Antimicrobial resistance (AMR) is a scourge that inflicts increasing damage in veterinary and human medicine. More and more resistant bacteria are catalogued. In veterinary medicine, we just have to think of methicillin-resistant Staphylococcus pseudintermedius (MRSP), the canine version of methicillin-resistant Staphylococcus aureus (MRSA), which more and more compromises success in the treatment of pyoderma in dogs.
Veterinary medicine is now faced with an important challenge. To find a balance that allows veterinarians to optimize the health and welfare of animals while preserving the efficacy of antimicrobials (AMB). Otherwise, their use will be at risk in veterinary medicine.
Conscious of this animal and public health issue, in November 2013, the CVMA Council declared that the prudent use of AMB would be its strategic priority for 2014.
Here is a summary of some initiatives addressing the prudent use of AMB in which the CVMA is participating.
In 1998, the CVMA developed a Position Statement on Antimicrobial Use in Animals. Find it on the website (www.canadianveterinarians.net/documents/antimicrobial-use-in-animals#.U6hV3_l5M1I).
In 1999, the CVMA developed General Guidelines on the Prudent Use of Antimicrobials in Animals (www.canadianveterinarians.net/documents/cvma-general-guidelines-prudent-use-of-antimicrobial-drugs-in-animals-1999).
In 2008, the CVMA published Antimicrobial Prudent Use Guidelines for Beef Cattle, Dairy Cattle, Poultry and Swine (www.canadianveterinarians.net/documents/cvma-antimicrobial-prudent-use-guidelines-2008-for-beef-dairy-poultry-swine). The Ordre des médecins vétérinaires du Québec later acquired permission to use this document for the benefit of its members.
In 2012, a Position Statement on the Importation of Veterinary Products was also produced (www.canadianveterinarians.net/documents/importation-veterinary-products#.U6hWxPl5M1I). This Position Statement aims to counter the legal loophole that allows the importation of drugs in Canada for one’s own use. Because of this loophole, antimicrobials could be imported into the country by producers without any veterinary supervision. Thanks to lobbying efforts by the CVMA and its partners in Health Canada’s Veterinary Drugs Directorate, the problem should soon be resolved.
A Position Statement on the Importation of Active Pharmaceutical Ingredients (API) was approved by the CVMA Council during the meeting in July in St. John’s. APIs can take various forms, including bulk antibiotics, before being transformed into their final therapeutic form. Antibiotics that are in an API form can be imported and used by producers without any veterinary supervision.
A CVMA Working Group, composed of small animal practitioners and representatives from academia, the pharmaceutical industry and human medicine, is now writing guidelines for the treatment of various bacterial infections in dogs and cats. Their first accomplishment is the CMVA Antimicrobial SmartVet App, an application for smart phones and tablets (iOS and Android), which deals with urinary infections in dogs and cats. This app has been available to all veterinarians since March 2014. The next application will deal with pyoderma.
The CVMA was a member of the Organizing Committee for the most recent Canadian Conference on the Prudent Use of Antimicrobials in Agriculture and Veterinary Medicine (www.antimicrobialcanada.com/). This conference assessed Canada’s performance in the prudent use of antimicrobials and identified projects to be undertaken in the future. A list of recommendations was developed during this conference and a special committee on the use of antimicrobials was struck to implement these recommendations. The CVMA sits on this committee.
“Prudent Use of Antimicrobials: A New World Order” was the topic of the Summit of Veterinary Leaders, held last July in St. John’s, Newfoundland. Specialists from Canada, the United States and Europe discussed various aspects of the prudent use of antimicrobials.
The Canadian Medical Association (CMA) and the Public Health Agency of Canada recently asked the CVMA to cooperate in the development of their respective position statements on AMR, which is an excellent sign of openness towards the CVMA and veterinary medicine in general. The CVMA was also involved in other initiatives pertaining to AMR.
As you can see, your Association is very active and very concerned by AMR. Is this enough? Unfortunately not!
A National Strategy on the Prudent Use of Antimicrobials is crucial to respond effectively to the growing concerns raised by AMR. Many stakeholder groups are concerned by the scourge, but there are no concerted efforts among the various groups. It is essential that the medical and veterinary communities work together in order to effectively address this problem. It is what the United Kingdom has done and we should carefully evaluate their initiative.
In closing, I would like to thank Dr. Warren Skippon, manager, National Issues and Animal Welfare, for his valuable help in writing this article.
Footnotes
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