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Bovine Practitioners Updated on Regulations

11 November 2009

US - Evolving drug regulations and public health concerns mean that bovine practitioners should be even more careful to use pharmaceuticals legally and judiciously, according to speakers at the recent conference of the American Association of Bovine Practitioners.

Dr. D. Dee Griffin, University of Nebraska feedlot veterinarian and professor, summarised relevant data from the US Department of Agriculture's National Residue Programme for 2007, noting that violative drug residues were most common in culled dairy cows.

Overall, meat inspectors found violative residues in fewer than 1 per cent of almost 150,000 samples from high-risk food animals, such as animals with signs of disease.

About a third of the violative residues came from veterinary prescription drugs—particularly flunixin meglumine and sulfonamide antimicrobials—rather than over-the-counter drugs, Dr. Griffin said.

One option to help prevent violative antimicrobial residues in cattle is to test urine for microbial inhibition, Dr. Griffin added, although the tests are not perfect.

Prescriptions, distribution

Shirley Arck, PharmD, a member of the Kansas State Board of Pharmacy and administrator of Kansas State University's veterinary hospital, said stakeholders who want to have a say in drug regulations need to make their messages clear, concise, compelling, and comprehensively researched. Even better is for stakeholders to reach consensus.

Big issues facing regulators include drug counterfeiting and abuse, Dr. Arck said, and programmes to control these problems can affect veterinarians.

Elaine Lust, PharmD, consultant for Professional Veterinary Products in Omaha, Nebraska, noted that veterinarians usually do not need a pharmacy license to dispense drugs incident to their practice, but they generally need a distributor license to sell prescription drugs to anyone other than a client.

Dr. Lust said the Verified Accredited Wholesale Distributors program, through the National Association of Boards of Pharmacy, provides a way for regulators and practitioners to identify drug distributors that are compliant with federal and state rules.

Difficulty is that no two states are alike in the US and wholesalers should update practitioners on shipping and distribution rules.

Antimicrobial resistance

Dr. Michael D. Apley, a professor of production medicine and clinical pharmacology at Kansas State University's veterinary college, said food animal practitioners should be aware that Congress is considering the Preservation of Antibiotics for Medical Treatment Act, which would restrict use of certain drugs in food animals in an effort to stem antimicrobial resistance.

State veterinary boards need to enforce existing regulations that affect judicious antimicrobial use, Dr. Apley said, by revoking the licenses of practitioners who write prescriptions without a valid veterinarian-client-patient relationship. Practitioners also should ask pharmacy boards to crack down on irresponsible drug distributors.

Dr. Neal Bataller, director of the Division of Compliance at the FDA Center for Veterinary Medicine, gave an overview of federal legislation and enforcement tools relevant to veterinary prescriptions.

Dr. H. Morgan Scott, an epidemiology professor at the K-State veterinary college, noted that resistant microbes spread differently in human populations than in cattle herds.

Human patients go from the community to the hospital and then back to the community. Beef cattle go from the original herd to the feedlot to the slaughterhouse.

"The bacterial populations in the animals are dead at the end of the feeding cycle, and nothing is returned to the community," Dr. Scott said, affording opportunities to stem antimicrobial resistance.

Dr. Scott presented results from a survey of feedlot veterinarians and operators that measured opinions regarding antimicrobial use.

Few respondents felt that antimicrobial use in feedlots poses a risk to public health. Most of the veterinarians had concerns about preventive use, however, in comparison with a minority of operators.

Competitive issues

Feedlot veterinarians and operators will follow voluntary guidelines on antimicrobial use only if they think others will comply, Dr. Scott said, because feedlots that limit antimicrobial use could be at a competitive disadvantage.

Dr. Scott said changing the microbial ecology of a feedlot is another approach to mitigating antimicrobial resistance.

He presented results of a survey of feedlot operators regarding willingness to change management practices that influence microbial ecology.

Respondents were willing to outsource chronically ill cattle or cull the animals sooner and to increase turnover in the sick pen.

"It's worth being proactive and being able to state that we know that there are management practices that work to reduce resistance, or at least reduce its progression, and others that may help to mitigate," Dr. Scott said.

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