Bridging the Gap: Improving Antimicrobial Access and Use Across One Health Image Access the Recommendation Report Bridging the Gap: Improving Antimicrobial Access and use Across One Health* Executive Summary The COVID-19 pandemic has transitioned more of people’s interactions with their medical and veterinary prescribers to virtual platforms to facilitate healthcare access. Among animal and human health domains, antimicrobial prescribing practices are known to differ by treatment setting, medical specialty, and by animal species. As such, there has been expressed concern by the antimicrobial resistance (AMR) community that the increased use of virtual care may exacerbate inappropriate antimicrobial prescribing and possibly result in greater antimicrobial access inequities. Furthermore, prescribing practices and antimicrobial use in animal healthcare versus agricultural settings, including crops, vary and are impacted by numerous known and unknown factors. Therefore, it is critical that antimicrobial stewardship practices be further researched, promoted, and in some instances, standardized across the One Health spectrum whenever such a framework is utilized to combat AMR. This process should include evidence-based guidance from the appropriate subject matter expertise to ensure equitable antimicrobial access and use in all settings to mitigate the ongoing issue of AMR. By identifying the research gaps needed to portray the correlation among all domains, further steps can be taken to ensure that the appropriate interventions for improved stewardship practices are better applied to human, animal, crop, and environmental health. While the report focuses on antimicrobial stewardship in the virtual care landscape, recommendations also emphasize the need for improvement in outpatient and urgent care settings. Antimicrobial prescribing practices in these settings have been slow to change, and educational interventions for prescribers are necessary. The report presents seven high-level recommendations, addressing research gaps, disparities in prescribing and stewardship, and ways to enhance antimicrobial stewardship in virtual care settings. These recommendations can also be applied to outpatient and urgent care settings. Associated PACCARB Working Group This report was compiled by the Antibiotic Access and Use Working Group, and was voted on and approved by the full council at the 17th PACCARB Public Meeting on June 29, 2021. This working group was established in response to a Task Letter* from U.S. Department of Health and Human Services Assistant Secretary for Health Brett Giroir, on behalf of the Secretary of Health and Human Services, Alex M. Azar, II. *People using assistive technology may not be able to fully access information in these files. For assistance, contact the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria by emailing CARB@hhs.gov.