Antibiotic Amnesty

Host

Welcome to the Bova UK Podcast, where we discuss diseases from diagnosis through to management. These episodes are aimed at registered vets and veterinary nurses. If you’re listening as a pet owner, we always advise that if you have any concerns about your animal, please consult your local veterinary surgeon.

Today, I’m joined by Fergus Allerton to discuss the Antibiotic Amnesty. Antibiotic stewardship is one of Fergus’s many interests. Through his involvement with SAMSoc, he has been actively engaged in tackling antimicrobial resistance (AMR) and has played a key role in the PROTECT ME initiative, promoting rational antibiotic use in small animal practice.

More recently, Fergus has been editing the latest edition of the BSAVA Formulary—my go-to resource—so we’re thrilled to have him with us. Thank you, Fergus, for taking the time to join us.

Fergus

Thank you very much. Yes, I agree—it’s a topic that should inspire action. The Antibiotic Amnesty is a great opportunity to improve stewardship this year.

Host

In this podcast, we’ll stay focused on the Antibiotic Amnesty. We’ve discussed a range of related topics—including the PROTECT ME initiative and short antibiotic courses—but we’ll be covering those in more detail in upcoming webinars and podcasts for Antimicrobial Awareness Week in November. So today, let’s explore how the Antibiotic Amnesty can serve as a One Health tool to tackle AMR.

Fergus, could you start by explaining the One Health approach and how the Antibiotic Amnesty came about?

Fergus

The Antibiotic Amnesty was originally developed by NHS Midlands, spearheaded by pharmacy professionals who recognised a missing link in antibiotic stewardship. While we encourage responsible prescribing, many people still end up with leftover antibiotics for various reasons—maybe they recovered early, experienced side effects, or sadly passed away.

Work on the human side found that about 14% of people had leftover, full-strength antibiotics, many of which were then misused or improperly disposed of—often down toilets or into household waste. This exposes the environment to antibiotic residues, contributing to the development of resistant bacteria in our rivers and waste sites. These resistant bacteria can eventually return to impact human and animal health.

Host

So it all ties into One Health—where environmental, animal, and human health are interconnected?

Fergus

Exactly. For example, a study found that surfers had higher levels of multi-drug-resistant E. coli than non-surfers, likely due to exposure to contaminated water. While the volume of discarded antibiotics may be small, the potential for driving resistance is significant.

Host

That’s quite a startling thought. Coming back to pet owners—how common is it for them to have leftover antibiotics, and how can we start addressing that?

Fergus

Great question. Our survey from last year’s Amnesty, although with small sample sizes, found that 24% of pet owners had leftover antibiotics, and 38% had at some point in the past. That’s even higher than in human medicine.

The important message is: don’t keep or reuse them, don’t share them, and don’t dispose of them down the sink or in the bin. Reuse can delay diagnosis, cause adverse reactions, or lead to ineffective treatment. We even had a former health secretary admit she shared antibiotics with friends, which is exactly the behaviour we’re trying to discourage.

Host

Absolutely. Pet owners do have the best intentions, but the risks aren’t always visible—unlike seeing rubbish on a beach. It’s hard for them to grasp the environmental and health impact of antibiotic residues.

Fergus

Right. But awareness is growing. Campaigns like Keep Antibiotics Working are showing up in mainstream media. And if we don’t act, AMR could lead to 10 million deaths annually by 2050—more than the annual population of Sweden.

COVID caught us off guard, but AMR is something we’re actively contributing to—and we need to act before it’s too late. There are no new antibiotics on the horizon. If we want safe surgeries, chemotherapy, or even simple treatments, we need to protect the antibiotics we have.

Host

And the amnesty helps start that conversation?

Fergus

Exactly. Asking clients if they have leftover antibiotics opens the door to talk about appropriate use and environmental safety. Vets don’t reuse returned products—they’re incinerated, safely and responsibly, which is a cost to the practice. It’s about doing the right thing.

Host

So how does the disposal process work in practice?

Fergus

Since June 2023, all GP-level RCVS-accredited practices are required to take an active role in recovering leftover pharmaceuticals—not just antibiotics. Practices have proper containers and collection pathways to ensure safe disposal. This isn’t about profit; it’s about stewardship.

Host

How did the 2022 Amnesty go?

Fergus

We were proud of the outcome. It started with the NHS Midlands pilot in 2021 and expanded to the veterinary sector in 2022. Over 150 practices got involved, with support from the VMD, RCVS, BSAVA, BVA, BEVA, veterinary corporates, and independent vets.

We recovered over 750 tablets, partial boxes, ear drops, injections—including some critically important antibiotics like fluoroquinolones. But more importantly, we raised awareness. People started having conversations, became more conscious, and committed to returning unused antibiotics.

Host

So what’s the plan for the 2023 amnesty?

Fergus

It’s already underway! Practices can sign up on the RUMA Companion Animal & Equine website or via RCVS Knowledge. There are posters, guidance materials, and videos to share with clients. We encourage practices to set up a collection container and train all staff—vets, nurses, and client care teams—to spread the word.

The amnesty runs throughout November to align with World AMR Awareness Week. Other initiatives like Go Blue for AMR will be happening too—last year, even Blackpool Tower lit up blue!

Host

And there’s a survey and prizes?

Fergus

Yes! At the end of the month, practices can report on how many antibiotics were returned and what conversations they had. That helps us understand what’s being left behind and how we can improve. There are prizes for completing the survey—everything from BSAVA manuals to Congress tickets. But most importantly, it helps us build momentum for 2024.

Host

That’s brilliant. I’ll include all the links in this podcast episode and future communications. It’s such an easy way for practices to get involved and make a difference. Fergus, thank you so much for your time—and we look forward to hearing more about the PROTECT ME poster and short course studies later this year.

Fergus

Thank you—and yes, please do get involved in the 2023 Antibiotic Amnesty. The more practices we have on board, the greater the impact.

Host

And as always, these podcasts are intended for registered vets and veterinary nurses. If you’re listening as a pet owner, please consult your local veterinary surgeon if you have any concerns.