New European categorization of antibiotics used in animals

At the end of January, a new scientific opinion was issued by the European Medicines Agency (EMA) on the risk categorization of antibiotics for animal use. The main change in this new advice is that four antibiotic risk categories A through D have been identified, replacing the previous three categories.

The categories classify antibiotics on the basis of both the risk to public health posed by their use in animals through the possible development of antimicrobial resistance and the need for their use in veterinary medicine.

This update takes into account the experience gained since the initial categorization of antibiotics in 2014, notes the EMA, which proposed three categories for antibiotics classified as Critically Important Antimicrobials (CIA) in the Organization’s CIA list. World Health, for example the most relevant ones. for human health.

The revised categorization takes into account all classes of antibiotics and includes additional criteria, such as the availability of alternative antibiotics in veterinary medicine.

The EMA also assessed the impact of the route of administration in the selection of antibiotic resistance and included their findings in a separate checklist to consider when prescribing antibiotics.

The four rankings are:

Category A

Category A (to be avoided) includes antibiotics which are not authorized in veterinary medicine in the European Union (EU). These drugs cannot be used in food-producing animals but can be administered to individual pets under exceptional circumstances.

Category B

Category B (Restrict) refers to quinolones, 3rd and 4th generation cephalosporins and polymyxins. Antibiotics in this category are of critical importance in human medicine and their use in animals should be limited to mitigate risks to public health.

Category C

Category C (Caution) covers antibiotics for which alternatives in human medicine generally exist in the European Union (EU), but only a few alternatives are available in certain veterinary indications. These antibiotics should only be used when there are no class D antimicrobial substances that would be clinically effective.

Category D

Category D (Caution) includes antibiotics that should be used as first-line treatment, whenever possible. These antibiotics can be used with caution in animals. This means that unnecessary use and long periods of treatment should be avoided, and group treatment should be limited to situations where individual treatment is not possible.

The categories are based on scientific advice, which was the subject of a public consultation launched in February 2019.

The new intermediate category C was created for antibiotics which are to be used when there is no product available in D that would be clinically effective.

Chris Lloyd, general secretary of the Alliance for the Responsible Use of Medicines in Agriculture UK (RUMA): “The introduction of Category C should encourage vets and farmers to discuss the possibility of using low risk category D products as an alternative.

“The new category should also focus on management changes that can be made to avoid the need for antibiotic treatments in the first place – such as biosecurity, vaccination, improved nutrition or changes to infrastructure, such as housing for handling facilities “.

He continued that the advisory recognizes that there is a lack of alternative treatments to many Category C antibiotics for illness. Veterinarians can still prescribe Category C products to protect animal health and welfare.

“There is no doubt that macrolides are extremely useful in the effective treatment of certain species of Mycoplasma in poultry, Lawsonia in pigs, respiratory tract infections in cattle and, in some circumstances, lameness in sheep.” , he added.

The new category C offers prescribers both flexibility and encouragement to think about alternatives. | Courtesy of EMA

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