To assess the effect of the achieved reduction in AMU and to link it with the AMR trends in animal and human pathogens in Belgium we aim to use as much available data as possible. In that respect, the study will identify and try to include all the relevant data on AMU and AMR as far back as possible both from public and private databases. Whenever databases remain non-accessible for the consortium we will include publicly available reports describing the main outcomes of the studies as we have done before (Chantziaras et al., 2014a). This will enable us to determine potential associations between changes in AMU in animals and both phenotypic and genotypic AMR in animal and human pathogens. The latter will enrich our understanding of the link between animal and human health and may be used for future recommendations and policy.

Therefore, the study will answer the following questions:

1. What are the trends in the phenotypical (and if available genotypical) resistance profiles of important animal pathogens and commensal bacteria of pigs, poultry, and veal calves?
2. What are the trends in the phenotypical (and if available genotypical) resistance profiles of important human pathogens that have a link to animals?
3. What is the evolution of antimicrobial use in animals in the last ten years and how can we retrospectively revert existing overall sales data into species-level usage data?
4. What are the associations between the trends in AMU at the species level and the phenotypical (and if available genotypical) resistance profiles in animal and human pathogens that have a link to animals?
5. What are the associations in phenotypical resistance profiles in animal commensals and animal pathogens and to what extent are trends in commensals predictive for the evolutions in resistance profiles in pathogenic bacteria?
6. How can available information on antimicrobial resistance in human and animal pathogens be made available/accessible in an easy manner to all interested stakeholders?