Antibiotic resistance is a major problem. Anyone that denies that is delusional. Anyone who thinks that antibiotic use in veterinary AND human medicine don’t contribute to resistance are similarly clueless.

Most people do understand these basic facts. However, what people feel should be done about the problem is quite variable, ranging from doing nothing to proposing strict bans on antibiotic use. More legislators are proposing strong restrictions on antibiotic use in agriculture, but little gets mentioned about use in companion animals and humans. A broad approach looking at all sectors, involving all available evidence, and looking at the potential impact of restrictions is needed. Restrictions that have so may loopholes that they don’t curtail overall use are not helpful, nor are restrictions that are so severe that they result in increased illness in animals (which could then require more antibiotics and/or public health risks because of more zoonotic infections). I certainly don’t have the answers.  A concerted, broad-based effort is needed.

In an era where we have major concerns about antibiotic resistant bacteria and scrutiny of antibiotic use in veterinary and human medicine, it’s completely ludicrous that you can walk into a farm supply store or pet shop in Canada and buy huge quantities of antibiotics, or order pretty much any antibiotic you want over the internet.  Politicians like to talk about antibiotic overuse and restricting drug use in animals, but fail to take the simple step of making NO antibiotics available without a prescription from a physician or veterinarian. That wouldn’t solve all our problems, but would be a great start! One case from my time in private practice stands out – it was a steer (a castrated male cow) with a broken leg. The farmer noticed that the animal wasn’t using the leg and tried treating it with penicillin for a few days, which didn’t fix anything (surprise, surprise). This certainly isn’t an uncommon event. Many people treat their animals (farm animals and pets) with antibiotics without any guidance, often for problems that are not bacterial infections, and sometimes using inadequate dosing regimens (which further increase the risk of microbial resistance). 

Taking the simple step of removing free access to antibiotics is easy and needs to be done. Controlling internet purchases is more difficult. One veterinary pharmacy website proudly states "We also have a wide variety of human grade antibiotics, none of which require a prescription!" This site has a wide selection of antibiotics for sale. Most are labeled for fish tank use, but the site mentions the human product names, and it’s very clear these products are not really being sold for fish. These pharmacies are harder to control, but many are clearly located in countries like Canada and the US, and are blatantly breaking existing regulations. Take a look at the picture above… this human pharmacy is offering free Viagra, a prescription drug, with every order of levofloxacin, another prescription drug… all without a prescription from a physician. This isn’t a matter of needing rules. It’s a matter of simply enforcing them.

Antibiotic resistance is a complicated problem and simple measures aren’t going to fix everything. However, if we don’t even take simple steps, how are we ever going to take the bigger steps required to address this issue?