Antimicrobials: EC sets out guidance on prudent use of antimicrobials
- Localización: Veterinary Record, ISSN-e 2042-7670, Vol. 177, Nº. 12, 2015, págs. 297-297
- Idioma: inglés
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Resumen
GUIDELINES for the prudent use of antimicrobials in veterinary medicine have been published by the European Commission (EC). The guidelines, which are not binding on member states, are intended to address the principles of prudent use and set out measures for member states to consider when developing and implementing national strategies to combat antimicrobial resistance (AMR).
The guidelines, which were published on September 11, form part of the EC's overall strategy on AMR, as set out in its action plan launched in November 2011. The Commission says that the existence of the guidelines will not prevent it from putting forward legally binding requirements if needed. While aimed at member states, some provisions are addressed to specific parties, including industry, farmers, veterinarians, associations and academia.
Noting that antimicrobials are essential for the medical care and health of animals and livestock populations, the EC emphasises the importance of applying general principles of prudent use ‘as a matter of routine on farms and in veterinary practices’. It continues: ‘The ultimate objective is to reduce the need for antimicrobials by preventing disease. Animal diseases and infections should primarily be prevented by ensuring biosecurity, following good production and good management practices and implementing integrated disease control programmes to minimise the occurrence of diseases and eradicate endemic disease.’ The principles for prudent use set out in the guidelines include the need for the prescription and dispensing of antimicrobials to be justified by a veterinary diagnosis and for the diagnosis to be made following a clinical examination of the animal by the prescribing veterinarian. Routine prophylaxis should be avoided, the EC says, and antimicrobials should be used for metaphylaxis only when there is a real need for treatment. ‘Antimicrobial metaphylaxis should never be used in place of good management practices,’ it states.
The guidelines emphasise the importance of susceptibility testing, correct administration and regular review of the need for antimicrobial therapy. The use of alternative strategies, such as vaccination, for controlling disease is highlighted.
Considering the antimicrobials regarded by the World Health Organization as ‘critically important’ in human medicine, the EC says that these should be used only in situations where a veterinarian has assessed, on the basis of antimicrobial susceptibility testing and relevant epidemiological data, that there is no non-critically important effective antimicrobial available. In exceptional cases, where the use of these antimicrobials under the prescribing cascade is unavoidable and legally permissible, the prescription and final use of the substance should be sufficiently justified and recorded.
The EC states that primary responsibility for the prudent use of antimicrobials lies with the prescriber and the person administering them. The guidelines state that the prescriber of an antimicrobial ‘should be a veterinarian familiar with the history of the herd, flock or animal being treated’. They also state that the prescriber must be able to make the treatment decision ‘in an independent way, so as to avoid a conflict of interest’.
Specific guidelines are aimed at the pharmaceutical industry, feed business operators and farmers' associations, among others. Guidelines aimed at veterinary faculties and agricultural schools state that sufficient attention should be given to the problem of AMR and prudent use of antimicrobials in undergraduate and postgraduate programmes. They also suggest that universities and other research facilities should make AMR a priority research area. Veterinary professional associations should continue to develop their own guidelines for prudent use and promote their implementation, the EC says.
The guidelines also cover areas such as raising awareness of AMR, enforcement and sanctions, surveillance and monitoring, and disease prevention. The use of antimicrobials in different species is considered, with guidance given on responsible use in each.
The EC draws attention to the importance of national strategies on AMR, saying that all member states should develop and implement strategies or action plans for tackling the issue. ‘These strategies or action plans should have a holistic approach, and should cover all sectors and aspects of AMR (eg, public health, animal health and welfare, food safety, consumer safety, the environment, research and non-therapeutic use of antimicrobials). They should involve the relevant competent authorities and all other parties concerned,’ it says.
