More Changes on the Way for Animal Agriculture and Antibiotic Usage

More Changes on the Way for Animal Agriculture and Antibiotic Usage By Dr. Kevin Cox of Alliance Animal Care

For the last several years, the words “antimicrobial stewardship” have become highly charged buzz words in animal agriculture. As it relates to animal agriculture, the concept of antimicrobial stewardship is a broad goal of using responsible practices to slow the rate bacteria develop resistance to the available antimicrobial drugs. The concept that medically important antimicrobials should only be used when necessary to treat, control, or prevent disease falls within the broad goal of responsible practices. When such practices are necessary, it should be done under the oversight of a licensed veterinarian.

This stewardship concept has been the goal and philosophy of the Center of Veterinary Medicine (CVM) at the FDA as early as the 1990s. The CVM has broad authority to regulate the use of animal drugs including which drugs must be used under the supervision of a licensed veterinarian.

The goal of antimicrobial stewardship in animal agriculture has its roots in the noble goal of public health. While the development of resistant bacteria in animal diseases is troublesome and costly, the concern that methods of antimicrobial resistance could be transferred into bacteria that have human health implications is a far graver concern.

Indeed, several types of bacteria can cause disease in both animals and humans. Antimicrobials have been used effectively for more than 60 years to treat disease in both humans and animals. Misuse and overuse of those same antimicrobials can lead to and promote antimicrobial resistance. The following statement appears in the document Supporting Antimicrobial Stewardship in Veterinary Settings published by the CVM in September of 2018.

“A part of its regulatory mission, CVM is responsible for ensuring the safety and effectiveness of animal drugs, including antimicrobials, and has taken steps to update the approved use conditions of medically important antimicrobials (i.e., antimicrobials important to treating human disease) to support their judicious use in food-producing animals.”

In early 2017, the CVM finished the process of moving medically important antimicrobials used in the feed or drinking water of food producing animals to veterinary oversight. This process revamped the veterinary feed directive (VFD) and moved these antimicrobial agents from over the counter (OTC) to requiring veterinary supervision.

Also, during this process, uses of these medications for production purposes (growth promotion, etc.) were revoked. Since this time, antimicrobials used in feed require a VFD and antimicrobials used in drinking water require a veterinary prescription.

As previously mentioned, the CVM has been moving toward more veterinary supervision for a number of years. The completion of this project in early 2017 was the first major step in restricting access to antimicrobials for animal agriculture. As one might imagine, this process required a lot of input from various stakeholders, producer education, feed retailer education, and a host of new policies, procedures, and oversight mechanisms.

With the completion of the transition of the feed through antimicrobials, the CVM set its sights on other dosage forms (injectable, intramammory, etc.) of the medically important antimicrobials in the mentioned Supporting Antimicrobial Stewardship in Veterinary Settings document published in September 2018.

This document lays out a phased timeline to move all dosage forms of these antimicrobials under veterinary supervision by the end of 2023. As was the case for the feed-through antimicrobials, additional infrastructure will be needed for education and oversight.

However, it is important to remember most of these things already exist for animal drugs that are already script only. Prior to the 2017 changes, a VFD was a relatively unheard-of process. Much education as well as many new policies and procedures had to be completed for the change to occur. In this part of the plan, much of the previous infrastructure will function the same for the coming changes of the additional dosage forms. For this reason, the transition is expected to move quicker and more seamlessly.

What does this mean for producers? Farmers will no longer go to the feed and farm supply store for a bottle of penicillin to treat a sick calf. Producers will no longer be able to buy LA 200 over the counter to treat pinkeye, foot rot, or metritis. All uses of these products will be at the direction of a veterinarian. This doesn’t mean all medicines have to be purchased from a veterinarian but the future purchases will require a script from a licensed veterinarian.

The world is a place of continuous change and animal agriculture is certainly not immune to that law of nature. Animal agriculture and veterinary medicine are already experiencing great change. Technology, e-commerce, and telemedicine will all play major roles in the future of animal agriculture. Relationships with veterinarians will become even more vital as these changes are made.

From an agricultural retail perspective, it will be important to know the direction of the future of antimicrobial usage and regulations to stay relevant in the marketplace. In these uncertain times, nothing seems to be “certain” anymore. While COVID-19 may slow down or delay the implementation of the transition of all dosage forms of medically important antimicrobials to veterinary oversight, it won’t stop it from happening. It is important to be ready!

Kevin Cox is the chief operating officer of Alliance Animal Care, an animal health distribution company based in Tennessee. He is a licensed veterinarian and prior to serving as the COO for Alliance Animal Care, he was the staff veterinarian and animal health manager at Tennessee Farmers Cooperative. Dr. Cox worked in private practice for a number of years in a busy mixed animal practice. Dr. Cox’s primary areas of interest are animal reproduction and preventive medicine. In his spare time, Dr. Cox enjoys riding/ showing horses, equine reproductive work, his family, and his church.