French Pharmacists’ and Veterinarians’ Ethical Perspectives about the Delivery of Antibiotics for Animals: A Content Analysis of Practitioner Literature

in Journal of Applied Animal Ethics Research
Restricted Access
Get Access to Full Text
Rent on DeepDyve

Have an Access Token?

Enter your access token to activate and access content online.

Please login and go to your personal user account to enter your access token.

Help

 

Have Institutional Access?

Login with your institution. Any other coaching guidance?

Connect

Abstract

Amongst the current, most important, international priorities in public health is the issue of bacterial resistance to antibiotics. This issue is due to the wide misuse and overuse of these drugs, both in human and veterinary medicine. Veterinarians fulfil a very important role as guardians of animal health and as public health actors; if they do not use antimicrobials judiciously, animal health and welfare as well as public health will be severely compromised. Therefore it is of particular importance to study the professional ethos of veterinarians as regards the delivery of antibiotics for animals. In Europe laws and practices regarding the delivery of antimicrobial drugs for animals differ from state to state. In some states, veterinarians are not allowed to sell drugs, they only prescribe, and pharmacists deliver the drugs. In other states, including France, veterinarians are allowed to deliver the drugs they prescribe. In France, veterinarians have thus been accused of conflict of interest; of overprescribing to sell more antibiotics and thus earn more money. Therefore, it appeared particularly accurate to not only study the ethos of veterinarians regarding the delivery of antibiotics to animals, but to also compare this ethos to that of pharmacists. To the authors’ knowledge, such a study has never been carried out in any country. Veterinarians’ and pharmacists’ professional literature was studied and compared using qualitative and quantitative content analysis. A sample of comparable journals was selected for both professions. The study was carried out over a relevant five year period extending from the beginning of 2008 till the end of 2012. All papers dealing with antimicrobial resistances as well as the prescription and delivery of antibiotics for animals were objectively and comprehensively searched and collected using keywords. The selected papers were subsequently independently coded by a multidisciplinary team of coders using conventional, inductive, thematic analysis. The final coding grid was obtained after consensus meetings were held in order to ensure reliability and validity of the data. The results showed that the veterinarians’ professional literature studied reflected a primary concern for ethics whereas the pharmacists’ professional literature primarily focused on marketing. Half of the veterinary continuing education papers dealt with different aspects of ethics; the other half focused on the scientific aspects of antimicrobial resistances. Amongst other papers, more than 30% tackled ethical questions in relation with the delivery of antibiotics for animals. Conversely, in the pharmacists’ literature, half of the continuing education papers concentrated on marketing; the other half described the pharmacology of drugs. Amongst other papers, 60% addressed marketing issues. Ethical questions per se were not approached in the pharmacists’ professional literature studied. In conclusion, veterinary ethos for prescription ethics, good antibiotic use and animal welfare seems to be a feature of the profession. According to this research, the claim that veterinarians are responsible for antibiotic resistances because of conflict of interest is not true.

  • AlanisA.J. (2005). “Resistance to antibiotics: are we in the post-siotic era?Arch Med Res. 36:6697705.

  • AndremanisaA.EyebeS.MolloB.RamassamyJ.-L. & VasilinA. (2015). Comparaison internationale des stratégies de contrôle de l’antibiorésistance. Institut Pasteur et Conservatoire National des Arts et Métiers (CNAM) [Accessed October 30 2017] p. 19. Available from: http://www.bichat-larib.com.

    • Export Citation
  • AndrillonC. (2011). “Découplage prescription délivrance: la presse pharmaceutique joue du sécateur”. Dépêche Vét. 11372.

    • Search Google Scholar
    • Export Citation
  • AndrillonC. & LafonM. (2012). “Découplage prescription délivrance: les têtes pensantes de l’hydre”. Dépêche Vét. 116149.

    • Search Google Scholar
    • Export Citation
  • BassettiM.PoulakouG.RuppeE.BouzaE.HalS.J.V. & BrinkA. (2017) “Antimicrobial resistance in the next 30 years, humankind, bugs and drugs: a visionary approach”. Intensive Care Med. 43:1014641475.

    • Search Google Scholar
    • Export Citation
  • BerelsonB. (1952). Content Analysis in Communication Research. Illinois: Glencoe, III., The Free Press (Foundations of Communication Research).

    • Search Google Scholar
    • Export Citation
  • BezerraW.G.A.HornR.H.SilvaI.N.G.TeixeiraR.S.C.LopesE.S.AlbuquerqueÁ.H.et al. (2017). “Antibiotics in the poultry industry: a review on antimicrobial resistance”. Arch Zootec. 66:254301307.

    • Search Google Scholar
    • Export Citation
  • BoyatzisR.E. (1998). “Transforming qualitative information. Thematic analysis and code development”. In: Thousand Oaks. California: Sage.

    • Search Google Scholar
    • Export Citation
  • CostelloeC.MetcalfeC.LoveringA.MantD. & HayA.D. (2010). “Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis”. BMJ. 340c2096.

    • Search Google Scholar
    • Export Citation
  • DahanM.HanotauxP.DurandF. & LiebertF. (2013). Encadrement des pratiques commerciales pouvant influencer la prescription des antibiotiques vétérinaires. Maisons-Alfort: ANSES (Agence Nationale Sécurité Sanitaire Alimentaire Travail).

    • Search Google Scholar
    • Export Citation
  • DuphotV. (2011). “Antibiorésistance: la séparation de la prescription et de la délivrance est une piste de réflexion pour John Dalli”. Dépêche Vét. 11316.

    • Search Google Scholar
    • Export Citation
  • EarnshawS.MonnetD.L.DuncanB.O’TooleJ.EkdahlK.GoossensH.et al. (2009). “European Antibiotic Awareness Day, 2008—the first Europe-wide public information campaign on prudent antibiotic use: methods and survey of activities in participating countries”. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 14:3019280.

    • Search Google Scholar
    • Export Citation
  • European Centre for Disease Prevention and Control (ECDC) (2017a). European Antimicrobial Resistance Surveillance Network (EARS-Net) [Accessed October 30 2017]. Available online: http://ecdc.europa.eu/en/about-us/partnerships-and-networks/disease-and-laboratory-networks/ears-net.

    • Export Citation
  • European Centre for Disease Prevention and Control (ECDC) (2017b). Annual surveillance reports on antimicrobial resistance [Accessed October 30 2017]. Available online: http://ecdc.europa.eu/en/antimicrobial-resistance/surveillance-and-disease-data/report.

    • Export Citation
  • FAO—Food and Agricuture Organization of the United Nations (2017). OIE—World Organization for Animal Health. Global Framework for Development and Stewardship to Combat Antimicrobial Resistance: Draft Roadmap. FAO. OIE. WHO.

  • French Ministry of Agriculture Agro-food and Forestry (2016). EcoAntibio: Reducing antibiotic use in veterinary medicine. EcoAntibio plan 2012–2016: Summary and Key Achievements [Accessed October 30 2017]. Available online: http://agriculture.gouv.fr/plan-ecoantibio-2012-2017-lutte-contre-lantibioresistance.

    • Export Citation
  • HoelzerK.WongN.ThomasJ.TalkingtonK.JungmanE. & CoukellA. (2017). “Antimicrobial drug use in food-producing animals and associated human health risks: what, and how strong, is the evidence?BMC Vet Res. 13211.

    • Search Google Scholar
    • Export Citation
  • HollowayK.A.KotwaniA.BatmanabaneG.PuriM. & TisockiK. (2017). “Antibiotic use in South East Asia and policies to promote appropriate use: reports from country situational analyses”. The BMJ. 358 [Accessed October 29 2017]. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598252/.

    • Search Google Scholar
    • Export Citation
  • HolstiO.R. (1969). Content Analysis for the Social Sciences and Humanities. Reading, MA: Addison-Wesley (Language Arts and Disciplines).

    • Search Google Scholar
    • Export Citation
  • FuehlauI. (1978). “Untersucht die Inhaltsanalyse eigentlich Inhalte? Inhaltsanalyse und Bedeutung”. Publizistik. 23718.

  • GerardsM. (2011). International Policy Overview: Antibiotic Resistance [Accessed October 29 2017]. Available online: http://apps.who.int/medicinedocs/en/d/Js19478en/.

    • Export Citation
  • Government of Alberta (2011). “Antibiotic Resistance: Why is it important and what are we doing?” Alberta Health and Wellness Community and Population Health. Available online: www.health.alberta.ca/…/Antibiotic-Awareness-Week-2011.pdf.

  • KlueverJ. (1979). “Kommunikative Validierung”. In: Theoretische und methodische Ueberlegungen zum Typus hermeneutisch-lebensgeschichtlicher Forschung. Hagen, Germany: Heinze T.6984. (Fernuniversitaet).

    • Search Google Scholar
    • Export Citation
  • KrippendorffK. (2013). Content Analysis: An Introduction to Its Methodology3rd edition. Thousand Oaks, CA: Sage.

  • KuckartzU. (2014). Qualitative Text Analysis. A Guide to Methods Practice & Using Software1st edition. Thousand Oaks, CA: Sage.

  • Le Coz P. (2013). “Avis n° 2013–2 relatif à la participation de vétérinaires praticiens au comité d’experts spécialisé « Médicament vétérinaire » [saisine n° 10]”. ANSES (Agence Nationale de Sécurité Sanitaire Alimentation Environnement Travail) Comité de Déontologie et de Prévention des Conflits d’Intérêt [Accessed October 30 2017]. Available online: https://www.anses.fr/fr/system/files/DEON-Ft-2013002.pdf.

  • ManageiroV.Salgueiro V.Ferreira E. & Caniça M. (2017). “Bacterial resistances”. In: Exposure to Microbiological Agents in Indoor and Occupational Environments. Springer403415.

    • Search Google Scholar
    • Export Citation
  • MaruchitchR. (2013). Le conflit d’intérêts des vétérinaires [Accessed October 30 2017]. Available online: http://www.lemonde.fr/sciences/article/2013/04/04/le-conflit-d-interets-des-veterinaires_3154143_1650684.html.

    • Export Citation
  • MayringP. (2014). Qualitative Content Analysis: Theoretical Foundation Basic Procedures and Software Solution1st edition. Austria: Klagenfurt. Available online: www.beltz.de.

    • Search Google Scholar
    • Export Citation
  • MazièreM. (2011). “Prescripteur et dispensateur de médicaments: La double casquette du vétérinaire agace toujours”. Quotid Pharm. 28415.

    • Search Google Scholar
    • Export Citation
  • Ministère du Travail de l’emploi et de la Santé (2011). Plan national d’alerte sur les antibiotiques 2011–2016. Ministère français de la Santé [Accessed October 30 2017]. Available online: https://www.antibio-responsable.fr/tous-responsables/pouvoirs-publics.

    • Export Citation
  • Moritz T. (2008). Contrôle de la prescription de la dispensation et de la délivrance des médicaments vétérinaires destinés aux animaux d’élevage par les Pharmaciens Inspecteurs de Santé Publique. Ecole des Hautes Etudes en Santé Publique (EHESP). Available online: https://documentation.ehesp.fr/memoires/2008/phisp/moritz.pdf.

  • NeuendorfK. (2017) The Content Analysis Guidebook2nd edition. Thousand Oaks, CA: Sage.

  • O’NeillJ. (2016). Tackling drug-resistant infections globally: final report and recommendations. Wellcome Trust and UK Government. Available online: https://amr-review.org/.

    • Export Citation
  • Pharmavet. (2011). “Antibiorésistance: ‘le pharmacien fait partie de la solution’”. Pharmavet. 1944.

  • PouzaudF. (2011). “Nos amis les vétos …Monit Pharm. 2897:12432.

  • Roca I.Akova M.Baquero F.Carlet J.Cavaleri M.Coenen S.et al. (2015). “The global threat of antimicrobial resistance: science for intervention”. New Microbes New Infect. 62229.

    • Search Google Scholar
    • Export Citation
  • RollinB.E. (2006). An introduction to Veterinary Medical Ethics. Theory and Cases2nd edition. Ames, IA: Blackwell Publishing Professional.

    • Search Google Scholar
    • Export Citation
  • RustH. (1981). Methoden und Probleme der Inhaltsanalyse. Eine Einführung. Tübingen: Narr Verlag.

  • Saam M. Huttner B. & Harbarth S. (2017). Evaluation of antibiotic awareness campaigns. World Health Association (WHO) University of Geneva Hospitals and Faculty of Medicine Geneva Switzerland. Available online: www.who.int/selection.../s6_antibiotic_awareness_campaigns.pdf.

  • SørumH. & Sunde M. (2001). “Resistance to antibiotics in the normal flora of animals”. Vet Res. 32:3–4227241.

  • SreejaM.K.GowrishankarN.I.AdishaS. & DivyaK.C. (2017). “Antibiotic resistance-reasons and the most common resistant pathogens—a review”. Res J Pharm Technol. 10:618861890.

    • Search Google Scholar
    • Export Citation
  • StegeH.BagerF.JacobsenE. & ThougaardA. (2003). “VETSTAT—the Danish system for surveillance of the veterinary use of drugs for production animals”. Prev Vet Med. 57:3105115.

    • Search Google Scholar
    • Export Citation
  • StoneP.J. (1997). “Thematic text analysis: new agendas for analyzing text content”. In: Text Analysis for the Social Sciences Methods for Drawing Statistical Inferences from Texts and Transcripts. Mahwah, NJ: C.W. Roberts3554.

    • Search Google Scholar
    • Export Citation
  • TadesseB.T.Ashley E.A.Ongarello S.Havumaki J.Wijegoonewardena M.González I.J.et al. (2017). “Antimicrobial resistance in Africa: a systematic review”. BMC Infect Dis. 17616.

    • Search Google Scholar
    • Export Citation
  • TannenbaumJ. (1985). “Ethics and human- companion animal interaction. A plea for a veterinary ethics of the human-companion animal bond”. Vet Clin North Am Small Anim Pr. 15:2431447.

    • Search Google Scholar
    • Export Citation
  • TeuberM. (2001). “Veterinary use and antibiotic resistance”. Curr Opin Microbiol. 4:5493499.

  • The White House (2014). US National Strategy for combating antibiotic-resistant bacteria [Accessed October 29 2017]. Available online: https://www.cdc.gov/drugresistance/federal-engagement-in-ar/national-strategy/index.html.

    • Export Citation
  • Van den BogaardA.E. & StobberinghE.E. (2000). “Epidemiology of resistance to antibiotics”. Int J Antimicrob Agents. 14:4327335.

    • Search Google Scholar
    • Export Citation
  • VentolaC.L. (2015a). “The antibiotic resistance crisis”. Pharm Ther. 40:4277283.

  • VentolaC.L. (2015b). “The antibiotic resistance crisis”. Pharm Ther. 40:5344352.

  • WHO (World Health Organization) (2015). Global action plan on antibioresistances. Available online: http://www.who.int/antimicrobial-resistance/global-action-plan/en/.

    • Export Citation
  • WHO (World Health Organization) (2017). World Antibiotic Awareness Week. Available online: http://www.who.int/campaigns/world-antibiotic-awareness-week/en/.

    • Export Citation
  • ZamanS.B.Hussain M.A.Nye R.Mehta V.Mamun K.T. & Hossain N. (2017). “A review on antibiotic resistance: alarm bells are ringing”. Cureus. 9:6e1403.

    • Search Google Scholar
    • Export Citation

Content Metrics

All Time Past Year Past 30 Days
Abstract Views 46 46 11
Full Text Views 3 3 0
PDF Downloads 4 4 0
EPUB Downloads 0 0 0