Unsafe “crossover-use” of chloramphenicol in Uganda: importance of a One Health approach in antimicrobial resistance policy and regulatory action

Since the introduction of antibiotics into mainstream health care, resistance to these drugs has become increasingly widespread. Policy decisions to mitigate the development of antimicrobial resistance (AMR) are hampered by a lack of surveillance data on antibiotic availability and use in low-income countries. This study collected data on the antibiotics stocked in human and veterinary drug shops in in Luwero, Uganda. Focus group discussions with drug shop vendors were also employed to explore antibiotic use practices in the community. Focus group participants reported that farmers used human-intended antibiotics for their livestock, and community members obtain animal-intended antibiotics for their own personal human use. Human consumption of chloramphenicol residues through local animal products represents a serious public health concern. A One Health approach is required to understand the wider impact of community antibiotic use and improve overall effectiveness of intervention policy and regulatory action.