欧盟兽用抗菌药耐药性管理概述

介绍负责管理欧盟兽用抗菌药耐药性的欧洲药品局下设的兽用药品委员会、健康与消费者保护司和食品安全局等相关管理机构以及成立耐药性管理工作组、进行耐药性风险分析、制定相关文件和实施耐药性监测等的管理措施,为我国兽药耐药性相关政策的制定和措施的实行提供参考.     

Animal welfare and the veterinary profession

Extract

The veterinary profession has a unique responsibility to society at the interface of animals and man. Veterinarians are trained in the healing sciences as well as in animal biology and management, formal training in animal welfare is now given in the undergraduate course, and the physiology of stress is taught in biology. This assists veterinarians to objectively assess the impact of the environment on animals, removing the frequently faulty interpretations that anthropomorphism presents in some situations. The scientific training of veterinarians also allows them to accurately assess the worth of various procedures in laboratories and on farms.     

The scope of a laboratory animal program needed at a veterinary school.

The discipline of laboratory animal medicine is one of the most rapidly expanding specialties within the veterinary profession. Veterinary schools should fully accept the responsibility for introductory instruction in laboratory animal medicine in the professional curriculum. Such instruction should articulate the varied opportunities that exist for the laboratory animal veterinarian within the biomedical research community, and provide an overview of the normal biological characteristics and pathologic conditions of the common laboratory animal species. In addition, the opportunity should exist within the veterinary school for graduate and undergraduate students utilizing experimental animals to receive a comprehensive introduction to laboratory animal biology, care, and management. Instructional responsibility for such courses should be accepted by faculty veterinarians with advanced training in laboratory animal medicine. Veterinarians with advanced training in this specialty are uniquely qualified to make substantial contributions to biomedical research by promoting the health and welfare of the research animal.     

Pharmacological treatments and risks for the food chain

Veterinarians play a pivotal role in public health control, in particular in the management of risks deriving from pharmacological treatments of food-producing animals. Veterinary medicinal products can represent a risk for animal health and welfare (side effects, decreased efficacy), for farmers and practitioners administering the drug, for consumers of food of animal origin (presence of residues, occurrence of antibiotic resistance) and for the environment. According to pending European guidelines, risk management starts from marketing authorisation that must be based on risk evaluation and can be denied when the risk/benefit ratio is not favourable considering the advantages for animal health and welfare and for safety of consumers. Veterinarians can prevent and control risks by using correct pharmacological criteria to choose and administer medicinal products and undertaking risk-based inspection of residues of drugs in food of animal origin. Moreover, a major tool for veterinarians to prevent and control drug-borne risk is “pharmacovigilance”. Risks for the environment are usually assessed during the pre-marketing approval process, however veterinarians, as risk managers, should educate farmers about correct drug handling and disposal, and periodically verify that suggested measures are applied.     

Pharmacological treatments and risks for the food chain

Veterinarians play a pivotal role in public health control, in particular in the management of risks deriving from pharmacological treatments of food-producing animals. Veterinary medicinal products can represent a risk for animal health and welfare (side effects, decreased efficacy), for farmers and practitioners administering the drug, for consumers of food of animal origin (presence of residues, occurrence of antibiotic resistance) and for the environment. According to pending European guidelines, risk management starts from marketing authorisation that must be based on risk evaluation and can be denied when the risk/benefit ratio is not favourable considering the advantages for animal health and welfare and for safety of consumers. Veterinarians can prevent and control risks by using correct pharmacological criteria to choose and administer medicinal products and undertaking risk-based inspection of residues of drugs in food of animal origin. Moreover, a major tool for veterinarians to prevent and control drug-borne risk is "pharmacovigilance". Risks for the environment are usually assessed during the pre-marketing approval process, however veterinarians, as risk managers, should educate farmers about correct drug handling and disposal, and periodically verify that suggested measures are applied.     

New approaches for education and training in veterinary public health: the SAPUVET projects

Continued contact between humans and animals, in combination with the ever-increasing movement of human and animal populations that is one effect of globalization, contributes to the spread of diseases, often with detrimental effects on public health. This has led professionals involved in both animal health and public health to recognize veterinary public health (VPH) as a key area for their activities to address the human-animal interface. Veterinarians, a profession with major involvement in this field, are in need of specific knowledge and skills to prevent and control public-health problems. As a result, VPH must be directly integrated into veterinary educational programs. At present, only few veterinary schools have specific VPH programs; in most institutions, VPH does not feature as a specific subject in either undergraduate or post-graduate curricula. SAPUVET and SAPUVETNET II are network projects supported by the ALFA program of the European Union (EU). Their main objectives are to reach a common understanding between European and Latin American universities in the definition of the areas in which VPH is important in their respective countries, and to design a harmonized training program for veterinarians in VPH, by making use of new technological applications and innovative teaching methodologies. The elaboration of educational material in combination with case studies presenting real-life problems provides a basis to apply the knowledge acquired on VPH. It is envisaged that the material and modules developed during the two projects will be integrated into the veterinary curricula of the participating universities, as well as in other partner organizations.     

Evaluating the economic and noneconomic impacts of the veterinary medical profession in Michigan

This study reaffirms the diversity and breadth of the veterinary profession. As it turns out, some of the furthest-reaching impacts of the veterinary medical profession were largely non-quantifiable. The veterinary medical profession had a substantial direct economic impact in Michigan during 1995. The total economic contribution of the veterinary medical profession to Michigan during 1995 that was attributable to expenditures on salaries, supplies, services, and their multiplier effect was approximately $500 million. In addition, the profession was associated with nearly 8,500 jobs (combined professional and lay positions). The veterinary medical profession was also considered to have an impact on the prosperity of the live-stock, equine, and pet food industries in Michigan, even though the economic contribution in these areas could not be directly quantified. Economic well-being of the individual businesses in these industries is directly related to the health and productivity of the associated animals, and improvements in output or productivity that accompany improved animal health likely carry substantial economic benefits in these sectors. In addition, progressive animal health management provides a crucial method of managing risk in the animal industries. Similarly, although the economic contribution could not be quantified, the veterinary medical profession enhances the safety and quality of human food through research, regulation, and quality assurance programs in livestock production, minimizing the risk of drug residues and microbial contamination. During 1995, approximately 5.3 million Michigan residents benefitted from the physical, psychological, and emotional well-being that accompanies companion animal ownership. By preserving the health and longevity of companion animals, veterinarians sustain and enhance these aspects of the human-animal bond. As Michigan enters a new century, it is likely that the state's veterinary medical profession will continue to make a highly valued societal contribution. Pets, equines, and food animals will continue to have prominent roles in Michigan for the foreseeable future, as will the human-animal bond, food safety, and medical research. Clearly, for economic and noneconomic reasons, it will be in the interest of the people of Michigan to seek opportunities to maintain and enhance the vitality of the state's veterinary medical profession. It was our hope that results of this study would provide university administrators, legislators, MVMA executives, and others with information needed to justify the ongoing provision of public support for the veterinary medical profession. In addition, we expect that the results will supply useful material for public relations and marketing campaigns by the MVMA and the Michigan State University College of Veterinary Medicine and will provide the media with public interest stories to promote the veterinary profession. Although this study considered the economic and noneconomic impacts of the veterinary medical profession only in Michigan, the results can provide an important reference point for educators, policy markers, and legislators in other states. In addition, this study could serve as a methodologic model for veterinary organizations in other states, or at the national level, to emulate.     

Modern trends in veterinary public health

The veterinary profession and its contribution to public health should expand in breadth, depth and flexibility to respond to the changing needs of community and society. This longstanding issue is still the subject of controversy between on the one hand those whose scientific activities contribute to our knowledge of food and environmental hygiene, enteric infections, food-borne diseases and zoonoses in general, and on the other the all too numerous traditionalists (even within the profession) who resist the venture of veterinarians into new territories and resent involvement in public health. Veterinarians are ideally suited to function in public health because of their orientation to populations, disease prevention, and the economic implications of disease.     

Ecologic and symbiotic approaches to animal welfare, animal rights, and human responsibility

Veterinarians confronted with situations involving animal welfare, animal rights, and human responsibility assume practical importance in the relationships of veterinarians with clients and other constituencies. To help resolve these situations, the authors briefly compare economics and ethics and discuss the types of rights. An attempt is made to bring animal welfare and animal rights into the same conceptual framework, using an ecologic approach. This reaches the thesis that the less human beings allow animals the right of self-determination, the more we should exercise responsibility in their care and welfare. Actively exercised human responsibility in all uses of animals is offered as a practical and valid alternative to the extreme of abolitionism. This alternative also is applied in a cautionary way to the role of veterinary medicine in specieism. The veterinary profession is urged to be active in the middle ground of the field of animal rights and to firmly establish its relationships to animal welfare and human responsibility.     

Food animal veterinary medicine: leading a changing profession

The veterinary profession has gone through periods of profound change in response to economic and social changes. We are currently in another such period: profound change is required in order for the profession to remain relevant in a marketplace where a rapidly expanding knowledge base and new technologies demand an ever-increasing level of expertise in a greater variety of areas. However, the veterinary profession is perceived both internally and by the public as possessing a narrow set of skills that supports a narrow group of careers focused on salvaging ill or injured companion animals. It will be necessary to dramatically change the way veterinary students are recruited and trained, as well as how graduate veterinarians are licensed and provided continuing education, in order for the veterinary profession to capitalize on our historical strengths and provide service and leadership in a greater diversity of career paths. Even though the number of veterinarians needed to provide primary care for livestock is decreasing, both the level of expertise demanded by livestock owners and the value of veterinary involvement on livestock farms are increasing. Colleges of veterinary medicine appear challenged to meet the changing needs for veterinary services in animal agriculture because of the declining percentage of veterinary students interested in food animal careers. Fortunately for animal agriculture, the skill set needed by food animal veterinarians is also needed by several emerging segments of the veterinary profession that have tremendous potential for rapid growth, including employment in all segments of food production systems, environmental monitoring and management, bio-security and disease eradication, laboratory diagnostics, and federal regulatory and bio-defense roles. Like previous periods of profound change, this moment in history will require creative thought, open discussion, and a willingness to step into the unknown.     

美国兽用抗菌药耐药性管理

全面介绍了美国兽用抗菌药耐药性的管理机构和管理措施,希望为我国兽药耐药性相关政策的制定和措施的实行提供一定的依据和参考。     

Drug and chemical residues in livestock

The problem of drug and chemical residues in foods of animal origin has become increasingly important to the entire livestock industry as growing consumer health concerns continue to erode the demand for these products. Although nearly 90 per cent of all drugs approved for use in livestock are available for over-the-counter sales, in the public's view, it is only the veterinarian who administers drugs to animals and who, therefore, is responsible for all drug residues in food. Congress has responded to these consumer concerns by applying increased pressure on the FDA to restrict the extra-label use of drugs by veterinarians. The veterinary profession now finds itself in a position in which it must reexamine its current drug-use policies and strive to develop policies that are more responsible to the consumer, both in appearance and substance.     

AVMA guide for veterinary medical waste management

Lawmakers have enacted a variety of laws and regulations to ensure proper disposal of certain potentially infectious or otherwise objectionable waste. The veterinary medical profession supports scientifically based regulations that benefit public health. In 1988, Congress passed the Medical Waste Tracking Act, a federal program that mandates tracking certain regulated waste. Several types of waste generated in the typical clinical veterinary medical practice are considered regulated veterinary medical waste. Discarded needles, syringes, and other sharps; vaccines and vials that contained certain live or attenuated vaccines; cultures and stocks of infectious agents and culture plates; research animals that were exposed to agents that are infectious to human beings and their associated waste; and other animal waste that is known to be potentially harmful to human beings should be handled as regulated veterinary medical waste. Regulated veterinary medical waste should be handled with care. It should be decontaminated prior to disposal. The most popular, effective methods of decontamination are steam sterilization (autoclaving) and incineration. Chemical decontamination is appropriate for certain liquid waste. Waste should be packaged so that it does not spill. Sharps require rigid puncture- and leak-resistant containers that can be permanently sealed. Regulated veterinary medical waste that has not been decontaminated should be labeled with the universal biohazard symbol. Generators retain liability for waste throughout the entire disposal process. Therefore, it is essential to ensure that waste transporters and disposal facilities comply with state and federal requirements. Veterinary practices should maintain a written waste management program and accurate records of regulated veterinary medical waste disposal. Contingency planning and staff training are other important elements of a veterinary medical waste management program. The guide includes a model veterinary medical waste management program; however, it does not address all the variations in state and local regulations. Veterinarians should obtain copies of state and local laws and regulations and modify AVMA's model plan to create an individualized practice plan that complies with federal, state, and local laws and regulations. State and local veterinary medical organizations should monitor state and local regulation to influence decisions that affect veterinarians and to keep their members informed of changing requirements. Veterinarians and veterinary medical organizations must stay involved so that regulations do not unfairly burden the veterinary medical profession.     

Producer quality assurance programs.

Essentially all animal commodity organizations have established quality assurance programs designed to ensure food safety and quality. Most of these programs were originally implemented to address problems with veterinary drug residues. Many of the current programs have or plan to include food safety critical control points with specific guidelines on how to control or reduce pathogen load. The continued focus placed on food safety by today's consumer demands that American producers ensure that their commodities are wholesome, safe, and of high quality in order to remain competitive in the global marketplace. Veterinarians should recognize that it is important to encourage food animal producers to participate in quality assurance programs for their clients' economic health and for food safety and protection of public health. Commodities certified as being produced under good production practices or by producers certified as following a recognized and validated quality assurance program often bring a premium price. Also, some slaughter establishments are beginning to require producers to be certified as practicing under a recognized quality assurance program before animals are accepted for processing. This practice is being driven partially by the demands placed on slaughter establishments by the US Department of Agriculture's implementation of the Pathogen Reduction, Hazard Analysis and Critical Control Point Systems regulation. Regardless of why producer trade association quality assurance programs have come into existence, veterinarians should promote the programs as an excellent mechanism to help ensure everyone's goal of a safe, wholesome food supply.     

A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.     

Nosocomial infections.

Nosocomial infections and antimicrobial resistance are topics that have been intensely studied in human medicine because of their significant impact on human health. In recent years, concerns have been raised that the use of antibiotics in veterinary medicine, animal husbandry, and agriculture may be contributing to the development of resistance in common bacterial species affecting human beings. Although there is inadequate proof at this time that the resistance is transmitted from animals to people, if antibiotics continue to be used indiscriminately in veterinary medicine, veterinarians may find themselves facing regulations restricting the use of some antibiotics. Nosocomial infections have been reported in veterinary medicine and are likely to increase in prevalence with the increase in intensive care practices in many hospitals. Prolonged hospitalization and the use of invasive devices and procedures increase the risk of nosocomial disease. As in human medicine, organisms isolated in the nosocomial infections reported in veterinary patients have an increasingly broad spectrum of antimicrobial resistance. Despite these findings, the use of empiric and prophylactic antibiotic therapy is still widespread in veterinary medicine. Nosocomial infections and antimicrobial resistance may have a serious impact on the future of [table: see text] veterinary medicine, because the cost and ability to treat our patients may be affected by the loss of access to or effectiveness of antimicrobial drugs. Despite the millions of dollars spent on research to reduce the incidence of nosocomial infections in human patients, the strategies that have consistently proven successful are simple and inexpensive to implement. The most important factor in preventing nosocomial infections is improving the hygiene practices of health care providers. Hand-washing or the use of disposable gloves can dramatically reduce the transmission of bacteria between patients. Aseptic technique should be used in the placement and management of all invasive devices. All staff members should be educated on the risks and symptoms associated with nosocomial infections so that cases can be detected early and treated appropriately. We in the veterinary profession have the opportunity to learn from the experiences of the human medical profession and can take steps to prevent the escalation of nosocomial infections and their impact on our profession.     

Tamworth ND alert - source under close surveillance

Governments, industry and community groups in Australia are jointly developing a national strategy for animal welfare. This will provide for improved national approaches and help in formulating international animal welfare standards. The strategy will recognise the point that animal welfare concerns the humane use and care of animals and is of concern to the community. Animal welfare is a significant issue for the veterinary profession, as the community expects veterinarians to fill a special role in alleviating animal suffering and pain. Many expectations and concerns influence the development of animal welfare standards. Established processes provide well-defined roles for national bodies such as the Animal Welfare Committee (of the Standing Committee on Agriculture and Resource Management) and the National Consultative Committee for Animal Welfare.     

American veterinarians' animal welfare limitations

American society is becoming increasingly interested in issues of animal welfare, and the public generally recognizes the need for guidance from experts in the field. Assessing an animal's welfare status requires a determination of the state of both its physical and its psychological well-being. American veterinarians are well trained to assess the physical state of most animals, but they do not receive equivalent training in assessing an animal's psychological state. Therefore, the recognized expertise of the American veterinary profession currently lies only in answering physical welfare questions, not in assessing the psychological (or societal) aspects of animal welfare issues. If American veterinarians wish to be seen as animal welfare experts, then it is critical for the profession to educate its members in assessing the psychological state of animals. Also, if the American Veterinary Medical Association wishes to be considered a leader in the field of animal welfare, it must partner with organizations with expertise in pertinent areas outside of the veterinary medical field to develop appropriate guidelines for American society, including the development of a widely accepted system for defining and determining overall animal welfare. If American veterinarians actively work to improve our strengths and combine them with those of experts in other fields, we can overcome our limitations as animal welfare experts and achieve wider acceptance as an important force for improving animal welfare.     

Educational preparedness of veterinarians for foreign animal diseases

Veterinary medical education in FADs has been and will continue to be critically important if veterinarians are expected to fulfill the profession's primary obligations to society--those of protecting our animals' health, conserving our animal resources, and promoting public health. It is imperative that curricula and instruction in veterinary schools and colleges provide the depth and breadth of knowledge and understanding necessary to prepare all veterinarians, including those in private practice, for their key role in defending against FADs. Development and implementation of governmental and military programs to diagnose, prevent, control, and eradicate FADs will require a dedicated cadre of public sector veterinarians who have a solid educational foundation in FADs and understand the contemporary issues and global challenges we face. Animal-related industries, associations, and organizations will increasingly rely on well-educated veterinarians to help guide them in ways that will protect animals, clientele, consumers, and trading partners from effects of FADs. Agencies and organizations concerned with conservation of animal resources will require veterinary expertise necessary to prevent FADs in a multitude of animal species, including marine animals, wildlife, endangered species, zoologic specimens, and important genetic lines as well as our domestic companion and livestock species. Species affected by FADs also include human beings for those disease agents with zoonotic potential; thus, veterinary education also plays a key role in public health.     

Current controversies in equine antimicrobial therapy

Controversies exist regarding the use, misuse and potential overuse of antimicrobial treatments in foals and adults. When antimicrobials are required for treatment of infectious diseases, veterinarians should follow a logical approach and not simply reach for the newest drug. Targeted, single drug therapy is probably best, and culture and sensitivity testing should be undertaken. The most likely infectious agent, potential drug toxicities, and age‐appropriate dose and route should be considered. The development of an increasing number of different multiple drug resistant pathogens requires that veterinarians use antimicrobial drugs responsibly to protect veterinary patients and the public at large.