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AgVetLink: Number 52, October 2005

Antibiotic resistance review

The report of the Antibiotic Resistance Expert Panel was publicly released at the New Zealand Food Safety Authority’s annual conference (11-12 October). The full report can be found on the ACVM website along with two peer reviews of the report and the recommendations of the Antibiotic Resistance Steering Group.

Expert Panel conclusions

The Expert Panel concluded that, while it is generally acknowledged that antibiotic resistance in humans is the result of the use and misuse of antibiotics in human medicine, the transfer of resistant organisms from animal and environmental bacteria to humans has also been identified as a potential pathway.

The Panel noted that the “development of resistance in bacteria is a natural response to exposure to antimicrobials and the prevalence of resistance is directly related to the degree of exposure” but they added that conclusions cannot be drawn on the specific relationship between the levels of resistance in animals and the levels of resistance in humans because available information is fragmented.

While research shows that some levels of resistance may be rising in New Zealand, in comparison with Australian, American and European data our rates are relatively low and the Panel considered the preservation of this favourable status should be a priority for NZFSA and industry.

The Panel suggests that resistance levels could be reduced by:

• administering antibiotics only when they are proven to be beneficial

• adopting vaccination and infection control systems (wherever possible) that do not utilise antibiotics

• controlling the pathways by which resistant bacteria can be transmitted to other bacteria (e.g. in food handling situations).

Key recommendations

The Panel made a number of recommendations. Key ones included:

Development of a surveillance and monitoring programme to monitor levels of resistance in animals and provide a clear picture of the New Zealand situation

The Panel found that, although some testing is done by industry, there is no wide-ranging surveillance and monitoring system that would provide information on the prevalence, patterns and trends of resistance levels in animals. The instigation of this programme was also a recommendation of the 1999 report but was not implemented due to the lack of international standards and conflicting priorities. The Panel reiterated that the implementation of this programme is of importance.

The development of ‘best practice’ guidelines for veterinarians in the prudent use of antibiotics

The Panel found that few resources are available to veterinarians to provide guidance in treatment options. Such resources are available in human medicine and provide a ‘hierarchy of drug choice’ and best practice treatment options. The Panel considered that with this information available to them veterinarians would be in a position to make the best choices for treatment and ‘prudent use’ would, in itself, preserve the efficacy of antibiotic products and reduce the need for regulatory intervention.

An ongoing advisory body

The Panel recommended that a group be appointed to provide ongoing advice on antibiotic use in animals and plants, antibiotic resistance and the design and implementation of the surveillance programme.

Recommendations were also made on individual antibiotics but no recommendations were made to ban or restrict use of them.

Recommendations were made to reconsider the registration of two antibiotic groups of high relevance to human medicine at the next review cycle.

Steering Group response

The Steering Group was generally in agreement with the recommendations of the report but felt that some required further clarification or comment. They recommended that parties considering the report should be encouraged to take into account all the information provided and that no part/s) should be considered in isolation. (The complete response of the Steering Group can be found on the website.)

Next steps

Now that the report has been made public, NZFSA will undertake a period of public consultation of approximately four months. Following receipt and analysis of submissions, NZFSA will provide their own response to the Expert Panel report and initiate appropriate action.