Microbial resistance to antibiotics is a global concern for humanity, recognized by the World Health Organization, the European Centre for Disease Prevention and Control, the National Institutes of Health, and many other health organizations. News articles have warned of the dangers from potential ‘super bugs’ created as bacteria have become resistant to current drug treatments. While there is less information available on the impact of antibiotic resistance in animals versus humans, the issue is still one of great concern.
A new study reveals that French veterinarians proactively address the public health issue of antibiotic resistance in their practice. Veterinarians actively incorporate ethical considerations when dispensing antibiotics.
The research in the Journal of Applied Animal Ethics, published by Brill, compares professional papers and educational resources from French veterinarians and pharmacists to address questions of professional conflict of interest; veterinarians had faced accusations of unethically profiting from selling antibiotics.
‘Animal deaths due to antimicrobial resistance may even be higher in number than human deaths as, in France for instance, there are fewer drugs available for them, last-resort antibiotics being reserved for human use’, according to the authors Denise Remy (Professor, University of Lyon) and Ruud Ter Meulen (Emeritus Professor, University of Bristol).
The French government launched its first comprehensive plan to address antibiotic resistance in animals in 2012 (the EcoAntibio Plan), which was aimed at reducing antibiotic resistance risks in veterinary medicine. The goal was to achieve a 25% reduction in the use of antibiotics in veterinary medicine over the next 5 years. The reason for this is the way antibiotics for animals are prescribed and sold in France and much of Europe. In certain European countries (Denmark, Spain, and Italy, for example), pharmacists sell the medications that the veterinarians prescribe. However, veterinarians in France can both prescribe and sell antibiotics, and this practice is prevalent in 70% of European countries. The question then arises whether veterinarians have any conflicts of interest; might financial gains outweigh professional ethics and concern for public health or animal welfare?
This study addressed that question through analysis of the professional literature of both pharmacists and veterinarians to determine whether and to what extent these two groups are aware of and proactive about antimicrobial resistance. The literature surveyed included monthly and weekly publications containing educational information, new products and scientific research, and other important profession-based information. The authors selected two widely distributed journals for each group ranging between January 2008 and December 2012. The latter date was chosen to gauge the impact, if any, of the EcoAntibio Plan implemented by the French government in 2012.
In order to identify salient themes and subthemes in the professional publications, the authors worked with an interdisciplinary team (including a philosopher) to review the papers in a multistage process. The total selection was 326 articles—195 from veterinarians and 131 from pharmacists. The authors state that, regarding the topic of antibiotic resistance, ‘The debate intensified in veterinary publications throughout the five years studied as the number of papers on the subject doubled between 2008 (4 papers) and 2012 (9 papers) in the veterinarians’ Statutory Body Journal and was multiplied by 3 in La Dépêche Vétérinaire (20 papers in 2008, and 63 in 2012). In contrast, the number of articles remained approximately the same in pharmacists’ publications’.
They also found that concern for ethical professional practice as related specifically to antibiotics was addressed in 46% of the veterinarian papers analysed but absent from pharmaceutical publications. At the same time, broader professional and ethical topics, such as the future of the profession, public service, and advancing expertise, were present in approximately 39% of the pharmacists’ papers (38% for veterinarians’).
Based on their analysis, the authors conclude that there does not appear to be a conflict of interest between public health and financial concerns. While veterinarians do make money on the antibiotics they sell, ‘the study of the professional literature highlights the fact that… ethical conduct is largely encouraged’.