A veterinary antibiotic policy: a personal view on the perspectives in The Netherlands

To reach a more adequate and responsible use of antibiotics in veterinary medicine a broad approach is required. The growing interest in the optimum use of antibiotics in veterinary medicine is stimulated by awareness of the necessity to prevent the emergence of resistance and the spread of resistant bacteria. This is a matter of primary importance to safeguard the efficacy of antibiotic therapy in animals now and in the future, but will also minimise possible public health risks. As resistance develops in rough relation to antibiotic use, the best way to minimise emergence of resistance, without interfering with optimal veterinary care, is to rationalize the use of antibiotics by, or under responsibility of, a veterinary surgeon. A second further improvement can be reached by developing a veterinary antibiotic policy to prevent emergence and spread of resistance as much as possible. Measures that must be taken in combination are: 1. Establishing a policy for the use of antibiotics jointly by veterinary practitioners and experts resulting in a formulary. 2. Systemic registration and analysis of patterns of bacterial resistance (not only of pathogens but of faecal flora as well) and the use (qualitative and quantitative) of antibiotics in veterinary medicine. 3. Regular feedback of these data to the veterinary practitioners and consultation about the efficacy of the formulary guidelines in daily practise. 4. Systemic monitoring and evaluation the impact of the antibiotic policy and, if indicated, updating of the formulary. 5. Continuous education of veterinary surgeons about infectious diseases and antimicrobial therapy and development of a veterinary audit system. The first step to rationalize the veterinary use of antibiotics was taken by publishing a veterinary antibiotic formulary in 1987, compiled by a group of experts. Despite the fact that this was a pure top down approach and bottom up input from veterinary practitioners was lacking, this first formulary was very well received. However the impact of this formulary on the veterinary use of antibiotics and prevalence of resistance has not been evaluated at this moment. Until now regular and nationwide systemic monitoring of resistance and registration of veterinary use of antibiotics is not practically feasible in the Netherlands. A new formulary, based on a veterinary antibiotic will be published by the end of 1992. However, to be able to evaluate the impact of this policy on the prevalence of resistance and, if necessary, to adapt the policy the development of facilities for resistance epidemiology is urgently needed.