The fourth joint inter-agency report on integrated analysis of antimicrobial consumption (AMC) and the occurrence of antimicrobial resistance (AMR) in bacteria from humans and food-producing animals in the EU/EEA (JIACRA IV) covers data from 2019 to 2021. The report aims to identify trends in AMC and AMR over 2014-2021 and to assess the associations between AMC and AMR in both human and animal sectors. Key findings include: - In 2021, the total AMC was 125.0 mg/kg of biomass for humans and 92.6 mg/kg of biomass for food-producing animals. - Between 2014 and 2021, AMC in food-producing animals decreased by 44%, while it remained relatively stable in humans. - Positive associations were observed between AMC and AMR for certain antimicrobial groups and bacteria in both humans and food-producing animals. - For some combinations of bacteria and antimicrobials, AMR in humans was associated with AMR in food-producing animals, which was related to AMC in animals. - Statistically significant decreasing trends in AMC and AMR were observed in several countries for food-producing animals and humans over 2014-2021. - Some countries that significantly reduced AMC also saw increasing susceptibility to antimicrobials in indicator E. coli from food-producing animals and E. coli from human invasive infections. The report emphasizes the need for continued and coordinated action to reduce AMC and AMR, as recommended by the European Council. It highlights the importance of measures promoting human and animal health, such as vaccination and better hygiene, to reduce the need for antimicrobial use.The fourth joint inter-agency report on integrated analysis of antimicrobial consumption (AMC) and the occurrence of antimicrobial resistance (AMR) in bacteria from humans and food-producing animals in the EU/EEA (JIACRA IV) covers data from 2019 to 2021. The report aims to identify trends in AMC and AMR over 2014-2021 and to assess the associations between AMC and AMR in both human and animal sectors. Key findings include: - In 2021, the total AMC was 125.0 mg/kg of biomass for humans and 92.6 mg/kg of biomass for food-producing animals. - Between 2014 and 2021, AMC in food-producing animals decreased by 44%, while it remained relatively stable in humans. - Positive associations were observed between AMC and AMR for certain antimicrobial groups and bacteria in both humans and food-producing animals. - For some combinations of bacteria and antimicrobials, AMR in humans was associated with AMR in food-producing animals, which was related to AMC in animals. - Statistically significant decreasing trends in AMC and AMR were observed in several countries for food-producing animals and humans over 2014-2021. - Some countries that significantly reduced AMC also saw increasing susceptibility to antimicrobials in indicator E. coli from food-producing animals and E. coli from human invasive infections. The report emphasizes the need for continued and coordinated action to reduce AMC and AMR, as recommended by the European Council. It highlights the importance of measures promoting human and animal health, such as vaccination and better hygiene, to reduce the need for antimicrobial use.