Safeguarding the future of antibiotics is our moral responsibility as vets

You don’t need me to remind you of the dangers we face if we do not act now to tackle antibiotic resistance. You are no doubt well aware that it is the biggest threat to modern medicine and, if we do nothing, could be responsible for 10 million deaths per year by 2050. This is the reality of the threat we face – yet these messages can make the problem feel overwhelming and insurmountable.

As vets, however, you are in a position where the day to day decisions you make can make a real, tangible difference. You are also at the sharp end of the debate. Faced with a client who wants to do all they can to safeguard the welfare of their animal, or a farmer that wants to avoid any loss in production, it can be hard to stand firm and insist that antibiotics are not the answer.

Committed to reduction

Last September the Government set out ambitious commitments to reduce infections and prescribing in both human and animal health – recognising the need for a One Health approach. Most notably for animal health were commitments to further restrict the use of antibiotics critically important to human health, setting sector-specific targets and reducing antibiotic use in farming overall to 50mg/kg by 2018 – around a 20% reduction from 2014 figures.

These commitments are ambitious and tough, but achievable. With the emphasis on changing prescribing practices the spotlight continues to fall onto vets. Although it’s clear that change requires your clients to share the same ambition to preserve antibiotics, as the gatekeepers, the burden of responsibility will always be placed onto the prescriber – you, the vets.

Antibiotics in farming

So a year on from these commitments where are we now?

The predominant area of scrutiny was, and continues to be, use of antibiotics in farming – and this year much activity has been going on in this area behind the scenes. RUMA (Responsible Use of Medicines in Agriculture) established a Task Force to respond to the challenge of sector-specific targets. The vets, farmers and representatives of industry bodies who make up the Task Force have been consulting with their colleagues in the wider industry to identify meaningful objectives to reduce, refine or replace antibiotic use. After many months of work they are now set to announce sector-specific targets at their conference, jointly hosted with the Veterinary Medicines Directorate (VMD), at the end of this week.

The fact these targets have been determined by experts and peers in each sector will be a catalyst for vets to have more challenging conversations with farmers. They set a clear expectation for vets working with livestock to conform to prescribing guidelines. We want farmers to understand that vets are there to help with both prevention and cure – that the need to reduce antibiotic use is also an opportunity to be proactive and look for ways to improve biosecurity and husbandry practices, including vaccination, to stop disease in the first place.

What next?

Among all this challenge it is encouraging to see momentum for change, in part down to the hard work of vets. Last November the VMD published its annual sales report showing a 9% decrease in antibiotics sold in 2015 for use in use in animals in the UK. This was a four-year low, continuing a ten-year downward trend showing the UK is on track to achieve the reduction target.

This week the VMD will publish figures for 2016 and it will be with great interest we watch to see if this trend continues. It is inevitable that the rate at which use is declining will slow over time after an initial fall, once we have harvested all the low-hanging fruit and face the knottier areas where reduction is not straightforward.

But this is a challenge we absolutely must meet, and a conversation we must continue to have with clients who insist on antibiotics when they are not needed. We need solidarity across the profession; no veterinary professional must offer an easy route to access antibiotics where they are not justified, and our code of professional conduct obliges us to use antibiotics responsibly.

I want to encourage you to allow the very real threat of losing the efficacy of antibiotics, or even access to those most important to human health, to motivate your prescribing decisions. To continue to prescribe where there is evidence that it is necessary but also to have conviction to say no when antibiotics are not needed, or can be avoided by improved management. You are making a difference and any actions you take now will ensure antibiotics continue to save lives for generations to come.

More information

• Our special blog series on antimicrobial resistance, AMR in Focus, invites experts from the fields of veterinary science, academia and government to share perspectives on key achievements, latest research and future action needed to tackle this serious issue. All opinions in the blogs reflect those of the writer.
• For more discussions on antimicrobial resistance, join us at BVA Congress at the London Vet Show (16-17 November) for a Friday afternoon session on 'The psychology of antimicrobial resistance: what can social science tell us?', featuring David Brodbelt, Professor of Evidence-based Veterinary Medicine at Royal Veterinary College; Ian Donald, Emeritus Professor of Psychology and Director, Mulberry Research & Consulting Ltd, and Kristen Reyher, Senior Lecturer in Farm Animal Science at the University of Bristol.