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Full antibiotic course ‘unnecessary’ - study
NOAH says animal keepers should continue to follow their vet's advice about using antibiotics.
Experts claim stopping treatment early encourages AMR

The time has come to drop the message that patients must always complete a course of antibiotics, according to experts in the British Medical Journal (BMJ).

Writing in an Analysis article, the authors argue there is little evidence to support the idea that stopping antibiotic treatment early encourages antibiotic resistance. In contrast, they claim that patients are put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary.

‘Research is needed to determine the most appropriate simple alternative message, such as stop when you feel better,’ they write.

‘Until then, public education about antibiotics should highlight the fact that antibiotic resistance is primarily the result of antibiotic overuse and is not prevented by completing a course. The public should be encouraged to recognise that antibiotics are a precious and finite natural resource that should be conserved.’

But the National Office of Animal Health (NOAH) says that animal keepers should continue to follow their vet’s advice about using antibiotics.

“Our advice is always to follow the instructions of the prescribing vet – as to whether antibiotics are needed at all, or if they are prescribed, to complete the prescribed course,” said a NOAH spokesperson.

“Outside of a hospital situation where there is daily monitoring, it is not practical for a farmer or a pet owner to make a subjective judgement on whether the symptoms have improved and treatment should stop, and any confusion over this could leave the door open for resistant bacteria to potentially proliferate.”

BVA junior vice president John Fishwick said that, until further studies are conducted, it is too early to change the way medicines are prescribed.

“Vets should continue to prescribe as previously, only when necessary,” he said. “It is also vital that clients continue to follow the directions given by their vets, both in terms of dosage and duration of treatment, carefully.”

He adds: “The article in the BMJ suggests that antibiotics should be used for as short a period as possible, and that we should move away from the concept of following a predetermined course. This may indeed be a very important advance but it is far too early to determine how this would work in veterinary practice. We need to clearly establish the evidence supporting it.”

Compiled by a collaborative group of experts, the BMJ article states that reducing unnecessary antibiotic use is  ‘essential’ to combat the growing problem of antibiotic resistance.

Together with colleagues, Professor Martin Llewelyn, from the Brighton and Sussex Medical School, asserts the idea that ending antibiotic treatment early encourages the growth of drug resistant bacteria.

He notes that, historically, antibiotic courses were ‘set by precedent, driven by fear of under treatment, with less concern about overuse’.  Today, however, there is growing evidence to suggest that shorter durations may be just as effective.

‘Shorter duration of treatment has been shown to reduce clinical efficacy in a few cases,’ he writes. ‘A notable example is otitis media, where five days’ treatment is associated with a lower clinical cure rate (66%) than 10 days (84%) in children under 2 years.’

The authors conclude that clinical trials are needed to ascertain the most effective strategies for optimising duration of antibiotic treatment.

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Blue Dog Programme wins WSAVA One Health award

News Story 1
 An educational initiative to help children interact safely with dogs has been awarded the WSAVA’s 2017 Global One Health Award.

The Blue Dog Programme offers an array of educational resources for children, parents and school teachers, including an engaging website, fact sheets, DVD and an accompany book for parents.

The award will be accepted by Professor Tiny de Keuster, a European veterinary specialist in behavioural medicine and founder of the programme, during WSAVA World Congress 2017.  

News Shorts
VMD stakeholder workshops to discuss Brexit implications

The Veterinary Medicines Directorate (VMD) has announced that it is to hold stakeholder group workshops to discuss the implications of EU exit.

The workshops will be held during Autumn 2017 and will discuss topics such as the prescribing cascade, pharmacovigilance and inspection of non-UK based manufacturers.

To register your interest, send an email to events@vmd.defra.gsi.gov.uk, including any topics, in order of preference, that you would like to be discussed.