Long acting antibiotic and resistance

Re: Long acting antibiotic and resistance

mariette asselbergs — Sun, 30 Oct 2011 16:42:53 GMT

We have only 5 dairy farms left, all relatively small. Most of them buy annually as many LC tubes times 4 as they have cattle. None of them want samples taken by us for microbiology and sensitivity. If we can at all convince them to send in samples they insist on taking them themselves, with results usually useless (mixed flora,contaminated) and then no more samples. They do not believe we know anything about milkmachine testing. They have Farm Health Plans but these are paper protocols not corresponding to actual practice. We are not an expensive practice but these farmers do not believe our time is worth the money and rather want the "newest" or "stronger" tubes. Now a new practice 25 miles away goes around our clients offering to sell them cheaper drugs..... If this sounds like moaning, thats not what I mean. I am just mainly very concerned about the difference between food chain quality control by vets on paper, and in reality. I agree that farmers their animals cured. However they prefer to have it done by injections instead of management. I am sure there are reasons for that, it is not out of "badness", but it results in a high use of antibiotics in uncontrolled ways on increasingly more crowded farms. VLA is now testing E coli in calves on these farms and they are resistant to all the antibiotics which we have been selling to them....

Re: Long acting antibiotic and resistance

Michael Woodhouse — Thu, 27 Oct 2011 16:59:41 GMT

[quote user="mariette asselbergs"]This means for example that the total mastitis control and treatment is completely outside our control. Farmers do not want our involvement, they do not believe we have something worthwile to offer, they just want us to stock the specific products they want to have. [/quote]

I would disagree with that. The vast majority of our farmers talk to us about their treatment protocols, and they do broadly what we say. With their herd health plan review we look to see the numbers of tubes bought and correlate with treated cases of mastitis. The majority tally fairly well.

In most cases we would use a tube and an injection and (depending on the farm) an NSAID. In their HHP they have a first and a second line treatment. If they want something different it has to go through a vet. You can argue all day which tube is better, but the simple fact is they are all licensed to kill everything and for some reason the blue box works on one farm and the yellow box on another. The bugs may be the same, the antibiotic sensitivity may be the same but some tubes don't work well on some farms. I take heed of that when deciding what to use. All our clients tube for longer than the data sheet says.

I'm a fan on long acting products as the animal gets the full course. In the case of pneumonia the lung damage can take a while to heal and shorter acting products can frequently lead to re-treatments and more antibiotic used overall. As time goes on I am doing more group treatments once there have been a few cases as it seems to offer much better control than chasing the bug around the shed. I'm certain I use less antibiotic overall that way.

Farmers want their animals cured, if we can give advice that leads to more animals getting better they will listen.

Re: Long acting antibiotic and resistance

Hannah Wynne Richards — Thu, 27 Oct 2011 15:28:59 GMT

Mariette

That is one of the reasons I'm glad I no longer do farm work

You can refuse to sell, but the economic problem is that when there were lots of small farms (and people were more deferential towards those more highly qualified ) it was easy to refuse 1 stroppy farmer.Now with a few large farms the loss of 1 client has a greater effect on practice profitability,and the balance of power has swung towards the farmer,not the veterinary surgeon

Wynne

Re: Long acting antibiotic and resistance

mariette asselbergs — Thu, 27 Oct 2011 15:01:07 GMT

Observation These undereduacated farmers cannot LEGALLY acquire antibiotics without the collusion of the veterinary profession, so why are farm animalveterinarians not more selective in whom they sell to ?

Wynne"

That is what I find the most frustrating in the job as farmvet in UK:

The law seems to control antibiotic use in the foodchain with lots of regulations and above all paperwork. But the reality is totally different. Since the law allows us to sell medicines to farmers "for animals under our care", and since in practice this seems to be defined as "animals on farms where we come sometimes", we cannot refuse to sell these medicines (for certain animals, for certain problems, with a protocol of how to use them), but once they are out of our hands, we no longer have any control over their actual use on farm. And as everybody in the sector knows, a farm has its own pharmacy with a range of products, supposedly to be used according to protocols, but when there are sick animals, most farmers open the cupboard, see what they have, inject some things often at phantasy doses, and call us when there is no result. In many cases they do not even want a visit then, but just advise over the phone .

I do not even want to make the point that if we don't sell, then the farmer simply goes to another practice which will. My main point is that even if we sell to farmers we know, for farms where we come, for a certain problem and with a protocol for use, we have no control over the use on farm once the medicines are out of our hands. As private vets we have no right to see the medicine book, and we can certainly not do anything if medicines have been used outside our protocol.

This means for example that the total mastitis control and treatment is completely outside our control. Farmers do not want our involvement, they do not believe we have something worthwile to offer, they just want us to stock the specific products they want to have.

And I find it baffling that within the EU there are on the one hand countries where the vet has to apply each mastitis injector, and on the other hand situations like here where we have no control at all.

It is amazing that there are training programmes and requirements for lay people to sell all kinds of medicines commercially and apparently no requirements at all for farmers who apply the products to food chain animals. The combination of the two often leads to situations of utter frustrations for the vet!

Mariette

Re: Long acting antibiotic and resistance

Evelyn Barbour-Hill — Thu, 27 Oct 2011 14:12:48 GMT

[quote user="mariette asselbergs"]

Since the development of resistance is based on the normal process of natural selection in favour of resistance populations in the bacteria flora, I would think that both long acting and highly effective products would lead to more efficient selection for resistant populations. Long acting by constants election pressure, and highly effective products by a strong selection pressure killing off everything that is susceptible leaving only the resistant ones.

Is my reasoning too simplistic?

[/quote]

To my simple mind this reasoning seems spot on. Would anyone else care to comment on this aspect?

Re: Long acting antibiotic and resistance

Bob Russell — Thu, 27 Oct 2011 11:53:35 GMT

Misuse of antibiotics on farms is a very good reason why POM drugs should not be advertised directly to farmers.

Re: Long acting antibiotic and resistance

Clive Ansell — Thu, 27 Oct 2011 10:24:24 GMT

[quote user="Hannah Wynne Richards"]

Total agreement with Alan

Wynne

[/quote]

I agree too, but this is not exclusive to farm animal practice.

I have recently come across 3 separate clients in different practices, all of whom run small rescue centres where they stockpile antibiotics and dish them out as they feel like. one lady openly admitted then when she is prescribed a 7 day course, she will give only 5 days keeping the remainder in reserve. In another case a cat on continuous Marbocyl had died and the lady continued collecting the repeat prescriptions to stockpile and use on other cats.

One benefit of Convenia (or any other one off long acting injectable that comes along) use would be to stop the indiscriminate use and hoarding of antibiotics tablets.

Re: Long acting antibiotic and resistance

Hannah Wynne Richards — Thu, 27 Oct 2011 09:53:22 GMT

Total agreement with Alan

Observation These undereduacated farmers cannot LEGALLY aquire antibiotics without the collusion of the veterinary profession, so why are farm animalveterinarians not more selective in whom they sell to ?

Wynne

Re: Long acting antibiotic and resistance

Alan Tevendale — Thu, 27 Oct 2011 07:28:59 GMT

One of my biggest pet hates in farm animal practice is the inappropriate use of antibiotics by certain groups of farmers. You will find there is a large number of undereducated farmers who seem to think a one of shot of an antibiotic at a low dose is a good idea when they bring an animal onto the farm from market. If anything is going to promote resistance surely this will.

We have had discussions previously regarding convenia and promotion of resistance and people do seem to be fairly polarised on this. You have to remember that these long acting antibiotics prevent the client (small or farm) from forgeting to give a dose.

In an ideal world I'm sure we would all be doing C&S on all our patients and selecting an appropriate antibiotic from those results - this however cannot happen and as such why not select an antibiotic that should be more likely to have an appropriate affect.

To my mind an interesting area for promotion of resistance is the long tail period that these long acting antibiotcs create after they have dropped bellow their MIC.