Veterinarians Urged to Use Caution when Prescribing Antimicrobial Drugs
Antimicrobial drug use has been acknowledged as one of the most important issues facing the medical profession today, due to zoonotic antimicrobial-resistant bacteria like Methicillin-Resistant Staph Bacteria. To assist practitioners, the ACVIM released a consensus statement titled "Antimicrobial Drug Use in Veterinary Medicine" that urges practitioners to employ caution and use drugs conservatively. Published in the July/August 2005 issue of the Journal of Veterinary Internal Medicine, the statement identifies the ethical dilemmas involved in a veterinarian’s charge to cure animals by prescribing antimicrobial drugs and protect public health.
“If all antimicrobial drug use tends to increase the prevalence of resistance in bacteria, then there is no use of antimicrobial drug use in animals that does not have the potential to affect public health,” said Paul Morley, DVM, PhD, DACVIM, chair of the eight-member committee that drafted the statement. “Therefore, the issue of using antimicrobial drugs poses a unique challenge to veterinarians. We want veterinarians to actively weigh the cost-benefit every time [they prescribe an antibiotic,]” Morley explained. Both AAHA and the AVMA have issued position statements about the use of antimicrobial drugs.
Committee members, who represented small and large animal medicine, government, industry, academia, and science, issued recommendations, not directives, Morley stressed in a telephone interview with NEWStat. “It is not intended to take the art out of veterinary medicine,” he explained. The statement urges doctors to use new antimicrobial drugs as a last treatment option instead of the primary line of therapy. “For example,” Morley said, “we shouldn’t generally jump to the last line of drugs for treatment of urinary tract and ear infections, we should start with a lower tier of drugs.” Acknowledging that drug use data is sparse, Morley admitted, “We do not have all the answers. Even among a bunch of experts we could not agree [on specific suggestions], but we are hopeful that if we take a more conservative approach [to drug use], the entire profession will be better off.”
The statement, which includes several recommendations for voluntary actions, includes a suggestion to limit access to antimicrobial drugs to veterinarians, which struck a chord with some industry members. Another concern, voiced during the public comment period, was that the statement might be used against veterinarians in courts of law if it was perceived as a Standard of Care document. However, Morley emphasized that the consensus statement should be used as a guide. “It’s a set of recommendations. We are not condemning veterinarians for specific drug use practices. Instead we hope that this document will aid veterinarians in making practical decisions about how to use antimicrobial drugs conservatively,” he added.