Prudent use of Antimicrobials in Farm Animal Medicine
by Carina Cooper, DVM, PhD, Dipl ACVIM – Large Animals
Technical Veterinarian at Vetoquinol, Farm Animals – Western Canada
Antimicrobial stewardship is an integral component of responsible veterinary practice, requiring a concerted effort to ensure the judicious use of antimicrobials. As professionals committed to the well-being of animals and public health, veterinarians play a pivotal role in implementing effective stewardship practices. Antimicrobial stewardship simply relies on “The use of the Right Antibiotic, in the Right Amount, at the Right Time, at the Right Dose, for the Right Reason”.
The concerns with use of antimicrobials always stems from the development of resistant bacterial infections. Although this conversation typically focuses on human medicine, antimicrobial resistance is also a concern in our veterinary practice as well. Each time antimicrobials are used resistant bacteria are selected – we never achieve sterility with treatment. New antibiotics are not being developed quickly, and there are limitations imposed in animal production systems. This can easily lead to our antibiotics becoming less effective to treat common diseases. For this reason, it is important to consider when not to use antimicrobials to avoid their overuse and unnecessary resistance development.
The WHO’s Global Action Plan on Antimicrobial Resistance (2015) serves as a foundational document outlining the critical strategies for combating AMR, and various versions have been developed for the veterinary community as well. The Canadian Veterinary Medical Association has their own guidelines for prudent antimicrobial use available. Veterinarians and producers are urged to adhere to these guidelines, which can be simplified into “The 5 Rs”: Responsibility, Reduction, Refinement, Replacement, Review.
Anyone who uses antimicrobials is responsible for any harm that can be caused beyond the disease being treated. When antimicrobials are used, they need to be recorded, and the response to treatment monitored. Ideally, we should be working proactively to reduce out antimicrobial use through vaccination, biosecurity, and animal husbandry practices whenever possible. Of course, antimicrobials cannot be avoided in all situations. When they are required, they should be carefully considered rather than used empirically. This is where the concept of the “The use of the Right Antibiotic, in the Right Amount, at the Right Time, at the Right Dose, for the Right Reason” comes in to play to refine our antimicrobial use. In other situations, we may not need to rely on antibiotics at all, and instead could seek out a replacement treatment options that promotes health or prevents the disease. Lastly, none of these actions can occur alone, therefore a team review of current management practices is needed to ensure that everyone understands the goal.
We can already begin to see how “The 5 Rs” are reliant on each other and will naturally lead to reduced antimicrobial use!
It is evident that there are roadblocks to prudent antimicrobial use in the veterinary world, as we have grown accustomed to our antibiotics being fairly effective, therefore changing practices can be difficult. There is a burden of cost associated with modifying the diagnostics used and timed taken to properly diagnose a condition, to the best of our ability. Unfortunately, there is no guarantee of optimal therapeutic protocol for treatment of every condition either, therefore guidelines have been developed to help with decision making.
For all of these challenges, protocols can be developed between veterinarians and producers to speed up and simplify some of the hurdles seen with antimicrobial stewardship. In other situations, a review of the biosecurity, cleaning, and disinfection protocols can reduce the exposure to certain diseases, negating the need to treat animals. Standard operating procedures help facilitate the identification of sick animals and manage them based on the veterinary-guided treatment plan. One example is the algorithm developed for the treatment of diarrhea in calves which significantly reduced the used of antibiotics without affecting the overall mortality on farms that implemented it. Regardless of the protocol or treatment plan implemented, farm and medical records are an essential factor in monitoring the efficacy and success of the livestock and the use of antimicrobials.
There is no simple solution because antimicrobial stewardship is a shared responsibility that necessitates a collective commitment from the veterinary community. Through ongoing education, implementation of best practices, and a dedication to diagnostic precision, veterinarians can play a pivotal role in ensuring the sustainable use of antimicrobials for generations to come. Producers in turn can do their part in seeking alternative options to antimicrobials, such as changes in farm management, biosecurity, and vaccination to help prevent disease occurrence.
Vetoquinol Canada supports the Stewardship of Antimicrobials by Veterinarians Initiative (SAVI) and reminds all our partners to review the CVMA veterinary guidelines for antimicrobial use published in 2018 (canadianveterinarians.net/AMU-UAM). Although the SAVI project was scheduled to end in 2023, the efforts, resources, and beliefs live on. To learn more about the Stewardship of Antimicrobials by Veterinarians Initiative, please visit https://savi.canadianveterinarians.net.
More information about antimicrobial stewardship in general can be found in the Farmed Animal Antimicrobial Stewardship Initiative (FAAST) https://www.amstewardship.ca/.