Helping veterinarians play an active role in combating antimicrobial resistance

President’s Column: Dr. John de Jong

Across our profession, whether at a veterinary conference or educational seminar or in a JAVMA article, we’ve all heard about the importance of antimicrobial stewardship. And we know how critical it is for antimicrobials to be used judiciously to help safeguard their effectiveness.

Consider these alarming statistics from the U.S. Centers for Disease Control and Prevention:

• At least 30 percent of antimicrobials in U.S. human outpatient settings are prescribed unnecessarily.
• Each year, at least 2 million people in the United States become infected with antimicrobial-resistant bacteria.
• Of those 2 million people, at least 23,000 die as a result of the infection. Many more die of complications from the infection.

As your national association, the AVMA, advised by our Committee on Antimicrobials, has been involved in multiple initiatives in recent months to address the critical issues of antimicrobial use and resistance.

Combating antimicrobial resistance requires a collaborative global One Health approach

At the request of U.S. Food and Drug Administration officials, the AVMA sent a representative as part of the U.S. delegation to a December meeting of the Ad hoc Codex Alimentarius Intergovernmental Task Force on Antimicrobial Resistance. Convened jointly by the United Nations Food and Agriculture Organization and the World Organisation for Animal Health (OIE), the task force is working to revise the Code of Practice to Minimize and Contain Antimicrobial Resistance, and to develop guidance for integrated monitoring and surveillance of foodborne antimicrobial-resistant bacteria. Codex Alimentarius standards relating to food production and food safety influence federal regulations and policy in the United States and other nations. With our members serving in all facets of veterinary medicine, it was both important and necessary for us to attend this meeting and contribute the veterinarian’s perspective.

The AVMA recently teamed with the Canadian Veterinary Medical Association and Federation of Veterinarians of Europe to issue a joint statement that outlines steps to support antimicrobial stewardship. 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. I encourage you to read the full statement in the policy section of avma.org.

In November, our Board of Directors approved new AVMA definitions of prevention, control, and treatment in the context of antimicrobial use. These definitions will make it easier for you to ensure that your use of antimicrobials in practice complies with best practices for antimicrobial stewardship. They also can be found in the policy section of our website.

The AVMA’s presence was felt at the OIE Global Conference on Antimicrobial Resistance, which took place in October and gathered OIE delegates along with experts, policymakers, and representatives of international organizations. Its purpose was to increase understanding of the current global situation on antimicrobial resistance in animals, and to develop recommendations for future control of antimicrobial resistance while protecting animal health, animal welfare, public health, and food security. Staff in the AVMA’s Division of Animal and Public Health presented a poster explaining how incorporating the principles of antimicrobial stewardship into veterinary medical education, continuing education, and USDA accreditation will ensure veterinarians are educated on the key tenets of successful veterinary antimicrobial stewardship and are well-positioned to integrate them successfully into their practices.

The AVMA in September proudly joined the CDC’s Antimicrobial Resistance Challenge, which aims to accelerate the worldwide battle against antimicrobial resistance. In committing to the CDC challenge, we’ve promised to:

• Continue collaborating with the U.S. Food and Drug Administration on veterinary oversight of antimicrobials.
• Educate veterinarians and veterinary clients about antimicrobial stewardship and provide guidance for implementing stewardship plans.
• Assist with enhanced surveillance of antimicrobial use in animals.
• Promote research on infection control, responsible use of antimicrobials, and development of alternatives.
• Engage with key international stakeholders to support antimicrobial stewardship.

In addition to all these efforts, the AVMA provides tools to help our members be active in the campaign to fight antimicrobial resistance. The antimicrobial resources on our website (avma.org/Antimicrobials) have been refreshed and reorganized to make them easier to use, and we’ve added new information to support veterinarians in conscientious decision-making and stewardship.

The depth and breadth of AVMA antimicrobial resources that are available to our members reflect how seriously we take this issue. Veterinarians play a critical role in ensuring the responsible use of antimicrobials in animals. Let’s do our part to ensure that the effectiveness of antimicrobials is preserved for years to come by being good stewards.