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BgVV calls for the reticent and cautious handling of veterinary medicinal products and feed additives

07/1997, 14.04.1997

Along with other institutions the World Health Organisation, WHO, is concerned about the world-wide development of the resistance situation to antibiotics. The main contributory factors to the development of resistances are overuse of antibiotics in human medicine although the use of antibiotics in animals and plants is also under discussion. It is difficult to quantify the share of veterinary medicine in resistance development in medicine. Studies confirm a causal relationship between infections in humans and resistant pathogens from animals. There are no major therapeutic alternatives to the antibiotics used today on the horizon. The Federal Institute for Health Protection of Consumers and Veterinary Medicine, BgVV, therefore calls on precautionary grounds for the reticent and cautious handling of veterinary medicinal products and feed additives.

In veterinary medicine antibiotics and antibiotic substances are not just used for treatment but also for prophylaxis. In animal nutrition feed additives are also used to promote growth. It is this very use which has been the subject of criticism in the past.

With regard to possible resistance development, the then Federal Health Office (BGA) had already imposed a ban in 1974 on the use of tetracyclines as feed additives in the European Community.

In 1985 the BGA was able for the first time to bindingly lay down microbiological criteria for the assessment of so-called performance-enhancing agents. They were incorporated into the "European Guideline for the Assessment of Additives in Animal Nutrition" which came into force in 1987. According to that, growth promoters must be examined prior to marketing authorisation for their resistance potential. Resistance development is also monitored after marketing authorisation has been given. On the European level, moreover, resistance monitoring is to be undertaken for all performance-enhancing agents with antimicrobial action. Substances which were on the market prior to the entry into force of the guideline will be examined within the European Union from 1998 onwards according to the stricter criteria. These "existing substances" include the glycopeptide antibiotic, avoparcin, the use of which was banned in Germany in January 1996 on recommendation of the BgVV by the Federal Minister for Agriculture, Nutrition and Forestry. This ban has been effective throughout Europe since April 1997.

In the opinion of BgVV the health protection of consumers is guaranteed through enforcement of the European guidelines.

BgVV also criticised the widespread, routine prophylactic use of antibiotics in the field of animal husbandry. The risk of resistance selection results more particularly from the use of feed medicinal products at sub-therapeutic doses, for instance when integrating bought in animals into existing stocks. In the opinion of BgVV the prophylactic use of veterinary medicinal products should not be used to compensate for inadequate hygiene.

Even if, in principle, every use of antimicrobial substances in both human and veterinary medicine leads to a selection of resistant pathogens, the animal has an ethical right to treatment by the attending veterinary surgeon. Antimicrobial medicinal products must be available for the treatment of animals. There is no statutory basis for the proposal made in the discussion for specific antibiotics to be reserved for use in human medicine. In the opinion of BgVV so-called reserve antibiotics in human medicine should only be used to a very limited degree as veterinary medicinal products because the efficacy of some of the most valuable medicinal product groups in future can only be guaranteed in respect of resistance development if the principles of rational use of antimicrobial substances are generally complied with.

Resistance development in the veterinary medicine sector has been constantly monitored since 1992 by the Federal Institute for Health Protection of Consumers and Veterinary Medicine. The results are published. Attention is drawn to critical developments. In the case of worrying resistance developments BgVV initiates so-called graduated plan procedures for authorised veterinary medicinal products. A procedure of this kind is currently under way for tetracyclines. The measures may range from warnings over constraints on use to the revocation of the marketing authorisation.

Furthermore, for use in veterinary medicine and animal nutrition BgVV recommends amongst other things:

• strict enforcement of the existing authorisation directives for feed additives
• prescription and use of antimicrobial substances only by veterinary surgeons
• improved resistance monitoring systems with targeted information for veterinary surgeons
• inclusion of growth promoters in resistance monitoring
• definition of assessment criteria for acceptable and unacceptable resistance rates
• antibiotic treatment only after prior exact diagnosis and sensitivity testing of the pathogen
• restriction of application and application duration of antibiotics to the absolute minimum
• use of more recent antibiotics only when there is convincing evidence of a therapeutic advantage or in severe emergencies
• diversification and rotation in the use of antibiotics given the resistance situation along the lines of "calculated chemotherapy"
• prophylactic administration of antibiotics only in conjunction with strict indications and not as a substitute for the necessary hygiene measures
• general reticence in prescribing antimicrobial substances for mass treatment
• optimising keeping and hygiene conditions in animal husbandry
• increased information for livestock breeders about the advantages of vaccines and immunoprophylaxis programmes
• more information for livestock breeders about the risks from the use of antibiotics.

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