Celebrating Antibiotic Amnesty Month

Veterinarians have a great responsibility when prescribing medications, particularly in relation to the responsible use of antimicrobials. AMR is a critical one health issue, with the emergence of multi-drug resistant bacteria in both human and animal medicine.

The launch of stewardship initiatives such as Responsible Use of Medicines Alliance, Responsible Use of Medicines Alliance Companion Animal and Equine, PROTECT ME (Small animal and equine), and RCVS Knowledge Farm Vet Champions have engaged veterinary professionals and increased awareness of AMR. Alongside this, the UK farming and agriculture sector have taken great strides to reduce antimicrobial use. However, the environmental impact of these medicines is of great concern, with antibiotic residues detected in rivers in all six continents of the world and the United Nations Environment Programme recognizing antibiotics as environmental pollutants of concern (Allerton et al, 2023). Whilst the full impact on human and animal health is unknown, the consequences of environmental contamination with these medicines has the potential to be catastrophic. It is therefore vital that veterinary professionals have oversight of the fate of medicines beyond the consultation and after prescription to the patient (Allerton et al, 2023).

The ‘Antibiotic Amnesty’ campaign was launched in November 2022 to support World Antibiotic Awareness Week. As part of the campaign, veterinary practices contact their client base to encourage the return of as many out-of-date, partially used or un-used antibiotics as possible. This campaign is a fantastic example of a one health approach to tackling antimicrobial resistance as it was launched in collaboration with the NHS Midlands Antibiotic Amnesty, in consultation with veterinary organisations and corporates, the Royal Pharmaceutical Society, NHS England, Integrated care boards and environmental organisations, raising awareness of the importance of AMR in both humans and animals.

The 2022 campaign, championed by BSAVA, recruited 106 practices from within the UK and internationally. Across the course of the month the return of 787 antibiotic tablets were reported alongside 12 part-boxes of tablets, 53 bottles of antibiotic ear drops and 17 antibiotic injections (Loeb, 2023). Reasons cited for having leftover medicines within the household included clinical resolution prior to the end of the course, patient death, difficulties in administration and instruction from the case veterinarian (Allerton and Ramsay, 2023). When asked about medicine disposal, 48% of respondents reported they disposed of antibiotics down the sink/toilet or as part of household waste (Allerton and Ramsay, 2023). This campaign stimulated discussion between health care professionals, veterinarians and members of the public and highlighted the need for further education to inform clients on the principles of responsible medicine use and disposal (Allerton et al, 2023).

The Royal College of Veterinary Surgeons has taken greater steps to recognise the importance of the environmental impact of medicines and has now included the return of un-used medications to ensure their appropriate and safe disposal. This amnesty campaign will feed directly into this, with practices invited to incorporate responsible medicine disposal into standard practice policy throughout the year, including the safe disposal of other medicines such as anthelmintics.

Find out more about what you can do to take part at: https://rumacae.org.uk/vet-antibioticamnesty/ and https://knowledge.rcvs.org.uk/amr/antibiotic-amnesty/

References:

Allerton, F., Jamieson, C., Aggarwal, R., Barker, A., Work, M., Cooper, D. and Ramsay, R. (2023) An antibiotic amnesty can be a one health tool to tackle antimicrobial resistance. Nature Medicine, 29 pp. 1046-1047.

Allerton, F. and Ramsay, I. (2023) Antibiotic Amnesty 2022: An Update. BSAVA Companion, 2023 (4) pp.8.

Loeb, J. (2023) Encouraging clients to hand back antibiotics. Vet Record, 193 (1) pp.7.