the specific needs outlined by FDA in this PAR. This effort will be led by the National Institute of Antimicrobial Resistance Research and Education (NIAMRRE), a member organization that fosters cross-sector engagement to combat the challenges presented by AMR, in collaboration with RTI International, a nonprofit research institute with expertise in scoping reviews, expert elicitation, and multi-criteria decision analysis. NIAMRRE expertise includes investigators and subject matter experts from four major agricultural research universities with deep expertise in animal health and livestock production: University of California Davis (dairy cattle lead), The Ohio State University (beef cattle lead), the University of Georgia (broiler chicken lead), and Iowa State University (swine lead). Collectively, this team provides an outstanding environment for successful completion of the project. The outcome of this framework is that a consistent approach will be applied across four major livestock species, resulting in consistent communications of recommendations for strategies to reduce reliance on medically important antimicrobials.
