Antimicrobial Resistance Rob Doyle SSVI Antimicrobial - PowerPoint PPT Presentation

In-Feed Medication and Antimicrobial Resistance • Rob Doyle SSVI • Antimicrobial Resistance, Veterinary Medicines, Animal welfare and Live Ruminant Trade Division. • Department of Agriculture, Food and the Marine

Outline • In-feed medication • Why is it of concern? • Actions being taken at national level • Future changes. 2 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Why Use In-Feed Medication? • a stress-free and safe way to safeguard farm animal health and welfare • To assist good husbandry • – NOT replace it….. • Challenges re prudent use… 3 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

How much in-feed medication is used and in what species? • Health Products Regulatory Authority (HPRA) data • Research data 4 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Latest data up to 2018 Year 2013 2014 2015 2016 2017 2018 Total 99.05 89.4 96.99 103.42 99.65 99.39 45 40 35 Tetracyclines 30 Sulphonamides & trimethoprim Tonnes sold 25 Penicillins Macrolides & lincosamides 20 Aminoglycosides 15 Amphenicols 10 Fluoroquinolones Cephalosporins 5 0 2013 2014 2015 2016 2017 2018 Year 5 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Pharmaceutical form breakdown of veterinary antibiotics sold in 2016 in Ireland 35 tonnes 35 tonnes HPRA 2018, Report on consumption of veterinary 6 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine antibiotics in Ireland during 2016

Pharmaceutical form breakdown of veterinary antibiotics sold in 2018 in Ireland HPRA 2019, Report on consumption of veterinary 7 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine antibiotics in Ireland during 2018

Antibiotic Use in Poultry • Feb 2017-Jan 2018 • large in use during 2017 and early 2018 Lisa Bradford, AMURAP Project

Patterns of Use in Pigs CREEP: LINK: SOW: WEANER: FINISHER: 7 - 14 days 4 - 6 weeks 10 - 12 7 - 14 days Medicated p.w. 8.9% of feed provided weeks farms did (+/- for 5 - 10 days not use nursery) once or twice medicated 53.7% of 20.9% of 79.1% of per year. diets farms farms farms 80.5% of 22.3% of farms farms 83.1 % creep link weaner 62.41% 6.67% 13.97% 13.67% 3.29% finisher mg 55.25% sow DDD 10.39% 17.63% 13.82% 2.90% 2 nd Stage Nursery: 1 st Stage Finisher: 4 weeks weaner: weaner: 10 – 12 4 - 5 weeks 4 weeks weeks

Zinc Oxide Patterns of Use CREEP: LINK: WEANER: 97% of 95% of 34% of farms farms farms • High levels of dependence on ZnO and antibiotics in feed at weaning • Ban on ZnO from 2022 10 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Outline • In-feed medication • Why is it of concern? • Actions being taken at national level 11 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

O’Neill Review on Antimcrobial Resistance, 2016

AMR in Humans - Ireland • ↓MRSA • ↑ESBL E. coli • ↑CPE

AMR in Animals - National Surveillance Programme • Broilers, pigs, calves • MDR Salmonella - pigs • ESBL-producing E. coli - poultry 2016 • Alternative year sampling

Outline • In-feed medication • Why is it of concern? • Actions being taken at national level 15 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Levels of Antimicrobial Resistance in Salmonella in Pigs - 2015

Antimicrobial Consumption Database • To enable policy makers to fight AMR • Identify areas of the animal population with low and high consumption • Monitor use of Critically Important Antibiotics (CIAs) ‘If you can’t measure it, • Monitor trends you can’t improve it’. • Peter Drucker, More meaningful outputs Business Management Consultant

Critically Important Antibiotics - CIAs • WHO categorises certain antimicrobials used in human health as ‘critically important’. • Given their importance these should NOT be used as first line treatment of animals • Should only be used when there are no effective alternative antimicrobials available for the respective target species and indication. • DAFM Highest Importance Critically important antibiotic policy.

Veterinary Written Directives (VWD) • DAFM review in 2019. VWDs must prescribe in line with the product characteristics, • Some issues with VWDs. — Not correctly completed — Underdosing of antimicrobials — Treatment length incorrect — Withdrawal period not correctly identified. • Follow up with Vets and Feedmills. — Good improvement but still some issues. 19 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Outline • In-feed medication • Why is it of concern? • Actions being taken at national level • Future changes. 20 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

New Legislation • Regulation EU 2019(4) on medicated feed • Regulation EU 2019(6) on Veterinary medicinal products. • Come into force 28 January 2022. • This legislation is focused reducing AMR • Far reaching changes 21 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

New Legislation • Use of Zinc Oxide in pigs will be prohibited. • Prophylactic use of antibiotics will not be allowed. • Metaphalytic use also not allowed. • Vets only allowed to prescribe on the basis of a clinical diagnosis. • Quantity prescribed is to be limited to the amount required to treat the diagnosed condition. 22 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine

Who’s Responsible? • Competent Authority - regulation/policy • Veterinary pharmaceutical industry • Veterinarians • Animal feed manufacturers • Distributors • Food animal producers 23 An Roinn Talmhaíochta, Bia agus Mara | Department of Agriculture, Food and the Marine http://oie-antimicrobial.com/

Take Home Messages • Antibiotic use drives antimicrobial resistance. • 67% of all veterinary antibiotics are given orally (in- feed/water/top dressing) • In-feed medication - challenges re. better targetting of treatments, ensuring correct dosages • Scope for other control measures for disease