Responsible use of antimicrobials: we all have a part to play

Responsible use of medicines is this month’s hot topic, with particular reference to the use of antimicrobials as we head towards European Antibiotic Awareness Day (EAAD) on 18 November.

Recently I was able to attend two events that echoed the importance of responsible use of medicines in practice, and highlighted the need for robust protocols for prescribing.

RUMA conference, London

The first event was the Responsible Use of Medicines in Agriculture Alliance (RUMA) conference in London, which centred on the following key questions:

• What do we mean by responsible use?
• How can we effectively communicate many of the good initiatives of the profession and sectors we work within, to government and the wider public?
• How can we better monitor where product is going?
• Can we target areas for reduced use without a compromise on welfare or our ability to deal with the impacts of infectious disease?
• How do we promote a multidisciplinary approach to working jointly with our medical (and dental) colleagues?

On the final point, it is important to recognise that even though there is scant evidence that use in the veterinary profession is a key driver within the human population for antimicrobial resistance, we will achieve far more by collaboration.

It’s hard to quantify the outcomes of the conference however the key message was clear. We must continually challenge ourselves to ensure our prescribing protocols are robust and we must communicate key messages on responsible use to those working in food production. We need to fill in the gaps to ensure that the evidence base is robust and we need to develop accurate recording systems so we can monitor use with time.

Collaborating with the medical profession

The second event was attended by community care physicians and organised by Public Health England.

I delivered a short presentation to medical colleagues on how we promote responsible use within practice. I focused on vets as the critical control point in the use of antibiotics on farm, with reference to disease control, looking at diagnosis, pathogen isolation, and sensitivity testing to get the “right drug for the right bug”. I then discussed alternative vaccine use “prevention being better than cure” and looking at the environment to try and disrupt the triangle of host pathogen environment to good effect.

One of our continued calls for action is for the development of rapid pen-side diagnostics to aid our decision making. I was interested to see such a piece of kit at the conference which measures C-reactive protein in patients, and is claimed to reduce prescribing of antibiotics as a first line treatment for respiratory infection at primary healthcare level by 40%.

Resources to promote responsible use

So, what next? EAAD is on 18 November and is a good opportunity to get some key messages out in the public domain. The BVA medicines group (a sub-group of the Veterinary Policy Group) has recently updated two posters for use as an aide-memoire in practice to help us all apply some critical thinking to the way we use medicines responsibly:

• Responsible use of antimicrobials 7-point plan (128 KB PDF)
• Responsible use of anthelmintics (256 KB PDF)

A full colour copy of the antimicrobials poster will also feature in Veterinary Record on 14 November.

We also have two excellent client information leaflets looking at roles and responsibilities of companion animal owners and farmers within the bigger picture.

• Antibiotics – your role as a farmer (99 KB PDF)
• Antibiotics – your role as a pet owner (92 KB PDF)

We all have to play our part, and if you haven’t already signed the pledge to become an Antibiotic Guardian I would encourage you to do so and see if it fits in to your own ‘responsible use’.

JB