Warning antibiotics may soon lose their usefulness in human and animal health alike, Ontario's doctors want to close what they call a "loophole" that allows farmers to buy and use such drugs to boost growth in livestock.
In a new position paper this week, the Ontario Medical Association also wants the province to set up a surveillance system for the farm industry, to keep track of the identities and quantities of antibiotics sold -- and of those being moved into or out of Ontario.
Surveillance of antibiotic movement "does not exist" today in agriculture in the province, the OMA said, and should also be strengthened in areas where it does exist -- such as in medicine -- to collect data for a "firmer understanding" about antibiotic resistance.
"Patients are at risk of becoming sicker, taking longer to recover and it some cases dying from previously treatable diseases," OMA president Dr. Doug Weir, a Toronto child psychiatrist, said in a release Wednesday. "Data shows that we can reduce antibiotic resistant bacteria when the use of antibiotics is modified."
"We call on federal and provincial governments to immediately enact regulatory changes that will help to reverse this threat by reducing the growth of antibiotic-resistant bacteria," the physicians' group said.
Ontario should ban the prophylactic (growth-promoting) use of antibiotics, whether extra-label or indicated, in animal husbandry, the OMA said, describing such a move as "fundamental to preserving the effectiveness of antibiotics."
A veterinary prescription-only standard of access to antibiotics for animals must be put in place, the OMA added.
Under such a standard, the province would require a veterinary prescription and/or supervision of the use of all antibiotics on farms.
The status quo, the association said, allows for "unsupervised, unscientific and ultimately dangerous application of important medications."
Such a move would take amendments to Ontario's Livestock Medicines Act to close the "own use" loophole -- one which the OMA said was created by the federal Food and Drugs Act and its regulations.
Changes are needed to ensure large volumes of antibiotics "cannot be freely imported into the province and be applied to animals en masse without surveillance or regulation," the OMA said.
The Canadian Veterinary Medical Association concurred in a separate release Thursday, calling on both Ottawa and the province to act.
The CVMA said it's been urging the federal government "for many years" to amend legislation and plug the "loophole" in Health Canada's own-use importation (OUI) policy, particularly for antimicrobials.
"OUI importation of veterinary products carries inherent food safety, public and animal health risks," the CVMA said.
"People importing antibiotics for any reason should all be held to the same standards, and surveillance should be established to allow the collection of data about which drugs are entering our country and what their intended use is," the OMA said.
That said, the doctors' group also called for the use of electronic health records that would allow physicians to compare patients' past prescriptions and diagnoses, which in turn would "reduce variability" and allow doctors to make "optimal decisions" about which antibiotics to prescribe.
Furthermore, the OMA recommended, an "independent institution" should be set up through one of Ontario's medical schools, using available data to draft and maintain antibiotic use guidelines.
Ontario doctors could then use such guidelines in their practice, "particularly when dealing with resistant bacteria and unfamiliar antibiotics," the OMA said.
Dr. Greg Douglas, the provincial ag ministry's chief veterinarian, responded Wednesday to the OMA's position paper, calling it "an important reminder of the need for prudent antibiotic use."
The province, Douglas said, already works with the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS), which tracks trends in antibiotic use and resistance in Canadian agriculture.
The ministry, he added, also works with producer groups and vets to promote prudent use of medicines and "alternative preventive approaches."
Douglas, chair of the Canadian Council of Chief Veterinary Officers, said that group has also made antimicrobial resistance a priority, and is working on ways to increase surveillance, outreach and education.
Antibiotics, he said in his response to Weir, "will always be an important part of an overall strategy for healthy animals, as they are with humans. And we know that they must be used responsibly and judiciously."
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