AMR Has Implications on Antibiotic/Antimicrobial Use In Veterinary Clinics, but Here's How Practices Can Take Action
Mon, April 19, 2021

AMR Has Implications on Antibiotic/Antimicrobial Use In Veterinary Clinics, but Here's How Practices Can Take Action

 

Antibiotics are critical in treating infectious diseases in pets, said George Valiakos and colleagues of BMC One Health Outlook, a new open-access journal portal. Unfortunately, the daily use of antibiotics has caused bacterial populations to emerge. These bacterial populations are resistant to many classes of antibiotics, which is a public health concern. 

Antibiotic-resistant/antimicrobial-resistant bacteria can hinder veterinarians from applying treatment to pets. They can also be transmitted to humans and other animals and pass their antibiotic-resistant properties to other types of bacteria. Antibiotic-resistant bacteria can pass the said properties through horizontal gene transfer, complicating disease treatment.

Antibiotic and Antimicrobial Use Among Small Animal Veterinarians in Greece (2020)

Valiakos and colleagues sent questionnaires to a total of 70 veterinarians that were mainly operating in Attica, Greece. Attica comprises nearly 50% of the Greek population, where veterinarians are operating solely in small animal practices. 46% of veterinarians said they have a written antibiotic policy in their practice.

90% said pet owners already administered antibiotics prior to bringing the animal to the practice (65% “sometimes”, 25% “frequently”). Every practitioner said they encounter treatment compliance challenges. With regard to microbiological analysis and antimicrobial susceptibility testing, 42% of veterinarians said they use them “frequently” while 56% answered “sometimes.” However, only 6% of veterinarians who use the said laboratory support said they “always wait for the results before prescribing an antibiotic".

When asked what they “prefer” to do even if they may be compelled to do it differently in many cases, 27% of clinicians said they prefer not to use antibiotics while waiting for lab results. Only 73% preferred to resort to an empirical treatment or a clinical “educated guess” when an accurate diagnosis is absent. 88% said they would use antimicrobials postoperatively in clean surgical procedures and half of veterinarians said they would use the antimicrobials in more than 50% of the cases. The researchers found that the veterinarians do not frequently prescribe combinations of different antibiotics, with 67% doing so infrequently and 33% frequently. Treatment periods varied depending on the organ system. In total, skin infections were treated for over 15 days by 60% of practitioners.

Most of them treated urinary (a total of 92%; 47.92% eight to 14 days; 37.50% 15 to 21 days; 6.25% over 21 days), reproductive (a total of 73%; 62.50% eight to 14 days; 8.33% 15 to 21 days; 2.08% over 21 days) disease for more than eight days. Likewise, respiratory diseases were treated between eight to 14 days (60.41%) and 15 to 21 days (22.92%). For ear diseases, they were treated between eight to 14 days (56.25%), 15 to 31 days (25%), and over 21 days (12.50%). Gastrointestinal tract (GIT) infection (47.91%) and eye diseases (58.33%) were treated for three to seven days.  

 

 

What Are Antimicrobials?

Antimicrobials refer to products that kill microorganisms or stop them from multiplying or growing, explained AVMA (American Veterinary Medical Association), a not-for-profit association founded in 1863. They can be naturally occurring or synthetic. Antimicrobials are commonly used to prevent, treat, or control diseases and infections caused by microorganisms. 

Different groups of antimicrobials kill various types of microorganisms such as bacteria, which can be treated with antibacterial products, for example. On the other hand, antibiotics are antimicrobials that can kill bacteria or prevent their growth or reproduction. AVMA said, “All antibiotics are antimicrobials, but not all antimicrobials are antibiotics.” One example of an antibiotic is penicillin, which is produced by Penicillium fungi. Penicillin can kill different types of bacteria. Hence, when used appropriately, it is an effective antibiotic to address infection susceptible to penicillin.

How Does AMR (Antimicrobial Resistance) Happen?

It occurs when bacteria develop the ability to grow in antimicrobial drugs, said Molly McCallister, DVM, MPH, of Today’s Veterinary Practice, a trusted source for peer-reviewed clinical information in veterinary medicine. It is a natural evolutionary practice, but AMR occurs quicker when antimicrobials are misused and overused. Resistance reduces the treatment options to address bacterial infections, making it harder for veterinarians to provide effective therapy to their patients. Hence, veterinarians need to use antimicrobials more judiciously to reduce the likelihood of AMR.

 

 

How Are Clients Affected by AMR?

AMR will be of equal or greater concern for pet owners since it can affect their animals and finances. Issues associated with AMR can include less effective treatment options for infections, leading to more dire results and greater mortality and morbidity. Decreased effectiveness of available treatment plans and prolonged therapy can entail higher medical bills. The risk of transmission of AMR infections from pets to owners or caretakers is also a pressing concern, regardless if it is through the zoonotic spread of transmissible disease or through resistance transfer.

 

 

What Can Practitioners Do About AMR?

Practitioners and clients should be educated on the rational use of antibiotics (and/or antimicrobials), as well as on locally developed antibiotic resistance patterns. This can help clinicians identify problems that arise from wrong practices and inform them of appropriate recommendations and incentives to address AMR. Official guidelines on AMR can be effective in dealing with AMR. Guidelines for the rational use of antibiotics and/or antimicrobials should be compiled by the country’s relevant authorities. Authorities can be a professional veterinary association or a relevant government department. Guidelines should include a “per organ system” recommendations approach to emphasize the most important changes that practitioners need to undertake in their practices.

Systematic antimicrobial use and AMR surveillance should be initiated to inform veterinarians of their initial choice of antibiotic upon the examination of local resistance profiles. Surveillance should involve a larger number of uncomplicated or first-time infections to improve monitoring quality and to provide an accurate perspective of resistance development. It is recommended for veterinarians to reduce the availability of antibiotics without prescription to pet owners. Through the One Health approach, clinicians are advised to educate their clients about AMR and the importance of the rational use of antibiotics on their pets. Veterinarians should be able to explain to pet owners why an antimicrobial is provided, including how AMR develops and how it jeopardizes their pet’s health.  

 

Antibiotics are helpful in treating diseases, but they should be used judiciously to reduce the likelihood of AMR. AMR can contribute to higher vet bills due to the decreased effectivity of antibiotics and available treatment plans.