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Action on responsible antimicrobial use
  1. Suzanne Jarvis

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This week we report on the progress being made in reducing the amount of antimicrobials used by the UK livestock industry within each farming sector (p 172).

The efforts being made are in response to RUMA’s (Responsible Use of Medicines in Agriculture Alliance) Targets Task Force, which at the end of 2017 set targets on antimicrobial use across eight different livestock sectors. This was, in turn, a response to the O’Neill report on antimicrobial resistance, published in 2016, and Defra’s commitment to reducing average use across livestock to 50 mg/kg.

The progress report from RUMA shows the livestock sector is doing very well in meeting the targets they have set. Some sectors have done particularly well in reducing both the overall use and the amount of highest priority antimicrobials (fluoroquinolones, third- and fourth-generation cephalosporins and colistin), but there is no sector involved that is letting the side down.

The success of the task force has shown the value of collaboration, education and also the need to have good data

The success of the task force has shown the value of collaboration, education and also the need to have good data so you know what you are measuring and can be consistent when tracking it.

A letter on p 197 from representatives of the British Veterinary Poultry Association on the reduction in use by the gamebird sector demonstrates the importance of all three factors in achieving the targets and promoting best practice.

But antimicrobial resistance is not an issue restricted to the livestock sector or to the UK.

While those in the companion animal sector have also made progress, it feels as if advancement here is slower, perhaps because the three important factors are not being entirely met.

Collaboration works well within the livestock industry – each sector in the RUMA task force is represented by a farmer and a vet. But in companion animal care, while it is happening to some extent, a more diffuse owner population makes collaboration more challenging. There are organisations, such as the Bella Moss Foundation, which aim to promote responsible use to both vets and owners, but these don’t seem at have gained the same traction it has in the livestock sector.

Education could also be improved. Last summer, we ran a column in In Practice, asking if small animal vets would prescribe vancomycin for a dog with meticillin-resistant Staphylococcus pseudintermedius. Despite BSAVA’s recommendation that vancomycin should ‘probably not be used in veterinary species’, over half our respondents said they would prescribe it as a first choice. The sample was small but it gives a snapshot that the responsible use message is not getting out there.

That leaves data. Again, there is some good data being collected, for example, from SAVSNET and VetCompass. And, as mentioned in our interview with Andrei Balta, the new CEO of the Pets at Home Vet Group, on p 178, the corporates will have large amounts of data that could be useful in optimising responsible use. But again the picture is patchy and the consistency of the data collected is not clear.

There is also the global picture to consider. Irresponsible use of antimicrobials, poor infrastructure, particularly in the shape of water and sewage facilities, and the continued use of antimicrobials as growth promoters in many countries is, as described by Peter Hawkey in our recent roundtable on antibiotic stewardship (https://bit.ly/2voISKZ), the ‘perfect storm’ for resistance developing.

This, along with, for example, the USA’s recent rejection of the World Health Organization’s guidelines on the use of medically important antimicrobials in food-producing animals, shows there is still a lot of work to be done globally to improve responsible use of antimicrobials.

Antimicrobial use is the archetypal tragedy of the commons scenario, but we must put self-interest to the side and make every effort to maintain their effectiveness so that they remain available to those truly in need, both animal and human.

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