World Antibiotic Awareness Week – 18-24 November
Antibiotic resistance threatens our survival. It makes antibiotic treatment useless. It is hard to imagine a world without effective antibiotics. We rely on them for the treatment of many important diseases of humans and animals that were previously fatal.
One of the quirks of history is that the first antibiotic, penicillin, might never have got past the trial stage. It was tested in mice and proved brilliantly effective. Had it been tested in guinea pigs it would have been a very different story. Guinea pigs are very susceptible to sudden imbalances between the two main sorts of bacteria, called Gram positive and Gram negative, in their intestinal tract. Penicillin readily kills Gram positive bacteria, leaving Gram negative bacteria to flourish. In guinea pigs this sudden imbalance often overwhelms their immune system leading to sudden death. Had guinea pigs actually been the ‘guinea pigs’ for testing penicillin it would likely have been thrown out as an interesting but misguided idea.
At first Gram positive bacteria were so susceptible to penicillin that tiny doses cured diseases caused by them. This included the common causes of mastitis in cows – Streptococci and Staphylococci. My father was a vet in country practice and I recall playing with small tubes of intramammary ointment as a young boy in Ngatea. They contained 25,000 units of penicillin and worked like magic. Less than 20 years later I was a vet in Waitara and the standard tube of intramammary penicillin contained 1,000,000 units. In less than two decades these bacteria had developed so much resistance to penicillin that even these massive doses often didn’t work.
New classes of antibiotics were discovered in the ‘50s, ‘60s and ‘70s and the same thing has happened to them. Bacteria multiply very fast. Mutations occur. Those with a mutation that makes them resistant to an antibiotic survive low level exposure to that antibiotic and their descendants inherit those resistance genes. Worse than that, bacteria can share antibiotic resistance genes with neighbouring bacteria. This seems to happen very readily with the sorts of bacteria that live in the gut. Antibiotic resistance can spread from bacteria that mainly live in animals to those that mainly live in humans and vice versa.
Research costing billions has failed to find new classes of antibiotics to defeat multidrug resistant bacteria. These bacteria are expected to cause disease costing trillions and terrible suffering.
Vets work at the intersection of animals, humans and the environment so as a profession we have to take the issue of antibiotic resistance seriously. New Zealand is one of the three countries in the OECD with the lowest use of antibiotics in animals, but in 2015 the New Zealand Veterinary Association decided to push the envelope further with this goal: By 2030 New Zealand Inc will not need antibiotics for the maintenance of animal health and wellness.
At Halifax we have just been reviewing our protocols for antibiotic use. We follow these broad principles:
- Using antibiotics only when there is a susceptible bacterial infection that needs antibiotic treatment and when no other treatment will work. This is sometimes a very difficult judgement call needing all our experience
- Following treatment protocols – a high enough dose for long enough of the selected antibiotic – that will deliver maximum effectiveness
- Minimising the use of antibiotics that are of key importance in humans
- We are reducing the total amount of antibiotics we use
We need your help!
We consider ourselves as partners with you in keeping your pets happy and healthy for as long as possible. The biggest part of that is in preventing illness, parasitism, trauma, degenerative disease. Good nutrition, parasite control, vaccinations, dental care, behaviour management and regular health checks play the major role in this. Our staff are always happy to discuss your pet’s well-being with you and tailor recommendations to your pet’s breed, your lifestyle and any special requirements.
When your pet seems unwell seek advice early. Grandma was right when she said “A stitch in time saves nine”.
We can do tests at the time of consultation that quickly tell us if bacterial disease is present and often what type of bacteria are involved. This helps us target the infection with the best treatment. Getting it right first time is good for your pet and your pocket.
We need to prescribe treatments that you can comply with. If you can’t give your pet pills, let us know. It is very important to give antibiotics as directed and to complete the course. Discuss any issues you may have about complying with a treatment program with us and we will find other options. There is nearly always another way to deal with a problem.
Following up at the end of a course of treatment is also important. This is especially the case with internal infections, bladder infections, ear and skin infections. Failure to fully clear up an infection often leads to relapse and a problem that is more difficult than before.
All these things will help us prevent or solve your pet’s health problems while minimising our use of antibiotics and the rate of acquired antibiotic resistance.