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I always think that far too much of the blame is laid at the feet of agriculture where antimicrobial resistance is concerned. Not that I am arguing that animal producers and veterinarians are saints and angels, but I think that they are seen as being far easier targets than the average consumer or medical doctor.
But antimicrobial resistance is important. I find myself in the unfortunate position where I have become allergic to a good few antibiotics. This makes me particularly cautious in a number of ways and on the odd occasion that I do have to take antibiotics, I am always a little bit worried. And what would happen if I became allergic to them all?
So the importance of resistance should never be underestimated, but what is really important is lack of treatment options. It does not really matter if a bacterium becomes resistant to an antibiotic – as long as there are other efficacious options available.
In November, the EU Commission published an action plan against the growing threat of antimicrobial resistance and set out 12 key actions over a five-year period aimed at human and animal use of antimicrobials. The plan has been met with a flurry of responses.
The British Veterinary Association welcomed the plan, but expressed its concern that the Commission had given only qualified support for new antimicrobials for veterinary use. “While the report recognizes the difficulties that have led to the hampering of research into new antimicrobials for veterinary use, we are concerned that there is only qualified support from the Commission for the development of these new medicines for animal use," said Carl Padgett, BVA president.
“Research into new antimicrobials should be supported in both human and veterinary medicine," said Padgett. "We need to ensure the creation of a more predictable regulatory environment to encourage new products for animals to be brought to the market. While the BVA supports the need for a new regulatory framework, any new regulations must not impede the ability of veterinary surgeons to prescribe and dispense medicines according to their clinical judgment.”
And this really is the point. Nobody objects to using resources, whatever they may be, cautiously, as long are still options available to treat disease. “Like all animal medicines, antimicrobials should be used as little as possible but as much as necessary," said Peter Allan of RUMA, which aims to promote best use of medicines on farm in the UK. "Change should come about by evolution rather than revolution, and regulation must be based on sound, scientific risk assessment and not on inappropriate application of the precautionary principle.”
Earlier this month, the British Poultry Council announced that its members had agreed to reduce the amount of antibiotics used in poultry production.
The BPC’s members have agreed to stop the use of all cephalosporins in UK poultry meat production with effect from January 1st 2012. Cephalosporins are not used poultry reared for meat in the UK, but they are sometimes at the breeding stage. Members also agreed to stop the prophylactic use of all quinolones for day-old chicks, although they are currently used only very occasionally, and to review the use of all antimicrobials during production; and to work with the government on options to survey Extended Spectrum Beta-Lactamase/Amp-C prevalence in the UK.
So certainly, agriculture is doing its part, and acting with care and caution. If all pathogenic bacteria become resistant to antibiotics, this, clearly, would be a dangerous situation. However, if restrictions on the veterinary medicines become so tight that there are no options left to treat disease then, from a production perspective, would this be much better?