PRODUCERS SHOULD PRACTICE ANTIMICROBIAL STEWARDSHIP

by: Brent Credille
DVM, PhD, DACVIM, Assistant Professor Food Animal Health and Management Program, College of Veterinary Medicine, University of Georgia


Introduction

One of the primary goals of a cattleman is the production of safe and wholesome beef products for future human consumption. To reach that goal, cattle have to remain healthy; and producers must utilize good management practices to optimize the health of their herd. Nevertheless, despite our best efforts, bacterial infections do occur, and antimicrobials are necessary to protect animal health and welfare. In recent years, antimicrobial use practices in production animal agriculture have come under intense scrutiny; and, with this scrutiny, have come new state and federal regulations that will have a dramatic impact on how antimicrobials are used in food-producing species. For example, Guidance for Industry 213 was passed by the Food and Drug Administration in December 2013 and goes into effect in December 2016. This Guidance has the effect of removing all claims for promotion of growth and improvement in feed efficiency in medically important antimicrobials (Aureomycin, AS700, Terramycin). In addition, medically important antimicrobials currently used in feed or water will no longer be available over the counter, and their use will require the input of a veterinarian who has a valid veterinarian-client-patient relationship with the operation in question. More recently, California passed SB 27; this legislation makes all medically important antimicrobials prescription products. As a result, products such as Procaine Penicillin G, LA 200, Tylan and Albon will no longer be available over the counter in that state. While this regulation will affect only California, it is likely that the Food and Drug Administration will follow suit with similar policies that affect cattle producers nationwide. The purpose of this document is to provide producers with judicious antimicrobial use strategies that will protect animal health, preserve antimicrobial efficacy by minimizing the development of antimicrobial resistance, and preserve antimicrobial availability.

Prudent Antimicrobial Use Guidelines

Implementation of the antimicrobial use guidelines outlined here can help reduce animal pain and suffering, protect the economic livelihood of cattle producers, ensure the continued production of safe and wholesome food, and minimize the development of antimicrobial resistance in important human and cattle pathogens. The following recommendations will help improve antimicrobial use practices on your cattle operation:

1. Focus on disease prevention. The use of vaccines, dewormers, biosecurity, appropriate nutrition, and good husbandry will reduce the incidence of disease and the need for antimicrobials. Herd management protocols should be reviewed regularly and changes made as needed.

2. Diagnose sick animals quickly and accurately. Not all diseases require treatment with an antibiotic. Even when animals have an infection caused by a bacteria, there may be other treatment options available that minimize use of antimicrobials on the farm.

3. Select antimicrobials appropriate for the condition being treated. Using veterinary and laboratory advice can help you select drugs that are most appropriate for the diseases encountered on your operation.

4. Keep records. Record the following: animal or group identification; the drug used; the date treated; the dosage used; the route given; and who administered the product. Keep all records and review them regularly. Implementation of Prudent Use Guidelines on Your Operation

Have a Veterinarian-Client-Patient Relationship

One of the most important principles, as it relates to prudent antimicrobial use, is developing a working relationship with a veterinarian familiar with your herd; this relationship is termed the veterinarian-client-patient relationship (VCPR). To establish a valid VCPR, the following requirements must be met:

a. The veterinarian knows your operation, your management and your cattle, and is involved in diagnosis and treatment. This requires regular and timely visits to the operation in question.

b. The veterinarian must be available for follow-up, in case of treatment failures.

c. A producer is willing to follow a veterinarian's recommendations for antimicrobial usage.

A valid VCPR is not in place if a veterinarian simply writes prescriptions, sells drugs, or makes drugs available to you. Veterinarians who engage in practices such as this are breaking federal law and can jeopardize your livelihood. It is also important to note that a valid VCPR is required by federal law when an antibiotic is used in any manner inconsistent with the directions found on the label or if the drug is a prescription product.

Establish Written Treatment Protocols

Diagnosis and treatment of most diseases does not need to be done by a practicing veterinarian in many cases. Recognition of many diseases (pinkeye, respiratory disease, footrot) is relatively straightforward, and treatment of cattle with these diseases can be done effectively and economically by producers or farm staff Nevertheless, working with your veterinarian to establish written disease diagnosis and treatment protocols can help simplify decision-making and improve response to treatment. In addition, written protocols provide accountability and determine liability, should questions about a treated animal arise. Complete treatment protocols should include a definition of the disease and detailed directions for treatment (drug, dose, route, duration, withdrawals, etc.).

Understand What Constitutes Extra-Label Drug Use (ELDU)

Drugs are approved for the treatment of specific diseases in a specific species at a specific dose, route, duration, and frequency of administration. Any use that deviates from what the label allows constitutes ELDU and requires a valid VCPR. ELDU issues are important because approved withdrawal times are based on label directions, and any other use may result in violative residues in edible tissues. There are certain drugs that are prohibited from ELDU in food-producing animals: these drugs are as follows:

a. Chloramphenicol
b. Clenbuterol (Ventipulmin)
c. Diethylstilbesterol
d. Metronidazole (and other members of the same antimicrobial class)
e. Nitrofurazone
f. Medicated feeds
g. Fluoroquinolones (Baytril, Advocin)
h. Glycopeptides (Vancomycin)

Examples of illegal ELDU would be: the use of Baytril to treat diarrhea in a calf; the use of nitrofurazone puffers to treat pinkeye in cattle; and the use of medicated feeds to prevent pinkeye in cattle.

There are other drug classes that are allowed to be used in an extra-label manner but carry significant restrictions on their use. The class that is most relevant to cattle producers is the cephalosporins (Excenel, Naxcel, Excede); any use of this class of drugs in ways that deviate from the label dose, route of administration, or duration of therapy is a violation of ELDU policy. For example, the administration of Excede in the muscle of the neck, as opposed to the base of the ear, is considered illegal. In addition, the administration of Excenel at a dosing rate or dosing frequency higher than what the label allows, for longer than the label allows (2 ml/100 lbs once daily for three to five days), is illegal.

In addition to ELDU that is clearly illegal because of restrictions placed by regulatory agencies, there are situations in which drugs cannot be justifiably used in an extra-label manner because: the risk of a residue is too great; the use is done purely out of convenience for the person administering the medication; or products labeled for the disease are just as effective as, if not more effective than, the product being used in an extra-label fashion. Examples include the use of Banamine intramuscularly and the injection of penicillin into the membranes of the eye to treat pinkeye.

Train People Who Work with Livestock on Your Operation

People working with livestock must be trained to recognize and treat disease according to established farm protocols. These individuals should have input on the development and implementation of protocols, and may provide insight that improves management of different disease conditions. All personnel should be trained using guidelines appropriate for Beef Quality Assurance programs; and all protocols should be reviewed regularly, with changes made as needed.

Conclusion

As new federal regulations come into effect, and as consumer preferences and demand change, cattle producers must be willing to adapt in order to remain competitive. Public pressure is dictating that we change our patterns of antimicrobial use. Producers and veterinarians must be committed to a culture that promotes judicious and appropriate antimicrobial use, in order to minimize the risk of antimicrobial resistance, maintain the long-term effectiveness of antimicrobials currently available, and protect future antimicrobial availability.







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