Antimicrobial use in companion animals and Good Stewardship Practice

• Autores: John F. Prescott, Patrick Boerlin
• Localización: Veterinary Record, ISSN-e 2042-7670, Vol. 179, Nº. 19, 2016, págs. 486-488
• Idioma: inglés
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• Resumen

  • THE growing threat of antimicrobial resistance (AMR) is focusing human and animal medicine on all aspects of how to improve antimicrobial drug use, so that we can not only try to preserve these ‘miracle drugs’, but also buy the time needed to develop new antimicrobials (AMs) and alternative approaches to the control of infections. In the 70-plus years since the development of antibiotics, we have largely taken their availability and efficacy for granted, but for many bacterial pathogens this is no longer the case. Much of the global focus on AMR in animals has been on reducing agricultural use as a way to mitigate AMR in zoonotic pathogens and commensals that can reach the human population. Only in recent years has antimicrobial use (AMU) in companion animals come under scrutiny, both as a source of emerging important resistance issues (such as meticillin-resistant Staphylococcus aureus [MRSA] and Staphylococcus pseudintermedius [MRSP]) and as a potential source for multidrug resistant (MDR) pathogens for people. Untreatable MDR infections are now being encountered in companion animals.

    To date, studies on AMU in primary care companion animal veterinary practice have been characterised by their small sample size and labour intensive nature. The study by Buckland and others (2016) summarised on p 489 in this issue of Veterinary Record, is a remarkable tour de force that quantifies AMU over a two-year period across 374 veterinary practices in the United Kingdom. It involved nearly 1,000,000 dogs and 600,000 cats. By far the most comprehensive study of its type, it demonstrates the power of mega-data that can be acquired through shared practice software, as well as the tenacity of the authors in sorting through the lack of standardisation in some electronic patient records. An estimated 1473 kg and 58 kg of AMU was found in dogs and cats, respectively. During the two years covered by this study, about 25 per cent of dogs and 21 per cent of cats registered with the practices received at least one course of antibiotics. Most AMU was of beta-lactam class antibiotics. Sixty per cent of AMU events in dogs and 81 per cent in cats were with AMs classified as ‘critically important’ for people using the World Health Organization's (WHO's) criteria, and in 6 per cent of dogs and 34 per cent of cats these AMs were of the WHO's ‘highest importance’ classification. This is an important study since it provides baseline data across the country and points the way both nationally and globally to future use of electronic records as a way of monitoring AMU, and perhaps to the future benchmarking of AMU against the norms across countries, practices and veterinarians.