Drug innovation traditionally follows a de novo approach with new molecules through a complex preclinical and clinical pathway. In addition to this strategy, drug repositioning has also become an important complementary approach, which can be shorter, cheaper, and less risky. This review provides an overview of drug innovation in both human and veterinary medicine, with a focus on drug repositioning. The evolution of drug repositioning and the effectiveness of this approach are presented, including the growing role of data science and computational modeling methods in identifying drugs with potential for repositioning. Certain business aspects of drug innovation, especially the relevant factors of market exclusivity, are also discussed. Despite the promising potential of drug repositioning for innovation, it remains underutilized, especially in veterinary applications. To change this landscape for mutual benefits of human and veterinary drug innovation, further exploitation of the potency of drug repositioning is necessary through closer cooperation between all stakeholders, academia, industry, pharmaceutical authorities, and innovation policy makers, and the integration of human and veterinary repositioning into a unified innovation space. For this purpose, the establishment of the conceptually new “One Health Drug Repositioning Platform” is proposed. Oncology is one of the disease areas where this platform can significantly support the development of new drugs for human and dog (or other companion animals) anticancer therapies. As an example of the utilization of human and veterinary drugs for veterinary repositioning, the use of COX inhibitors to treat dog cancers is reviewed.

Antimicrobial resistance (AMR) in Escherichia coli from clinically healthy poultry flocks can indicate antimicrobial selection pressure and the potential entry of resistant bacteria into the food chain. Because chicken and turkey production systems differ, aggregation into a single poultry category may obscure relevant AMR heterogeneity. We characterized phenotypic AMR in 880 E. coli isolates collected in Hungary during 2022-2023 from breeder chickens (n = 98), broiler chickens (n = 185), egg layers (n = 127), broiler turkeys (n = 338), and turkey breeders (n = 132). Susceptibility to 11 antimicrobials representing seven class/group endpoints was determined by broth microdilution using CLSI, EUCAST, and literature-derived interpretive thresholds. Resistance profiles were summarized descriptively and by a fixed seven-cluster exploratory k-means analysis. Associations with production type and sample source were evaluated using county-random-intercept mixed-effects logistic models, with county-fixed-effect Firth logistic models used as sensitivity analyses; resistance-count burden was assessed using Conway-Maxwell-Poisson mixed-effects regression. Multidrug resistance was most frequent in broiler chickens (99.5%), followed by turkey breeders (87.1%) and broiler turkeys (84.3%), and resistance patterns differed across production categories. In resistance-count models, broiler chicken and broiler turkey isolates had higher expected numbers of resistant class/group endpoints than breeder chicken isolates (IRR = 1.63, 95% CI: 1.38-1.93; and IRR = 1.33, 95% CI: 1.20-1.47, respectively). Sensitivity analyses showed that several associations were robust in direction, whereas aminoglycoside/aminocyclitol and folate-pathway estimates were particularly model-dependent because of sparse data and limited geographic overlap. These findings support AMR surveillance stratified by poultry species and production category, while production-type associations should be interpreted within the geographic structure of the present sampling framework.