The overuse of antibiotics is not only evident in the human population, but it crosses over into animals and livestock. We hear from two experts on innovations in the reduction of antibiotic use in their field.
Reducing antibiotic use in livestock
Director, Itinerant Vets ltd and former Chief Vetinary Officer of the UK
It is great to see antibiotic use in UK livestock continue to fall, with significant reductions in all the major species. This results from a real effort in all sectors regardless of the overall level of use in each. The ‘targets task force’, co-ordinated by the Responsible Use of Medicines in Agriculture (RUMA) Alliance, has succeeded in setting stretching goals for each of the eight major livestock sectors against which real progress is being made, driving down use beyond the overall target set by government of 50mg/kg which was met in 2016.
Livestock sectors focus on disease prevention
By aiming to reduce levels of use to as low as possible, taking into account the challenges for each species and production system, the sectors have had to focus on disease prevention. Unlike human populations, where disease has to be tackled across the age groups – from neonates to the elderly and in a range of situations including elective surgery – livestock populations are generally young and healthy and in environments controlled by human management.
Disease can therefore be prevented by good management; keeping animals healthy and less susceptible to disease, reducing exposure to disease by biosecurity measures, and vaccination to make them immune to specific pathogens.
Essential funding for research into vaccines
However, bacterial disease can never be completely prevented. When it happens, we have a duty to use antibiotics responsibly and it is encouraging to see the low and reducing levels of use of high priority critically important antimicrobials (HP-CIAs). Challenges remain in some sectors but I expect progress to continue. To help all the sectors we need to maintain funding for research into new vaccines, management systems and better diagnostics.
Thoughts on rapid diagnostics and antibiotic use
Professor Mark D Fielder
Professor of Medical Microbiology, Kingston University and President of the Society for Applied Microbiology
Targeted treatment is the most effective
One of the clear areas we need to collectively act upon in both animal and human medicine is ensuring we employ targeted treatment when we use antibiotics. Know your organism, treat appropriately and so treat effectively.
This requires the use of a diagnostic tool that can quickly identify the organism, and do so cheaply, be easy to use and robust. All of these factors are important to allow us to provide information to our medical and veterinary clinicians, so they can target treatment and resolve the infection.
However, this is easy to state but harder to act upon. Questions remain such as: What does ‘rapid’ mean? What is ‘cheap’? Does this have to be point-of-care or should we be thinking point of decision making? Additionally, we need to consider that knowing the identity of the organisms doesn’t necessarily mean we know their antibiotic sensitivity profile. All these factors are significant challenges, but they are challenges we can overcome!
Research into the longevity of effective antibiotic treatments
The UK AMR Diagnostic Collaborative is undertaking a large piece of work to help answer these questions. Researchers in universities, research institutes and industry are all working to ensure we have the novel diagnostics we critically need to ensure the longevity of effective antibiotic treatments. These tools not only help protect the drugs we have but also aid in the continued drive to limit the use of antibiotics in both the human and animal sectors.
We need to ensure a continued research funding stream to tackle AMR. New drugs and vaccines are part of the solution, but better diagnostic tools will be critical in determining both organism identity and antibiotic sensitivity patterns.