|Home | About | Journals | Submit | Contact Us | Français|
There’s a bit of a tornado brewing out there, and veterinarians are in the middle of the funnel.
The winds of debate are swirling around concerns that use of the antimicrobial drug ceftiofur in poultry production may be making some bacteria resistant to important drugs used in humans — and that those strains are making their way into humans through the chicken they consume.
The debate is focusing on ceftiofur because it is used for both humans and animals. It is registered for use in turkeys, cattle, and dogs, and is occasionally prescribed by veterinarians for other species, including chickens. This “extra-label” application is both legal and common in human and veterinary medicine; research constantly leads to new applications of existing drugs.
The worry is this: if ceftiofur-resistant strains of bacteria emerge in animals and are passed to humans — say, in the chicken they consume — the effectiveness of the drug in treating human illness might be compromised. Indeed, some have argued that this is already happening.
Transfer through consumption is, however, highly unlikely: proper refrigeration, handling, and cooking eliminate all bacteria present in chicken meat — resistant or not. And there are other explanations for recent regional spikes in anti-microbial resistance (AMR) in bacteria found in humans over the past few years.
But the research — and the heated debate — continues. And veterinarians are at the centre of the storm.
On the one hand, they’re responsible for treating animals effectively in order to relieve suffering and control disease, helping to ensure the security of Canada’s food supply. At the same time, they’re responsible for using drugs carefully and wisely to achieve those ends. That means employing pharmaceuticals properly registered in Canada (unless by special permit), avoiding residue issues through correct withdrawal practices, and prescribing judiciously, at treatment levels that minimize AMR development.
Fortunately, veterinarians can draw on a variety of resources in making their drug-related decisions. First, is a deep knowledge of the issues involved, backed by a wealth of precedent. An increasing number of veterinarians are employing advanced principles of “population medicine,” focusing on moderate and selective drug use to prevent disease rather than waiting for livestock to get sick, then treating.
Canadian veterinarians also have access to detailed guidelines on extra-label use drawn up by Health Canada. And since 2002, they’ve been able to consult an enormous online Global Food Animal Residue Avoidance Database (gFARAD) that offers guidelines on the use of over 1200 drugs and chemicals in animals. The database will be a critical resource for veterinarians exploring the use of potential alternatives to ceftiofur if regulators move to tighten its use.
Finally, the Canadian Veterinary Medical Association is helping its members by opening channels of dialogue with the medical and research communities, and with food producers.
In the meantime, veterinary professionals are increasingly caught up in the vortex of debate. And in a sense, that’s where they belong. By being informed, by using the best tools, and by acting on the basis of solid science and thoughtful ethics, the middle of the storm is precisely where they can do the most good.