Dear Canadian Medical Association Journal:

Re: Editorial, Farm-grown Superbugs: While the world acts, Canada dawdles

The Alberta Veterinary Medical Association (ABVMA) is the professional regulatory organization responsible for the practice of veterinary medicine in Alberta, under the authority of the Veterinary Profession Act. Veterinarians registered under this act are medical practitioners with the authority to prescribe medications for the treatment of animals. Like our colleagues in the human health field, we are acutely aware of the hazards posed by the use of antimicrobial drugs.

We believe every effort must be taken to maintain the utility and safety of these products both for animal and human health. The ABVMA is partnering with animal industry stakeholders in an effort to increase awareness in all sectors of the need for appropriate stewardship of this essential commodity. We have launched a program called Alberta Platform for the Responsible Use of Medications in Animals (APRUMA) and have developed a site to exchange information on this topic, www.apruma.ca.

While we applaud the effect Barbara Sibbald, Deputy Editor, has had in stimulating awareness of this timely topic, we believe the published editorial also highlights some common areas of confusion. Certain antimicrobials can be and are used in animal agriculture in both a preventative and growth promoting capacity. These are not the same purpose, although one might support the other. In reality, both of these uses are in accordance with existing drug label claims as approved by Health Canada, and therefore should not be confused with “off label use”.

When used according to label, however, these antimicrobials do not require a prescription from a veterinarian and consequently professional supervision might be lacking.

The writer is correct in stating that the practice of veterinary medicine is regulated provincially. The classification of pharmaceuticals as either prescription only or non-prescription, however, is the federal responsibility of Health Canada. A drug classified as non-prescription is available for over the counter sales for use in animals. These then fall outside of the scope of regulated veterinary practice.

While appreciating the writers’ assertion that improved agricultural practices can contribute to safer use of antimicrobials, I believe it might be more correct to say that improved standards of animal production and hygiene might lead to improved animal welfare and reduced use of antimicrobials. There is real concern that restriction of appropriate antimicrobial use might actually lead to animal welfare concerns. This apparently has been seen in other jurisdictions.

My final reservation comes from the reference to the total percentage volume of antimicrobials used in animals versus human health. These numbers are seemingly meaningless unless the biomass of patients treated is considered.  These numbers are commonly discussed and I am not certain anyone has the best solution of how to report and compare volume of antimicrobial use.

Despite these reservations, I think the editorial is successful in once again raising the signal flag that our processes need to continually be reviewed and updated where necessary.

Sincerely,

Dr. Duane Landals BSc. Ag., DVM

Registrar, Alberta Veterinary Medical Association

Vice President, World Veterinary Association