Ahead of the European Antibiotic Awareness Day, we talked to Jernej Kužner from our Slovenian member company Krka. With a background in veterinary medicine, medical science, pharmacology and toxicology, he has been a member of Access VetMed’s antimicrobial working group for a decade.
Tell us please, what does the antimicrobials working group do?
We discuss and prepare responses to challenges regarding the use of antimicrobials. The most recent debates have evolved around the categorisation of antimicrobials in animals and on the reserve list for human use. The antimicrobial resistance is a very popular topic to which a lot of people like to take part, but not all the views are based on science.
Why is a working group on antimicrobials needed?
It’s very important that Access VetMed provides appropriate information and responds to public concerns. Antibiotics are still crucial for animal and human health, and we can provide the proper responses and comments. The professionals, such as veterinarians, are well aware. It is the general public that would need to be better informed.
This is continuous work. Every now and then alerts appear that raise concerns and activate discussion. Antibiotics need to be used responsibly and most veterinarians are well aware of this. However, often animal owners have certain expectations regarding the treatment and the veterinarians may feel pressured under these demands.
During the last decade, have you noticed any changes with respect antibiotics?
There is an ongoing pressure and need to reduce the antibiotics use. In the EU, we have managed to decrease the use of antibiotics significantly, as the annual EU and national reports show. They are not used for growth promotion or prophylactic purposes, and for most infections in animals, we still have at least a second or third choice of antibiotic. This shows, we must be doing something right. We will never get to zero level, because some antibiotics will always be needed.
There are also changes in therapies. For example, in the past, antibiotics were often used to treat diarrhoea in companion animals, but now the evidence shows they are not needed in all cases. We have more evidence of how gut microbiome and metabolome are important for immunological response both for animals and humans, and there is growing interest for research on pre- and probiotics in animals.
However, there are still differences between the EU countries but even more so between the EU and other regions of the world. Despite the increasing global awareness, the viable alternatives for animal welfare, such as proper hygiene or technology are not equally available in all parts of the world.
What would you say to those who would prohibit the use of antibiotics in animals?
First of all, they are essential to prevent unnecessary suffering of animals in infectious diseases. Secondly, they are also needed to combat zoonosis. People are in close interaction with animals, so treating animals protects public health as well.
How would you describe responsible use of antibiotics?
There is an abundance of guidelines (for example EPRUMA’s best practice guidelines). The question is, how to communicate it to the public. The message would need to be simple, short, and clear to get through.
The basic principle is that antibiotics are to be used only when necessary and in accordance with guidelines and the product leaflet, SPC. The prescription needs to be based on a diagnosis and pharmacology. Testing is always preferred, if possible. The attending veterinarians are experts as they know the situation in the region and the local resistance rate.
The ideal timing for using antibiotics for treatment is when the infection burden is still low. It is an ongoing debate in the profession, how to establish this threshold. The treatment success needs to be monitored continuously, and in case the treatment is not working, it needs to be altered promptly.
Oftentimes, the treatment of animals also involves emotions and people’s livelihoods. It is important for the veterinarians to be able to manage people’s expectations and tell them clearly what can be done to successfully combat the infection in their animal.