Notably, 56 worldwide experts gathered for the Antimicrobial Assessment on Global Aquaculture Production (AGAP) series of workshops to (1) evaluate the current state of knowledge on antimicrobial use and identify existing gaps; (2) formulate strategies to identify ecologically relevant impact indicators and establish thresholds for assessment; (3) identify pivotal socioeconomic factors and effective governance mechanisms essential for implementing monitoring practices in aquaculture and extending them across sectors and countries for aquaculture sustainability; (4) develop pathways to enhance our comprehension between antibiotic use in aquaculture and antimicrobial resistance; and (5) explore potential antibiotic monitoring tools that can be universally adapted and implemented across region and sectors. The main outcomes were a roadmap for establishing investigation priorities on the relevant topics regarding antibiotic use in aquaculture, socioeconomic drivers for using antibiotics and behaviors that need more robust and transparent regulatory frameworks to guide farmers, training on antimicrobial use, and access to veterinarians and extension services agents for education. Overall, the workshop evidenced the power of collaboration in addressing complex global challenges to achieve sustainable aquaculture. Despite diligent efforts, some constraints may have inadvertently narrowed the possibility of having more experts and left some pertinent topics unaddressed, but they are needed in the discussion.

Background: Chilean salmon aquaculture, a sector crucial for global food security, faces persistent challenges from bacterial pathogens, particularly Piscirickettsia salmonis, resulting in substantial antimicrobial use (351.1 tons in 2024). Objective and methods: To address this issue, the “Sustainable Management of Aquaculture Bacterial Diseases” workshop convened 27 experts to develop a roadmap for prudent antimicrobial stewardship, with the goal of informing public policies and industry best practices. Discussions focused on four critical areas. Results: Antimicrobial Resistance Prevention recognized aquaculture’s dual role in antimicrobial resistance development, underscoring its ecological dimension, the need for international collaboration, proactive policy design, and the establishment of comprehensive “One Health” surveillance systems guided by expert committees. Communication and Education identified critical gaps in specialized veterinary aquaculture training and public outreach, advocating for interdisciplinary teams and clear communication strategies, with a projected timeline of a decade for effective implementation. Therapeutic Alternatives acknowledged current limitations of vaccines against P. salmonis but underscored promising Chilean innovations, including the use of plant extracts, gut-microbiota modulation, and passive immunotherapy, as well as the importance of early intervention. Finally, environmental impact discussions revealed data deficiencies in aquatic ecosystems, emphasizing the need for advanced molecular tools, adaptive regulatory frameworks, and harmonized requirements for environmental risk-assessment procedures. Conclusions: The workshop’s findings provide a vital framework for advancing sustainable antimicrobial use within the Chilean salmon industry as a case study. The insights and lessons derived from this sector can significantly contribute to global aquaculture’s transition toward sustainability, providing a solid foundation for developing a comprehensive roadmap and universally applicable recommendations for stakeholders across aquaculture and other animal-farming industries worldwide. This roadmap, with its essential components, is designed to enhance the understanding of AMU in farmed salmon through a One Health approach, incorporating global guidance for all aquaculture stakeholders.