A VETERINARY ANTIBIOTIC POLICY - A PERSONAL VIEW ON THE PERSPECTIVES IN THE NETHERLANDS

To reach a more adequate and responsible use of antibiotics in veterin ary medicine a broad approach is required. The growing interest in the optimum use of antibiotics in veterinary medicine is stimulated by aw areness of the necessity to prevent the emergence of resistance and th e spread of resistant bacteria. This is a matter of primary importance to safeguard the efficacy of antibiotic therapy in animals now and in the future, but will also minimise possible public health risks. As r esistance develops in rough relation to antibiotic use, the best way t o minimise emergence of resistance, without interfering with optimal v eterinary care, is to rationalize the use of antibiotics by, or under responsibility of, a veterinary surgeon. A second further improvement can be reached by developing a veterinary antibiotic policy to prevent emergence and spread of resistance as much as possible. Measures that must be taken in combination are: 1 . Establishing a policy for the u se of antibiotics jointly by veterinary practitioners and experts resu lting in a formulary. 2. Systemic registration and analysis of pattern s of bacterial resistance (not only of pathogens but of faecal flora a s well) and the use (qualitative and quantitative) of antibiotics in v eterinary medicine. 3. Regular feedback of these data to the veterinar y practitioners and consultation about the efficacy of the formulary g uidelines in daily practise. 4. Systemic monitoring and evaluation the impact of the antibiotic policy and, if indicated. updating of the fo rmulary. 5. Continuous education of veterinary surgeons about infectio us diseases and antimicrobial therapy and development of a veterinary audit system. The first step to rationalize the veterinary use of anti biotics was taken by publishing a veterinary antibiotic formulary in 1 987, compiled by a group of experts. Despite the fact that this was a pure top down approach and bottom up input from veterinary practitione rs was lacking, this first formulary was very well received. However t he impact of this formulary on the veterinary use of antibiotics and p revalence of resistance has not been evaluated at this moment. Until n ow regular and nationwide systemic monitoring of resistance and regist ration of veterinary use of antibiotics is not practically feasible in the Netherlands. A new formulary, based on a veterinary antibiotic po licy, will be published by the end of 1992. However. to be able to eva luate the impact of this policy on the prevalence of resistance and, i f necessary, to adapt the policy the development of facilities for res istance epidemiology is urgently needed.