role of veterinary profession in antimicrobial …...role of veterinary profession in antimicrobial...
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Role of veterinary profession in antimicrobial resistance prevention
Paris, 13th – 15th March 2013
OIE – Global Conference on the Responsible and Prudent Use of Antimicrobial Agents for Animals
Herzog U., Fuchs K.
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Contents
• General remarks
• Antimicrobial use in Austrian poultry production
• Future data acquisitions on antimicrobial consumption
• Summary
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International activities
• WHO – European strategic action plan on antimicrobial resistance http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/antimicrobial-resistance
• OIE – What does OIE do on antimicrobial resistance? http://www.oie.int/fileadmin/Home/eng/Media_Center/docs/pdf/AMR_OIE.pdf
• USA & EU - Transatlantic Taskforce on Antimicrobial Resistance http://ecdc.europa.eu/en/activities/diseaseprogrammes/tatfar/pages/index.aspx
• EU – Commission - Action plan against the rising threats from Antimicrobial
Resistance http://ec.europa.eu/health/antimicrobial_resistance/policy/index_en.htm
• EU – Council – Council conclusions on the impact of antimicrobial resistance
in the human health sector and the veterinary sector – a „One Health“
perspective http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2012:211:0002:0005:DE:PDF
• EU – Parliament - ENVI– 6. November „The Microbial Challenge – Rising
threats from Antimicrobial Resistance“ http://www.europarl.europa.eu/meetdocs/2009_2014/documents/envi/am/914/914122/914122en.pdf
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EU – Parliament - Statement
• EU – Parliament - ENVI– 6. November „The Microbial Challenge
Rising threats from Antimicrobial Resistance“
– Considers that the pending revision of Directive 2001/82/EC
offers an important opportunity to take effective measures to
reduce AMR through strengthening the provisions for veterinary
medicines, such as:
– limiting the right to prescribe antimicrobials to professionally
qualified veterinarians only;
– separating the right to prescribe from the right to sell
antimicrobials thus eradicating economic incentives to
prescribe;
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Does it help to meet our
challenges ??
My answer is NO!!
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Agricultural structure in
Austria
Species Livestock Holdings Average
Cattle 1.976.527 69.586 28
Pigs 3.097.253 31.726 98
Sheep 431.083 16.374 26
Goats 92.816 10.901 9
Equids 73.202 15.257 5
Poultry 11.848.183 52.849 224
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Source: Austrian Veterinary Report 2011
Animal Health Services (AHS or VHS)
Participation rate (2010) • Public Private Partnership
– Authority of federal and provincial
level
– Chamber of Agriculture,
Veterinarians, Consumers and
Economy
• The objectives
– Improvement of animal health
– Prevention of infectious diseases
– Best possible diagnosis
– Advice
– Quality assurance of foodstuffs
– Increasing the productivity
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Use of veterinray medicines
• Contract between livestock
owner and veterinarian
• Education of livestock
farmer
• Documentation
• Regularly implemented
livestock surveys
• Sanctions
• Animal health programmes
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Contents
• General remarks
• Antimicrobial use in Austrian poultry production
• Future data acquisitions of antimicrobial consumption
• Summary
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Which questions are
important?
• Analysis of the data which was collected by the
“Austrian Poultry Health Service” (QGV) over the
period 2008 – 2011.
• Three main questions
– Does antimicrobial treatment change with time?
– Are there „special“ premises which use markedly more
or less antimicrobial agents?
– Are there differences between Vets concerning
diagnoses and use of antimicrobial agents?
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Question 1:
Does antimicrobial treatment
change with time?
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Broilers, AB-treatment / time
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Year of treatment
2008 2009 2010 2011
Treatment Livestock with
treatment number 106 105 134 132
Livestock without
treatment number 331 344 318 332
Year of treatment
2008 2009 2010 2011
Substance [tons] 2,39 2,42 2,38 2,35
Antimicrobial [g] and
n PDD / Livestock unit (LU)
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Antimicrobial [g] / LU and year “prescribed daily doses”
(PDD) [n] / LU and year
for example : broiler
Question 2:
Are there „special“ premises which
use markedly more or less
antimicrobial agents?
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Special premises
Steps to do:
1. Select the population
For example: breeding young laying
hens
2. Statistical analysis of the
collected data.
For example: nPDD/LU and year
3. Define a threshold:
For example: outlier of boxplot
(4,46 PDD/ LU and year)
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Special premises – young laying hens
Deviation of n PDD per livestock unit and year from overall threshold Laying hens 2008 -2011
livestock
De
via
tio
n o
f n
PD
D/ L
U/ ye
ar
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Question 3:
Are there differences between Vets
concerning diagnoses and use of
antimicrobial agents?
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Relationship between
veterinarian and diagnoses
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Veterinarian- Code
Nu
mb
er
of
dia
gn
ose
s
Diagnoses - broiler ATC Code 1st level Total
number QA QJ01 QP % QJ01
Bacterial infection
VET-Code
QGV0144 0 152 0 152 100,0%
QGV0146 8 32 0 40 80,0%
QGV0150 0 14 0 14 100,0%
QGV1183 170 1184 0 1354 87,4%
QGV1713 271 2192 1 2464 89,0%
QGV1742 11 188 0 199 94,5%
QGV1778 44 1740 0 1784 97,5%
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For example: bacterial infection - broiler
Relationship between
vet, diagnoses and antibiotic
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Quantity of
antimicrobial
[g]/LU
n PDD/LU
Median Median
Vet-Code
QGV0144 2,8 0,1
QGV0146 1,6 0,2
QGV0150 1,2 0,2
QGV1183 2,3 0,1
QGV1713 0,6 0,1
QGV1742 0,5 0,1
QGV1778 1,0 0,2
Relationship between
vet and quantity of antibiotic
For example: bacterial infection – antimicrobial QJ01 (broiler)
Contents
• General remarks
• Antimicrobial use in Austrian poultry production
• Future data acquisitions of antimicrobial consumption
• Summary
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AMC – Three levels
Pharmaceutical industry
Veterinarian Veterinarian Veterinarian
Livestock Livestock Livestock Livestock
S A L E
T R E A T M E N T
D E L I V E R Y
P U R C H A S E
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Data acquisition
P R E M I S E –
R E G I S T E R
PRACTICE-
SOFTWARE
S AL E V E TP H AR M
( 2 0 1 5 )
TREATMENT
Database
(compulsary)
Database
(voluntary)
Livestock
T R E AT M E N T
Pharmaceut. industry
Livestock
DELIVERY (TAKG)
PURCHASE
ESVAC
P R A C T I C E
- S O F T WA R E
QGV, producer groups (Pig
or Beef, Milk, or breeding )
AB-Treatment
Bundler –
“bottle - neck”
Veterinarian
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What is the benefit?
– De-bureaucratization of recording obligations - when electronic
systems are used.
– Minimization of documentation deficiencies in Animal Health
Service - improving system performance.
– Use of existing information - arguments for the retail (- see Poultry
and antibiotics)
– Additional value for quality assurance systems.
– Discussion of the antimicrobial consumption in livestock
production on the basis of facts and not with the help of
assumptions! - Strengthens the credibility of the system
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Veterinarian´s role
• Veterinarians play key roles concerning
– prudent use of antibiotics
– documentation on the farm
– supervision of the farmer
– data collection
– data quality
• Veterinarians have to fulfil further obligations.
• Veterinarians should remain the right of prescription
and the right to sell antibiotics
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Contents
• General remarks
• Antimicrobial use in Austrian poultry production
• Future data acquisitions of antimicrobial consumption
• Summary
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Summary
• What does the future implicate?
– The use of antimicrobial agents determines future national and international discussions.
– Public discussions of use of antibiotics are often launched topics –
but the real issues are the agricultural systems, animal welfare or food production.
– Responsibility of veterinarians and livestock owners will be called.
– Electronic record keeping requirements will get standard.
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There is the need for substantive
arguments, which are supported by facts
in order to justify the use in livestock
production and to ensure the veterinary
medicine cabinet in the hands of veterinarians!
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Thanks to
Thank you for your attention !
Austrian Poultry
Health Service (QGV) www.qgv.at
Klemens Fuchs Austrian Agency for Health and Food Safety,
Department for Data, Statistics and Risk Assessment,
Vienna, Austria
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