Antibiotics and similar drugs, together called antimicrobial agents, have been used for the last 70 years to treat both humans and animals that have infectious diseases. Since the 1940s, these drugs have greatly reduced illness and death from infectious diseases. Antibiotic use has been beneficial and, when prescribed and taken correctly, their value in patient care is enormous.
Changes needed in antibiotics use in vet medicine and animal production
Antimicrobial drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective.
However, these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. Both humans and animals infected with antimicrobial-resistant organisms are more likely to have longer, more expensive illnesses and may be more likely to die as a result of the infection.
The level of interest in antimicrobial resistance generated by European Antibiotic Awareness Day, which is held each year on November 18, continues to grow. Last year's event saw a number of developments, the most significant of which was the launch by the European Commission of an action plan against antimicrobial resistance setting out 12 ‘concrete actions’ over the next five years.
This year's event has again been accompanied by a flurry of activity, including a well-publicised warning from England's Chief Medical Officer that ‘antibiotics are losing their effectiveness at a rate that is both alarming and irreversible – similar to global warming’.
The Department of Health, working with Defra and other government departments, is currently in the process of developing a new cross-governmental Antimicrobial Resistance Strategy and Action Plan, which it intends to publish sometime next year. Meanwhile, attention continues to focus on veterinary use of antimicrobials, as various developments have illustrated.
Most recently, earlier this month the European Parliament's Environment, Public Health and Food Safety Committee adopted a resolution which emphasises that ‘more efforts are needed to control the use of antimicrobials in the veterinary sector’ and which ‘strongly disapproves of the uncontrolled prophylactic use of antimicrobials in animal husbandry’.
It also calls on the European Commission to come up with a legislative proposal for the veterinary sector to limit the use of third- and fourth-generation antimicrobials that are critically important in human medicine .
The resolution, which was adopted unanimously by the committee, will be considered by a plenary session of the European Parliament in December. Although not binding on the Commission, it is nevertheless worrying because the Commission is currently in the process of updating legislation on veterinary medicines and has previously indicated that is considering whether the legal framework should be changed to restrict the use of antimicrobials considered critical in human medicine.
More generally, it comes on the back of a series of developments in Europe and further afield which suggest that political efforts to tackle antimicrobial resistance are focusing particularly on the use of antimicrobials in animals at present when effort is needed across the board.
This is illustrated in the European Commission's action plan itself. Although this aims to tackle the problem in both people and animals, it appears to give only qualified support to developing new antimicrobials for veterinary use and contains more actions relating to veterinary use than to use in human medicine.
There is clearly a need to develop new products and preserve the efficacy of existing products for use in people, but it is also important to ensure that effective products remain available for use in animals when they are needed. Unfortunately, there seems to be a political momentum gathering around veterinary use that could be difficult to stop.
Antibiotics are needed for people and animals. In practical terms, it is important that both vets and doctors use them appropriately, for example, by following guidelines on responsible use, while in political terms it currently seems particularly important that vets are seen to be doing so.
Resistance is undoubtedly a problem, but it is one that needs to be addressed at a practical level rather than by kneejerk legislation that could all too easily end up doing more harm than good.