The sales of certain types of antibiotics – fluoroquinoles – were down by 35% over four months, from January to April 2022.

That is according to Galway-based vet and former president of Veterinary Ireland, Dr. Conor Geraghty. He was contributing, as a panel member, to a recent MSD Animal Health event – the One Health and Sustainability Conference, which centred around reducing the carbon footprint of farming, and sustainable livestock production.

Addressing new European (EU) legislation that governs the authorisation and use of veterinary medicines, Dr. Geraghty said that while progress is being made by vets and farmers in Ireland, as they transition to a new way of using antibiotics, there is still work to be done.

New veterinary regulation
According to the European Medicines Agency, the Veterinary Medicinal Products Regulation (Regulation (EU) 2019/6) updated the rules on the authorisation and use of veterinary medicines in the European Union (EU) when it became applicable on January 28, 2022. It contains measures to support the availability and safety of veterinary medicines and enhanced EU action against antimicrobial resistance.

However, he pointed to the reduced sales of fluoroquinoles as evidence that vets are, indeed, changing how they use and prescribe antibiotics.

Fluoroquinloes are categorised as ‘highest priority critically important antibiotics (HP-CIAs), or those used as a ‘last resort’ in treatment.

“Fluoroquinolones sales are down by 35% from January to April 2022. So if you are talking to vets, that is because they are only using them in isolated situations rather than prescribing them for farmers to use themselves,” he explained.

A new approach

Dr Geraghty’s colleague, Caroline Garvan who is a superintending veterinary inspector at the Department of Agriculture, Food and the Marine (DAFM) explained that the new legislation, essentially, demands a new approach to prescribing antimicrobials, in the context of anti-microbial resistance (AMR).

“What they are now saying in the legislation is that you cannot prescribe preventively except in exceptional circumstances and for individual animals only.

“There are also controls around metaphylactic use of antimicrobials, so vets have to make a diagnosis and justify prescribing.”

The vet will become the controller in terms of prescribing and use of antibiotics, she said, adding:

“It is putting huge responsibility on vets, and that will be a challenge.”

New veterinary regulation in Ireland
The requirements on prescribing and time limit for valid prescriptions for antimicrobials, including antibiotics, and medicated feed, took effect on January 28, 2022. The implementation date of the prescription requirement for anti-parasitics is now December 1, 2022.

Dr. Geraghty stated that greater clarity is needed, however, around certain aspects of the legislation.

Farmers, he said, are still of the view that they can have a stock of antibiotics in case of an emergency.

The DAFM does state that “there can be a small quantity of medicines on a farm that are essential to protect animal health and welfare” – this may well be a source of confusion for both vet and farmer.

Huge opportunity

The new legislation does provide us with a “huge opportunity” at a time when it is needed most, the DAFM veterinary inspector said.

A paper published recently in The Lancet, revealed that 4.95 million deaths were associated with AMR in 2019.

Researchers identified the six major pathogens that caused these resistance-associated deaths: Escherichia coli, followed by Staphylococcus aureus, Klebsiella pneumonia, Streptococcus pneumonia, Acinetobacter baumannii, and Pseudomonas aeruginosa.

“AMR is the story that we don’t actually hear,” Garvan said.

“What this legislation is doing is it addresses AMR as a public-health issue, but it is also an issue for animal health, plant health, and our shared environment. 

“If we don’t address AMR, we risk having no effective disease treatments for animal, plant and human health and we also put food safety and food security at risk,” she said.

National usage of antimicrobials is still not collected at farm level but that is set to change in order to comply with the new EU legislation.

By January 28, 2027, Ireland must collect all antimicrobial use data from all food-producing animals.

Garvan added:

“This is an opportunity to step up and develop a whole preventative-medicine approach to disease, and that is the only way that we can sustainably produce food into the future.

“This legislation is supporting that and it is also saying that antibiotics cannot be used to compensate for poor animal management and farm husbandry practices. That will be a challenge for practitioners too.”

But, as a profession, she said, vets will have to look at how they use antimicrobials and change their behaviour because the public health challenge is too great. 

It is about moving from “fire-brigade therapy to preventative medicine” she said.