Veterinary groups release statement on combatting antimicrobial resistance

Veterinary organizations in North America and Europe have teamed up to combat antimicrobial resistance while ensuring the continuing availability of medications essential for human and animal health.

The American Veterinary Medical Association (AVMA), Canadian Veterinary Medical Association (CVMA) and Federation of Veterinarians of Europe (FVE) have released a Joint Statement on Continuous Monitoring of Antimicrobial Use and Antimicrobial Resistance. The statement describes broad steps and strategies veterinarians around the world can take to preserve the effectiveness and availability of antimicrobial drugs while safeguarding animal, public and environmental health.

“Antimicrobial resistance doesn’t recognize borders, so efforts to combat antimicrobial resistance need to cross borders as well,” said Dr. John de Jong, AVMA president. “This joint statement is an important step in recognizing ways we can work together to prevent resistance and ensure that antimicrobials continue to be used judiciously in animals.”

“As veterinarians, we oversee the appropriate and responsible use of antimicrobials in animals, thereby helping minimize the emergence and spread of antimicrobial resistance,” said CVMA President Dr. Terri Chotowetz. “By working together, we are demonstrating our professional responsibility in supporting the overarching international strategy on antimicrobial resistance and use.”

The statement makes the following recommendations:

• All countries shall have a robust regulatory system in place in respect to the authorization and manufacture of human and veterinary medicinal products, including antimicrobials. In addition, a legislative system shall be in place to regulate the distribution and sales, including internet sales, of these same medicinal products.
• Illegal manufacture, distribution or sales of medicines shall be prosecuted.
• Medically or critically important antimicrobials, as defined by the relevant national health authority, or in its absence, the World Health Organization, shall only be administered to animals with the oversight, in accordance with national legislation, of a licensed veterinarian.
• In order to evaluate the effectiveness of these actions, a robust global network of surveillance and monitoring systems for antimicrobial use and resistance development shall be established. Antimicrobial use shall be monitored both in the human and animal health sectors and any other sector in which antimicrobials are used. The levels of antimicrobial resistance shall be monitored in people, animals, food products and the environment.
• Easily available, effective, rapid and standardized diagnostic tests shall be available in order to carry out susceptibility testing. Results of these tests shall be made available to facilitate evidence-based decisions about antimicrobials. Development of national or regional level databases for collecting and sharing susceptibility data and metadata is encouraged. The use of modern techniques such as genomics, which trace the origin and circulation of bacterial strains, should be promoted as appropriate in accordance with available resources.
• Sufficient funding shall be available for further research and development of rapid and affordable diagnostic tests.
• In order to establish a truly One Health system and to be able to compare what is happening in the different sectors, harmonized standards for measuring, evaluating and interpreting data on antimicrobial use and resistance need to be developed. The AVMA, CVMA and FVE shall support the work of the OIE and European, Canadian and American agencies in this area.
• Veterinarians must retain access to effective antimicrobials for therapeutic purposes for animals suffering from a bacterial disease in order to safeguard animal health and welfare and public health; therefore, antimicrobials must not be unilaterally limited for use in humans only.
• Record keeping at the patient or practice level is essential for the evaluation of the success, and where necessary, modification, of antimicrobial treatments. In addition to the evaluation of individual cases, there is also a need to monitor the overall use of antimicrobials in animals, both in food producing animals as well as in companion animals.
• The collection of significant and informative data is essential to enhance the responsible use of antimicrobials and control misuse and minimize potential resistance development.
• The AVMA, CVMA and FVE shall call on all organizations working to address antimicrobial resistance at a global level (i.e., OIE, WHO, TATFAR, and others) to ensure that our organizations are always consulted.
• The AVMA, CVMA and FVE shall call upon their members, veterinary professional organizations, all veterinarians, veterinary technicians and animal keepers to actively engage and contribute to the collection of relevant data on antimicrobial use in animal health and on the occurrence and spread of antimicrobial resistance.
• The AVMA, CVMA and FVE shall call on decision makers to ensure that when trade standards are established and agreed to, these take into account the monitoring of antimicrobial use and resistance development and antimicrobial stewardship.
• The AVMA, CVMA and FVE shall collaborate in promoting responsible use of antimicrobials in animal production and animal care in all countries, and in particular, in the developing world.
• The AVMA, CVMA and FVE, shall continue to take a leadership role in promoting global antimicrobial stewardship.