Response to healthcare professionals’ letter regarding ‘mass medication’ and preventative treatments

In a letter published in the Daily Telegraph today (14 November), a number of healthcare professionals urge Andrea Leadsom MP, Secretary of State for Environment, Food and Rural Affairs and Jeremy Hunt MP, Secretary of State for Health, to ‘immediately introduce a UK-wide ban on the routine preventative mass medication of animals and urgently curb farm use of the ‘critically important’ antibiotics’.

This message is exceptionally disappointing considering the strong directive from those heading human and animal medicine in the UK to stop the ‘blame game’ on antimicrobial resistance (AMR) as we all work together to implement the global One Health AMR strategy.

In fact this type of orchestrated rhetoric, supported by scant facts, is potentially harmful to the health and welfare of our farm animals, pets and horses.

We currently use 37% of the UK’s antibiotics to manage disease and infection, and produce safe food from over a billion farm animals in the UK every year. Strict withdrawal periods mean antibiotic residues in food are not an issue, but overall use, as in human medicine, must fall as farming plays its part in reducing the spread of antibiotic-resistant bacteria.

The farming industry is taking this seriously. In poultry meat production total antibiotic use fell by 43% between 2012 and 2015 and use of some critically important antibiotics (CIAs) halved; in 2016, a further commitment was made to stop the prophylactic use of fluoroquinolones in day old chickens. The vital antibiotic colistin, which for decades was used almost solely in veterinary medicine, has been voluntarily restricted in all species and many CIAs – currently forming less than 1% of annual use – can only be applied by individual injection.

The UK is among the lower users of antibiotics in farming within the EU and, in reducing use by some 60% in the past six years, the Netherlands is now at approximately the same level as us. While we rise to the challenge the Government has set of reducing antibiotic use in farming by around 20% by 2018, we are pushing ahead with setting our own sector-specific objectives to cut and refine use through a RUMA-led Targets Task Force set up earlier this year.

We eagerly await the latest annual UK antibiotic data, to be released later this week, to see what progress is being made and keep focused on the goal of progressively reducing, refining and replacing antibiotic use in a measured and scientifically-robust way. This is despite resistance in humans continuing to be largely attributed to human medicine – studies across five European countries including the UK indicate farm animal use is potentially associated with as few as 1 in every 370 human clinical cases of E. coli infection.

On method of treatment, we need to be clear. Taking away the option, without good reason, to treat preventatively or to administer treatment in the most effective manner or to restrict certain products already being used responsibly and at very low levels, risks creating more severe disease problems and poor welfare.

We need to migrate to methods of managing disease which involve lower use of antibiotics but when disease threatens, preventative treatment, sometimes of groups of animals, can be the most effective and least stressful course of action for the animals involved. Healthcare professionals mirror this when treating meningococcal infections in children.

Caring for the health and welfare of animals is a serious business and one which should not be jeopardised by poor research and avoiding responsibility. During this World Antibiotic Awareness Week, we urge all those in human and animal medicine alike to use this opportunity to find out more about the specific and joint challenges faced by our respective industries, and to come together in sharing knowledge, best practice and responsibility.