By Kate Klimesh,
Just as human medical treatment is cautious about overuse of antibiotics to prevent pathogen resistance to useful medicines, animal treatments too are attempting to lower antibiotic use to prevent pathogen resistance, as well as minimize potential transfer to humans of drug-resistant microbes.
Starting June 11, all currently available over-the-counter antibiotics for livestock will be available only as prescription medications, according to a directive from the U.S. FDA, as recommended by their Center for Veterinary Medicine. This new rule will impact all livestock species.
According to publication PMC4638249 in the American Journal of Public Health, “Of all antibiotics sold in the United States, approximately 80% are sold for use in animal agriculture; about 70% of these are “medically important” (i.e., from classes important to human medicine). There is growing evidence that antibiotic resistance in humans is promoted by the widespread use of nontherapeutic antibiotics in animals. Resistant bacteria are transmitted to humans through direct contact with animals, by exposure to animal manure, through consumption of undercooked meat, and through contact with uncooked meat or surfaces meat has touched.”
Over-the-counter antibiotics are moving to prescription only, to provide more veterinary oversight. Similar to the Veterinary Feed Directive, placing antibiotics under the supervision of veterinarians should result in more judicious use and less antibiotic resistance.
The medically important antibiotics (used by humans and animals) becoming prescription-only include injectable tylosin, injectable and intramammary penicillin, injectable and oral tetracycline, sulfadimethoxine and sulfamethazine, and cephapirin and cephapirin benzathine intramammary tubes.
Some medications are not considered crucial for human medicine and will remain over-the-counter, including: Ionophores including rumensin and bovatec, parasiticides such as ivermectin, oral pre/pro/postbiotics and topical non-antibiotic treatments.
The new regulation on antibiotics by prescription-only is for more than just cows, but for any type of animal that may require antibiotics. According to Janee Kale, Practice Manager of Harmony, Minn., and Cresco Veterinary Clinics, each veterinarian will need to enter into a veterinarian client patient relationship (VCPR). For large herd animals or flock animals, this requires an on-site visit from the vet to evaluate the status of the flock or herd as a whole.
The vet evaluates the group of animals and gets to know the client’s pet or other animals well enough to be able to diagnose and treat any medical conditions they develop. Once the VCPR is established, it is generally good for one year. Any concerns that come up in the flock or herd covered under the VCPR can be called in to that vet, and the vet can then assist in diagnosis and treatment of that animal – in most cases over the phone.
If antibiotics are prescribed, the owners can pick those up at the vet’s clinic for treatment of their animals. Single animals that can easily be brought into the vet’s office don’t need an on-site visit, but can be diagnosed and treatment prescribed in the vet’s office.
This new regulation doesn’t change the fact that veterinarians have always needed to establish a VCPR to prescribe any treatments. Now, they simply include antibiotics as a prescribed-only treatment. The listed treatments are simply no longer available over the counter.
According to the American Animal Hospital Association (AAHA), the veterinarian-client-patient-relationship (VCPR) is the essential basis for interaction among veterinarians, their clients and their patients. It is critical to providing quality veterinary care and vital to animal welfare by allowing a veterinarian to regularly assess an animal’s entire physical status, family environment and to regularly communicate with the owner. AAHA defines VCPR to require all of the following:
The veterinarian has assumed responsibility for making medical judgments regarding the health of the patient and the need for medical treatment, and the client (owner or caretaker) has agreed to comply with the veterinarian’s instructions.
The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of its medical condition. This means the veterinarian has physically examined the patient within the past 12 months, or more frequently as dictated by the age of the patient, medical condition or treatment therapy such as with controlled substances.
The veterinarian is available for ongoing care of the patient or has arranged for emergency coverage or continuing care and treatment of the animal by an appropriate veterinary professional.
The veterinarian maintains complete and legible medical records, including assessment and treatment plan, in such a way that another veterinarian will be able to proceed with the continuity of care and treatment of that patient.
In specific situations (e.g., rescue shelters, disaster response, hoarding intervention situations) “patient” may refer to a group of animals and “sufficient knowledge of the patient” means the veterinarian:
• conducts medically appropriate and timely visits to the facility where the animals are housed
• conducts examination of representative patients/animals and review of medical records and laboratory or diagnostic procedure records
• consults with those individuals providing care to the animals regarding ongoing health management programs
Contact your local extension educator with questions.