In a perfect world, antimicrobials used in animals would be unrelated to those used in humans. But we are not in a perfect world. All of the antimicrobial drug classes that we use clinically in companion animals are also used in humans. As a result, we have to be cognizant of the potential impact of veterinary antimicrobial use on public health while maintaining a high level of patient care.
When not presented with a sick animal, or when not working as a veterinary clinician, it can be easy to say “Do not use important drugs in animals.” I have had interesting debates with colleagues, mainly from northern Europe, who say that we should never use such drugs as carbapenems in animals. Although I understand their point—and completely agree that veterinary use of drugs that are used to treat serious infections in humans must not compromise human health—I also know that I have many patients that had multidrug-resistant bacterial infections and are alive today because we used those drugs. Further, although any use can lead to resistance, does rare and prudent use in animals constitute any real risk for public health when we consider the tremendous use of these drugs in humans? I don’t think so, but admittedly, it’s a slippery slope. As we encounter more and more resistant bacteria, we will have more and more pressure to use subsequent generations of antimicrobials.