Vets call for tightening of ‘prescription without examination’ rules

Irish vets have called to end practise of prescribing antimicrobial drugs, including intra-mammary mastitis treatments, without conducting a veterinary examination first.

Veterinary Ireland has launched a policy on antimicrobial resistance and, as part of it, calls for to tighten up legislation which allows prescribing antimicrobrials without a vet having hands-on personal knowledge of the animals.

Veterinary Ireland said at its AGM that it wants to see an end to any tolerance in legislation for the long-distance prescribing of antimicrobrials including intra-mammary mastitis treatments for animals. It also wants to see better targeted, intelligence-led enforcement to deal with any illegal supply, sourcing (within our outside of the State), sharing or unethical prescribing of antimicrobrials.

Dr. Vivienne Duggan, President of Veterinary Ireland said Irish vets have been working for some time to reduce the overall use of antimicrobials and eliminate the unnecessary use of AMs in animals; but the regulatory authorities must strengthen and enforce the relevant legislation so as to reduce inappropriate antimicrobial usage.

“Veterinary Ireland recognises and is very concerned about the growing global problem of antimicrobial resistance (AMR) in human and animal medicine,” she said.

Its policy document was prepared by a Veterinary Ireland working group comprising vets working in the food animal, equine, companion animal, local authority and state sectors; alongside vets involved in education, research and industry.

Speaking at the Veterinary Ireland conference, Dr. Joe Collins, Chair of Veterinary Ireland’s Working Group on Anti-Microbial Resistance (AMR) said that, given the nature of the problem, the overall effect of the use of antimicrobials in animals on the development of AMR as it affects both human and animal disease, will not be accurately determined until all countries or jurisdictions legislate for prescription-only use of these drugs, regulate all routes of supply and take a strategic approach to the reduction of the general usage of antimicrobials in both humans and animals.

“We must not confuse the issue of anti-microbial resistance (AMR) with the separate subject of antibiotic residues in food, which is well controlled through observing adequate withdrawal periods when a sick animal needs to be treated, thus preventing the occurrence of antibiotic residues in food of Irish origin.

“The presence of AMR bacteria in food should be managed by proper production, handling, processing and cooking of food. Food quality is taken very seriously in Ireland and it is produced to a very high standard. We must be careful that we do not import food that isn’t produced to a similarly high standard with regard to both antibiotic residues and AMR bacteria.”

The Veterinary Ireland Policy on AMR’s includes eight recommendations to promote the prudent use of antimicrobials, only in accordance with best practice; and the responsible role of vets in the control of AMR.

Veterinary Ireland’s Policy on Antimicrobial Resistance (AMR) – Summary Recommendations

1. A national educational campaign should be conducted by stakeholders including Veterinary Ireland as well as DAFM, VCI, AHI and the IMB (aimed at each section of the AM supply chain from manufacturer to vet/other wholesaler/retailer to end-user) in order to promote awareness of:
a. The risks posed by AMR;
b. The progress made on replacing AMs in veterinary medicine with preventative measures;
c. The difference between antimicrobial residues in food and anti-microbial resistance;
d. The reasons why antimicrobial use should be restricted in line with prudent use policies.
2. There should be appropriate legislative change (with enforcement) in relation to the prescribing/use of antimicrobials in animals:
a. The prevention, by DAFM of the acquisition by farmer purchasing groups of large amounts of antibiotics from rogue traders both within and outside the State, for use in the future without a veterinary consultation.
b. Schedule 8 and Regulation 43(9) of the European Communities (Animal Remedies) Regulations, 2007 (ARR) should be repealed to ensure that intramammary antibiotic remedies can be prescribed only as per other antimicrobial products for animals.
c. Ethical Veterinary Practice (as per the Veterinary Practice Act of 2005) should be enshrined in the legal enforcement of the ARR.
d. DAFM (the Department of Agriculture) and the VCI (Veterinary Council) should apply a conjoined approach to the enforcement of legislation such that Registered Veterinary Practitioners (RVPs) prescribing antimicrobials operate through a registered veterinary premises and demonstrate on-going and real, not nominal, veterinary clinical contact with animal keepers.
e. AMs should only be supplied to a registered veterinary practitioner at their registered veterinary practice.
f. Legal and financial penalties should be levied on commercial companies that employ RVPs to supply antimicrobials outside ethical veterinary practice.
3. Herd/group treatment of animals with antimicrobials should be limited to cases where on farm veterinary involvement deems the need. The practice of mass medication should be reviewed at national level in line with EU recommendations.
4. The principles of Veterinary Ireland’s policy document “Sustainable Animal Health” should be incorporated into Food Harvest 2020, in order to minimize expansion-related disease and associated AM usage.
5. Funding should be made available by DAFM to promote PVP led on-farm technology transfer and risk assessment in order to reduce disease levels and hence antimicrobial usage.
6. Bord Bia Quality Assurance schemes should insist on the requirement for a meaningful on-farm risk assessment and antimicrobial management plan by the farms’ PVP, the fee for which should be paid centrally. The level of reduction in declared antimicrobial usage on these farms over a period of time could then be assessed.
7. Funding should be ringfenced for Research & Development into novel antimicrobials or alternatives to conventional antibiotics and consideration given to either patent extension for novel products and/or a levy on generic antimicrobials.
8. Critically important antimicrobials should be recategorised as Veterinary Pracitioner Only (VPO), to restrict usage.

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