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Focus on resistance

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AFTER a brief lull following a flurry of activity around the turn of the millennium, political interest in combating the development of resistance to antimicrobials used in people and animals has undergone a resurgence. In the UK, this was reflected in a call by the Chief Medical Officer in his annual report for 2008 for the use of quinolones and cephalosporins to be banned in animals to help to preserve their efficacy for human use (VR, April 11, 2009, vol 164, p 444) while, at EU level, consideration is being given to the idea that veterinary medicines legislation should be amended to provide a legal basis to restrict veterinary use of antimicrobials considered critical for human medicine (VR, May 1, 2010, vol 166, p 540). In the European Parliament, it was recently suggested that a proposed resolution on antimicrobial resistance should be amended in a way that could have prevented vets selling medicines directly to farmers and other animal owners in non-acute cases, ‘thus reducing the incentive to prescribe more antimicrobials than needed’. In the event, the proposed amendment was rejected (VR, April 16, 2011, vol 168, p 392), but the fact that it was put forward gives an indication of the way some people are thinking about the subject while underlying the importance of vets being seen to use antimicrobials responsibly.

At global level, the World Health Organization chose antimicrobial resistance as the theme for World Health Day 2011, making use of the event (on April 7) to launch a worldwide campaign under the slogan ‘Antimicrobial resistance: no action today, no cure tomorrow’. Concerned primarily with safeguarding antimicrobials for human use, the WHO's campaign also focuses on the use of antimicrobials in animals. A WHO press release announcing World Health Day included the comment: ‘Collaboration between human and animal health and agriculture professionals is also vital, as the use of antibiotics in food animal production contributes to increased drug resistance. Approximately half of current antibiotic production is used in agriculture, to promote growth and prevent disease as well as to treat sick animals. With such massive use, those drug-resistant microbes generated in animals can be later transferred to humans.’ During World Health Day itself, the WHO's Regional Office for Europe launched new policy guidance on ‘Tackling antibiotic resistance from a food safety perspective in Europe’.*

The WHO's booklet aims to ‘raise awareness of the importance of antibiotic resistance as a food safety issue and the responsibilities of all players in food production to prevent and control the spread of antibiotic resistance through the food chain’. It highlights the role of national governments in taking steps to address the problem and makes recommendations in a number of areas, discussing, among other things, regulation and the development of guidelines on prescribing, as well as surveillance for antimicrobial resistance and research. Among the recommendations are that the need to use antibiotics in animals should be reduced by improving animal health through biosecurity, disease prevention and better husbandry, and that consideration should be given to ‘requiring that antibiotics identified as critically important in human medicine – especially fluoroquinolones and third- and fourth-generation cepahalosporins – only be used in food animals when their use is justified’.

In the UK, the WHO's recommendations relating to the development of prescribing guidelines are reflected in a BVA poster on Responsible Use of Antimicrobials in Veterinary Practice that was produced and distributed in 2009. The poster, along with more detailed guidance, can be downloaded from the Association's website, www.bva.co.uk. Similarly, the UK already has an antimicrobial resistance surveillance strategy, which was last updated by Defra in 2008 (VR, August 23, 2008, vol 163, p 227). This does not mean that anyone can afford to be complacent and it may be that these initiatives will have to be developed further. Meanwhile, coordinated research and surveillance continue to be necessary to determine the size of the problem, the true extent to which antimicrobial use in animals contributes to resistance in human pathogens, and the effectiveness of the measures being taken.

Political pressures aside, there are good biological reasons for using antimicrobials responsibly in people and animals. It is obviously important to preserve the efficacy of antimicrobials for use in people, but products need to be available for the treatment of animals too.

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