Role of the Veterinarian in the Oversight of Antimicrobial Use
February 25, 2016
The veterinary profession serves the public interest by providing health care to many species of animals. As one of the cornerstones of modern veterinary medicine, veterinarians use antimicrobial medications for the prevention and treatment of disease.
As part of their professional responsibility, veterinarians are cognizant of the need to oversee and apply principles of good antimicrobial stewardship on a daily basis in their private and public practice activities.
Disease Prevention and Control
Veterinarians work with clients and their animals to optimize health, prevent disease and minimize the need for antimicrobials. This role involves the provision of advice and services in areas that support good animal husbandry, including:
- Other essential activities
Veterinarians must establish a relationship with the client and their animals (known as Veterinary Client Patient Relationship) so as to be knowledgeable of potential disease hazards and levels of susceptibility of the animals prior to developing a disease prevention plan that may include the use of preventative medication.
Evidence-Based Diagnosis of Disease
When presented with a sick patient (individual or herd/flock), veterinarians must take the necessary steps to gather enough relevant medical knowledge to establish an evidence-based diagnosis or presumptive diagnosis.
Directing Treatment for Disease
Veterinarians must direct the most appropriate treatment for the disease when it is diagnosed, reasonably suspected or anticipated, based on professional evaluation of the evidence at hand,
This decision must consider whether antimicrobials are to be used or not.
If antimicrobials are prescribed, the veterinarian must use professional judgment to determine the correct treatment plan, considering:
- which drug is most effective,
- a duration of treatment for as long as necessary and as short a time as possible
- the appropriate dosage and route of administration, and
- the potential impact on public health
Follow up on Treatment
It is the responsibility of the veterinarian to ensure that the prescribed pharmaceuticals are used properly and that the expected response to treatment is obtained. This includes client training and education on appropriate use, handling and storage The veterinarian must be available in the event of treatment failure or adverse reactions.
If the expected response is not obtained, appropriate steps must be taken by the veterinarian to adjust treatment. Reporting adverse events and ensuring appropriate compliance through client education and training are the responsibility of the prescribing veterinarian.
Dispensing of Pharmaceuticals
Dispensing is a professional practice activity that is performed by a registered veterinarian.
The veterinarian dispensing the product must ensure the accuracy and validity of the prescription as well as inform and educate the person receiving the prescribed medications on their intended use.
Create and Maintain Records
Veterinarians are required to maintain records of all client and patient interactions. This includes the investigation undertaken to establish medical need and documentation of all prescribing and dispensing activities.
Veterinarians are expected to contribute data as appropriate to official surveillance programs as required by legislation.
New Reality for Veterinary Oversight
New federal regulations resulting in the removal of all production claims for antimicrobials in animal feed and water and requiring mandatory veterinary oversight in the use of antimicrobials in food producing animals are expected by end of 2016. As a result, the veterinarian’s role in implementing the principles of antimicrobial stewardship will be greater than ever.
The Canadian Council of Veterinary Registrars and the CVMA’s Veterinary Pharmaceutical Stewardship Advisory Group are developing a pan-Canadian framework for professional standards for veterinarians pertaining to the veterinary oversight of antimicrobial use. Recognizing the autonomy of provincial veterinary regulatory bodies, this framework will provide a common understanding of objectives and help guide veterinary professionals as they assume greater responsibility.
The Framework will be presented at a broad stakeholder consultation and discussion to take place at the CVMA Summit on July 7, 2016, during the CVMA Convention in Niagara Falls, Ontario. We hope you will be part of the discussions.