30 Jul 2017
Medicines use in farm animals and the potential for antimicrobial resistance development and transfer to humans is of increasing scientific, public and political concern. Veterinary surgeons must take the lead in driving change: challenging the currently accepted norms of prescribing and administration, advocating and adopting an evidence-based approach to therapeutic decision making, and monitoring patterns of medicines use to identify opportunities for intervention and measure impact, while at the same time partnering with farmers to improve herd health management. This article discusses how such a multifaceted, collaborative approach, which involves the whole practice team working in partnership with farm staff, can be highly successful in achieving and sustaining more responsible medicines use on farm and improving animal health.
Changes to prescribing practices as described in this paper may reduce the selection pressure for AMR. On dairy farms, recent use of third- and fourth-generation cephalosporins is strongly associated with an increased likelihood of the presence of extended-spectrum betalactamase Escherichia coli (specifically CTX-M), while use of first- and second-generation cephalosporins is not similarly associated (Snow and others 2012). For veterinarians interested in responding to the threat of AMR, this work shows that it is possible to achieve marked reductions in the use of CIAs in food-producing animals alongside reductions in total use, while keeping farmers on board and continuing to improve animal health and welfare, and without the need for legislation. The continued use of CIAs as first-line treatments cannot be justified and should be phased out as a matter of priority.
The need for change is clear and our experience is that farmers are keen to play their part. We do not need to wait for legislation to force change upon the livestock sector; these very necessary changes should be led by the veterinary profession in collaboration with livestock producers.
Keywords: leadership, cultural change, CIA, critically-important, AMR, antimicrobial, EVBM, evidence-base, veterinary medicine, collaborative, participatory, practice-wide, sustainable, clinical governance, client, audit.