April 2016
Farm & Field

Antibiotic Stewardship

 
Antibiotics can be used at all livestock operations including dairy, beef, swine, sheep and goats.  

Creating a plan for reduced and refined use

Antibiotic resistance is a concern for many consumers in today’s world. The aspect that most concerns, for most consumers, is the use of antibiotics in animal agriculture. We know how careful we are with antibiotics and that there is a withdrawal period for all antibiotics to keep people safe. But consumers don’t know this, so we need to inform them that we are using antibiotics safely. We also know how incredibly important antibiotics can be when treating sick animals. We need to explain antibiotic stewardship, but to do that we need to fully understand what that is.

What does antibiotic stewardship mean? For human medicine it is the right drug, at the right dose, at the right time. But as we know, human medicine is vastly different from animal agriculture medicine.

Dr. Brian Lubbers, DVM, explained that there are two parts to stewardship: identifying the problem and correcting the problem. The best definition for practical antibiotic stewardship is a continuous commitment to reduced and refined use of antibiotics. Lubbers is the director of Clinical Microbiology at Kansas State Veterinary Diagnostic Laboratory.

Reduced use is pretty self-explanatory. It involves keeping animals from getting sick in the first place; this is pre-treatment. Prevention can come in multiple ways including immunity, vaccination, parasite control, nutrition, housing and even genetics. Next you need to identify the root cause for antibiotic need; this is the treatment and post-treatment stage. Then evaluate the effectiveness of management changes; this is the continuous part. If what you are doing is not working, then why continue?

The refined portion is to make sure to use antibiotics proven to either treat or control the disease. Then, once again, evaluate the effectiveness of the antibiotics to be used.

A specific antibiotic stewardship plan for your operation is vitally important, and not difficult to implement. The first step is disease prevention. Your plan should include disease-specific references, diseases that could actually occur on your operation. Then you should be specific about antibiotic selection: which antibiotic, which animals get treated, when, how long, what dosage and withdrawal time. A lot of this will be influenced by your veterinarian’s diagnosis and treatment protocol.

"Emphasize to consumers that disease prevention is part of your antibiotic stewardship plan," Lubbers said.

What is the ultimate goal of antibiotic stewardship? It is to minimize the negative consequences of antibiotic use. But why is that important? Because the negative consequences can be major. The negative consequences of antibiotic use are resistance, residues and regulations.

Let’s discuss antibiotics a little more to be able to better discuss antibiotic resistance. Antibiotics are chemicals that kill bacteria. Lubbers explained that if used incorrectly those bacteria can survive to adapt in the presence of antibiotics; this is resistance. The more adaptive pressure (antibiotic use) raises the likelihood of resistance. When bacteria become resistant, infections are harder to treat. This is one reason why refined and reduced antibiotic uses are important, because if we use less antibiotics there is less adaptive pressure – meaning we can decrease antibiotic resistance.

Antibiotic residues are any amount of an antibiotic above the allowed limit, residues of any drugs remaining in a carcass is illegal. In 2012, the USDA changed their testing method. They have a simultaneous screen for 53 veterinary drugs such as hormones, antibiotics, beta-agonists and anti-inflammatories. This new test can detect parts-per-billion of drugs. Lubbers further explained that as the ability to detect a compound the size of half a paperclip in an entire cow carcass.

If residues are found in animals from a specific operation more than once, then it is placed on a list on the FDA website. On this list, it has the number of offenses, which drugs and at what levels. If it continues for a certain number of times, the FDA will come to the operation and investigate what is occurring.

"We don’t have safe food because we’re missing residues. We have safe food because we have a good surveillance program, a good drug-approval process and good on-farm practices," Lubbers added.

There are multiple reasons that residues can occur. The main ones Lubbers stated were lack of animal identification, lack of proper treatment records, lack of written protocols, failure to train employees or failure to follow label directions. All of these issues can be easily resolved by creating and implementing an antibiotic stewardship plan.

The previous two consequences combine to control the last. The FDA uses residue and resistance data to make new regulations involving antibiotics. You may think that is not applicable to our state or to your operation, but, the truth is, it’s already happening. Recently, there have been numerous regulations passed down from the FDA that directly affect farmers and ranchers. These are Cephalosporin Extralabel Use Restriction, FDA Guidance 209, FDA Guidance 213 and Veterinary Feed Directive.

Lubbers explained that both Guidance 209 and 213 applied to the use of medically important antibiotics in food-producing animals. They essentially limited the use of medicated feed and water, and also led to the creation of the Veterinary Feed Directive.

VFD is a written, nonverbal, statement issued by a licensed veterinarian authorizing the use of a VFD drug or combination VFD in or on animal feed. This can only be in accordance with the VFD drug’s approved labeling. There also has to be a valid Veterinary-Client-Patient Relationship in place. This means that the veterinarian is familiar with the animals on the operation and the vet must be available for follow-up. Extralabel use of feed-grade drugs is prohibited. This directive is still being perfected, but it is proof that regulations are being used to prevent antibiotic abuse.

So how and why should antibiotic overuse, misuse or abuse be prevented? Because it means overall healthier animals and a safer food supply. Antibiotics are used to help treat sick animals, so they are extremely necessary. But they also have the potential to be abused. We as agriculturalists have to prevent this from occurring.

"We have to use the tools we have, to the best of our abilities, trusting that the tools will continue to improve," Lubbers concluded.

Michelle Bufkin is is a freelance writer from Auburn.