Frequently Asked Questions
Why is BEVA promoting responsible antimicrobial usage?
Antimicrobial resistance is an emerging clinical problem that is recognised internationally as one of the largest threats to health. AMR has been recently classified as a clinical disease in its own right. All major human health and veterinary organisations are working to try and limit the development of resistance so that we can retain effective antimicrobials for use in clinical practice.
Antibiotics are effective, and resistance is not causing any problems in our practice. Why change?
Although the clinical impact of antimicrobial resistance is a moderate term problem, the regulatory response that could be adopted to limit further development could have significant impacts on veterinary practices in the short term. BEVA believe that effective self-regulation is preferable to changes in legislation.
Is BEVA trying to regulate clinical practice?
No, BEVA are providing members with a toolkit to help them develop their own policy around antimicrobial use, in the same way that they develop policies around health and safety. There are always concerns that such policies limit clinical freedom and formularise veterinary practice, however BEVA believe that well formulated policies allow for clinical ‘freedom’, while regularizing routine cases. In equine practice antimicrobial choice is already limited, so in many cases you will be simply converting current practice into a policy.
Why is BEVA adopting a one-policy-fits all approach?
BEVA does not believe in a one-for-all policy. All of the documents that are available to download are examples. They demonstrate the procedures and standard operating procedures that should be adopted by practices. You are welcome to take this policy, to modify it, or create your own from scratch.
Do I have to formulate a policy?
No, currently there are no requirements of veterinary practices to develop antimicrobial policies. However if the industry does not demonstrate the ability to self-regulate then regulation is likely to be forced upon it.
Why is BEVA not developing a more uniform equine policy?
There are a large number of variables, include case profile, regional variations in antimicrobial resistance that means that a country-wide policy could be ineffective. We therefore believe that practices should develop their own policy.
What should I do if I do not believe the BEVA antimicrobial use policy will work in my practice?
Develop your own. The steps required to do so are detailed. BEVA would be happy for you to share your policy with them and others
What are other organisations doing?
BSAVA: SAMSoc developed the PROTECT concept and created a poster to allow practices to develop the first line antimicrobial for common clinical conditions
BVA: Developed the framework for the development of responsible antimicrobial use
ACVIM: The American College of Veterinary Internal Medicine developed a consensus statement for responsible antimicrobial use.
Why is BEVA trying to develop more regulation than BSAVA?
Monitoring antimicrobial usage and emerging resistance is an essential tool to help practices understand whether their policy is effective and identify when changes may be needed. BEVA do not believe that the proposal will add considerably to workloads and are ‘light-touch’ and effective.
Why is BEVA discouraging the use of licensed antimicrobials?
The ‘important’ antimicrobials are the 3rd and 4th generation cephalosporins and the fluoroquinolones . These are relied upon for treatment of challenging infections in human health. BEVA believe that these products should continue to be available to veterinary surgeons, and through self-regulation, they can be preserved for similar use in veterinary practices.
Why is BEVA encouraging the use of unlicensed products?
Our unique privilege to prescribe drugs using the ‘cascade’ means that in some clinical cases, one can predict that certain unlicensed products maybe effective. The benefits of using these products, rather than a licenced, but PROTECTED antimicrobial are for the wider community to prevent emergence of antimicrobial resistance in these species.
Why is BEVA encouraging off-label use by suggesting doses that are different to the data sheet?
For some antibiotics, evidence in the literature supports the use of dose rates and frequencies outwith the datasheets. Sub-therapeutic dosing is an important factor in the development of resistance and therefore we would encourage members to review this evidence when constructing these policies.
What has happened in other countries?
Any financial incentive to dispense has been prevented in some Scandinavian countries either by preventing profits being made from antimicrobial sales, or by preventing dispensing of antimicrobials by veterinary surgeons.