By Hayley R. Springer
Discussions of antibiotic stewardship within the dairy industry typically focus on preventing drug residues in milk and meat produced by the farm. This aspect of antibiotic stewardship is crucial for maintaining a safe food supply, but it is not the only important aspect of antibiotic stewardship. Outside of animal agriculture, discussions of antibiotic stewardship center on preventing the development and spread of antibiotic resistant bacteria. Although we cannot lose sight of the importance of residue prevention in animal agriculture, we also need to embrace the concept of antibiotic stewardship to prevent antibiotic resistance as well.
Antibiotic resistance is a characteristic of a bacteria when it is no longer affected by an antibiotic that should kill it or stop its growth. Infections caused by antibiotic resistant bacteria are harder to treat and can increase the risk of death, whether the infection is in an animal or a person. Often, inappropriate use of antibiotics is blamed for antibiotic resistance, but this statement is not entirely true. Though inappropriate use certainly drives the development of resistance, any use of antibiotics, even for the most appropriate reasons, can lead to more resistant bacteria. Everyone can play a role in improving both human and animal health by embracing antibiotic stewardship practices. In fact, the first core principle of antibiotic stewardship, as presented by the American Veterinary Medical Association (AVMA), is to commit to stewardship. By implementing the remaining four AVMA core principles of antibiotic stewardship, farms can make a commitment to help slow the spread of antibiotic resistance while also benefitting the health and productivity of their livestock.
The second core principle of antibiotic stewardship is to focus on the prevention of disease. Since any antibiotic use can lead to resistant bacteria, reducing the need for antibiotics by reducing disease is an ideal way to prevent resistance. Disease prevention in dairy herds has the added benefits of improving animal wellbeing, reducing veterinary costs, and increasing productivity. This may be implemented through protocols directly targeting animal health, such as vaccination, biosecurity, and colostrum management protocols. While other opportunities may be less obvious, such as training milking parlor staff in appropriate milking techniques to minimize the risk of mastitis while also improving milk let down and parlor turn-over rate. Facility design and management can also improve animal health through assuring appropriate stocking rates, providing adequate ventilation, and good cow comfort. Finally, assuring animals are fed a well-balanced diet gives them the nutrition they need to support their immune system to fight disease, while also improving production. These practices, can be summarized as optimizing health, optimizing housing, and optimizing nutrition. When all three are well optimized the result is not only improved animal health, resulting in less need for antibiotics, but maximal production too, a true win-win for the dairy and for public health.
The third core principle of antibiotic stewardship is to select and use antibiotics judiciously. In animal agriculture, veterinary-developed treatment protocols are the hallmark of judicious use. The decision of which antibiotic to use and when is challenging, even for the veterinarian. When choosing an antibiotic, a veterinarian must weigh the ability of the antibiotic to treat the disease at hand, how well it has performed on the farm or nearby operations, how use of the medication may impact public health, the risk of residues, as well as the convenience and ability of the farm to utilize the product properly. A veterinary-developed treatment protocol will provide a description of how to identify the disease, and in some cases the severity of the disease, how to treat an animal identified with the disease, and when to seek further care if treatment is not effective. It may also outline how to manage the animal differently and, if extra-label medications are used, will provide an extended withhold time to avoid drug residues. These protocols not only assure the best antibiotic for the problem is used, but they can also be more cost-effective due to less antibiotic use and improved health.
The fourth core principle of antibiotic stewardship is to evaluate antibiotic use practices. On the dairy, this translates to good recordkeeping, not only of antibiotic use and withhold periods, but also of what diseases are treated and the outcome of treatment. This can help the herd veterinarian identify if a treatment protocol is working well or not. When a protocol is not effectively treating a disease, the herd veterinarian may suggest a change in treatment protocol or may recommend diagnostics to better understand why the treatment is not working. This helps to assure that the best antibiotic for the operation is being used and that resistance is not developing in pathogens on the farm. Good disease records can also provide early warning of diseases that may be increasing in prevalence, allowing for changes in management or nutrition to correct the problem before it becomes even larger. In addition to targeting treatment choices and early problem identification, good recordkeeping is, of course, critical to preventing antibiotic residues as well.
The final core principle of antibiotic stewardship is to educate and build expertise in antimicrobial stewardship. This can be as simple as reading this article, but there is another side of this education that is far more important to antibiotic stewardship. Many of the core principles discussed in this article revolve around protocols. It is important to remember that behind every successful protocol are people. Whether a protocol is targeting treatment, management, or nutrition, it requires good employee training to assure the protocol is understood and implemented properly. Assuring employees understand and know how to implement the protocols associated with their responsibilities is essential to antibiotic stewardship as well as all the added benefits to animal health and productivity that can be achieved with effective management protocols.
Antibiotic stewardship, both in terms of residue prevention and antibiotic resistance prevention, is the right choice to promote animal health, public health, and productivity on a dairy. To embrace antibiotic stewardship, focus on four P’s: Prevention, Protocols, Paper, or Pixels (records), and people. By far, the most important of which is to have people committed to stewardship and well educated in their area of expertise working on the dairy.
Source : psu.edu