First of all, the idea of veterinary oversight regarding the use of antibiotics in animals is nothing new. However, as of December 1, 2018 what animal owners will notice as “new” regarding the purchase of all antimicrobials for animal health is the need for the involvement with a veterinarian to ensure prudent use of antibiotics.
New federal regulations will require all antimicrobials used in animals be under the oversight of a registered veterinarian and will require a medical record and prescription be generated prior to their purchase.
The intention of this initiative is to address the development of antimicrobial resistance which has recently been recognized by the World Health Organization (WHO) to be an urgent global concern.
Antimicrobial resistance happens when micro-organisms such as bacteria, fungi, viruses, and parasites change when they are exposed to antimicrobial drugs. Antimicrobial drugs include antibiotics, anti-fungal, anti-viral and anti-parasitic agents. Antibiotics are only one of many drugs that belong to the class of antimicrobials, although the two terms, antibiotics and antimicrobials, are often used interchangeably to mean the same thing. Micro-organisms that develop antimicrobial resistance are sometimes referred to as ‘superbugs.’ As a result, the medicines become ineffective. Health-care professionals, both in human and animal health rely on antimicrobials to treat, prevent and control infections.
The WHO is leading multiple initiatives to reduce antimicrobial use and address antimicrobial resistance in order to avoid the emergence and spread of antibiotic resistance. This includes optimal use of antibiotics in both humans and animals.
In accordance with the WHO, federal regulatory bodies such as Health Canada recognizes that only veterinarians operating within a veterinary-client-patient relationship (VCPR) have the necessary training to assess the health of the animals and to diagnose disease conditions. By determining the need for antimicrobial treatment, veterinarians can ensure that the right antibiotics at the correct doses are prescribed and administered to effectively manage disease in animals.
So what does this mean for the individual horse owner? In the past, farm and ranch supply stores have been licensed to sell a variety of over-the-counter (OTC) animal health products, including antimicrobials such as procaine penicillin G and tetracyclines. However, effective as of December 1, 2018 the status of these and other antimicrobials will be added to the federal veterinary prescription drug list.
With these new regulations in place animal owners will no longer be able to visit a veterinary practice or medicine outlet (such as a farm supply store or feed mill) to pick up antibiotics for treating sick animals, as has been done in the past without first establishing a valid veterinarian-client-patient relationship (VCPR). The VCPR is necessary to establish a need for antibiotics and generate a prescription. A prescription is a direction issued by a registered veterinarian that an animal or group of animals be treated with a specified drug at a specified dose for a specified period of time for treatment of a specified condition. In order to issue a prescription, a veterinarian must document that a valid VCPR exists.
The limits of the VCPR will vary with the experience level of both the veterinarian and the animal owner. Each situation will be different and will depend on the veterinarian’s professional judgment and the presenting circumstances of the animal or group of animals in question. However, in general all animal owners, including horse owners, will notice a greater degree of vigilance from the veterinarian and their support staff in establishing a VCPR prior to the purchase of antibiotics.
Initial contact will begin with a conversation between the animal owner and the veterinarian. The veterinarian will ask questions in order to establish and document a medical record which then determines whether or not there is sufficient need for the use of an antibiotic. It will be at the veterinarian’s discretion as to whether or not “sufficient” need has been established. Circumstances will vary. At times a picture, or short video of, or email about the animal may suffice. Under other circumstances clinical examination of the animal(s) by the veterinarian may be the requirement necessary to fully establish sufficient knowledge of the animal(s) on which to base the assessment, diagnosis and treatment of the medical condition.
The upcoming federal regulations and policy changes will also address the personal importation of medically important antibiotics through avenues that existed in the past such as online purchases.
As part of a global community we all have a role to play in the stewardship and prudent use of medically important antimicrobials. This includes a better understanding of the reasons why regulatory changes are taking place and allows all stakeholders to maintain the highest-quality care for both humans and animals.