Lepianka and Sitkiewicz concluded that "“Horses, especially in sports and breeding environments, are a reservoir of multidrug-resistant bacteria, including β-lactam-resistant strains, even though these antibiotics are rarely used in practice. Mobile genetic elements such as plasmids and integrons promote the rapid spread of resistance genes, increasing the risk of difficult-to-treat infections. The lack of action to reduce antibiotic abuse threatens to lead to increasing deaths and health problems in humans and animals, so rational drug use strategies and education are urgently needed.”"