ANSES publishes three reports on antimicrobial resistance and veterinary pharmacovigilance
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News of 21/10/2013
ANSES publishes several reports on veterinary antimicrobial sales, animal antimicrobial resistance and veterinary pharmacovigilance.
2012 sales survey of antimicrobials
The French Agency for Veterinary Medicinal Products (ANSES-ANMV) has been monitoring veterinary antimicrobial sales since 1999. Along with bacterial resistance monitoring, the information gathered through this national monitoring scheme is indispensable for enabling antimicrobial resistance risks assessment. ANSES has been particularly active in this area for the last three years with regard to surveillance and risk assessment. While our involvement has shown encouraging results, a certain number of issues of concern still remain which merit our undivided attention.
In 2012, the total volume of antimicrobial sales came to 782 tonnes, which represents the lowest tonnage recorded since monitoring began. This confirms the decline in sales volumes observed in the preceding years (-41.2% since 1999, -33.3% over the last five years, -14.0% between 2011 and 2012). To assess the exposure of animals to antimicrobials, it is however necessary to take into account the dosage and the duration of treatment as well as changes in animal populations over time.
When taking all animal species into account, all-around exposure to antimicrobials in 2012 fell by 6.1% as compared to 2011. Between 2011 and 2012, exposure fell by 19.9 % for rabbits, by 10.1% for pigs, by 8.4 % for domestic carnivores, by 5.6% for poultry and by 0.6% for cattle. Therefore, an overall reduction in exposure of 10.9% has been observed over the last 5 years. A rise in exposure by cattle, which remains high (+4.6% since 2008 and +22.7% since 1999), and in poultry (-4.9% since 2008, +48.3% since 1999) should however be mentioned.
Overall, exposure by the oral route has fallen by 21.7% since 2007 while injection administration rose by 8.6%. This drop in oral route exposure is mainly due to a reduction in the use of medicated pre-mixes (-68.6% over 5 years) which seemed to pick up speed in 2012 (-28.6% compared to 2011). These variations most likely represent a reduction in preventive antimicrobial use.
However, the situation remains serious with regard to the exposure of animals to critical antimicrobials (3rd and 4th generation cephalosporins and fluoroquinolones). While exposure has practically remained stable, the level of exposure remains high in certain sectors. It has increased 2.5-fold since1999 and rose by nearly 25% over the last five years. The sharp decrease in use of these critical antimicrobials in certain animal sectors is proof that the targeted proactive initiatives that have been set up are producing results. Thus, following the voluntary restriction initiative conducted by the pork industry with regard to the use of latest generation cephalosporins, exposure of pigs to this antibiotic class decreased by 62.1% between 2010 and 2012.
2012 Annual Résapath network report – monitoring of antimicrobial resistance in animals
The Résapath network is an essential programme for the monitoring of antimicrobial resistance in animals to most of the bacteria responsible for infections in all animal species. It is coordinated by two of ANSES's laboratories (Lyon Laboratory and Ploufragan-Plouzané Laboratory) and its objective is to monitor the trends and changes in antimicrobial resistance in animal bacteria, detect certain cases of emerging resistance, and to characterise their molecular mechanisms. The network publishes an annual report providing an overview of its observations.
For 2012, the network's scope has been enlarged, with a significant increase in the number of data collected as well as a diversification of the sectors handled: 31 211 antibiogrammes from 64 laboratories in 2012 compared to 26 049 and 63 laboratories in 2011.
The main bacteria isolated is Escherichia coli, which represents 70% of the strains tested in poultry, approximately 50% in cattle and pigs, and 25 to 35% in small ruminants, rabbits and cats. E. coli comes in second in dogs, after coagulase-positive staphylococci, as well as in horses, after streptococcus.
Taking all species as a whole, the analysis of data shows a reduction in resistance in certain sectors, especially as concerns critical antibiotics such as 3rd and 4th generation cephalosporins. However, these results must not mask the fact the resistance to these antimicrobials in certain sectors remains high or continues to increase.
Resistance has therefore fallen in hens and chickens (from 21% to 14%), although this sector still has the highest level compared to the other animal groups: dogs (11.5%), calves and horses (8.5%), cats (8%), pigs (5%), sheep (4%), goats (3%), turkeys (2%), and rabbits (1%).
In addition, resistance continues to rise in cattle (butchery calves for the most part), as well as in dogs and horses.
Finally, multiple antimicrobial resistance is common in most sectors, especially for strains resistant to 3rd and 4th generation cephalosporins. This phenomenon is even more pronounced in cattle, horses and dogs.
2012 veterinary pharmacovigilance report
The goal of pharmacovigilance is to detect as quickly as possible any signs of emergence, whether an unexpected adverse effect, or an expected one whose frequency or severity is unexpected, and to take adequate measures, from inclusion of additional precautions for use to withdrawal of marketing authorisation (MA).
In 2012, the ANMV registered in its national data base 3 058 cases of adverse effects in animals, 43% of which were considered to be serious adverse effects.
Over 90% of the declarations submitted to institutional entities are sent in by veterinarians. Those sent in by animal owners or breeders represent 7.57%.
As in 2011, the vast majority of the adverse effects reported in 2012 involved domestic carnivores, with cats and dogs representing 82% of all declarations. Declarations concerning cattle represented 9.3 % of all declarations. Declarations for other species represented less than 2% per species.
For domestic carnivores, the most commonly mentioned drug class was antiparasitics (43% for dogs and 47% for cats, excluding permethrin). For cattle, vaccines are the group most commonly mentioned (32%).
The distribution of serious and minor cases varies depending on the drug class involved. For external and internal antiparisitics, the declarations are mostly minor (75% and 64% respectively). However, for vaccines, non-steroidal anti-inflammatory drugs and antimicrobials, the declarations involve mainly serious cases (74%, 65% and 59% respectively).
In 2013, ANSES-ANMV's priorities with regard to the monitoring of marketed drugs are concentrated in two areas:
- First, the reinforcement of post-authorisation monitoring of already-marketed drugs, which aims to account for all the issues regarding the use of veterinary medicinal products as well as their availability.
- And second, heightened awareness in the various sectors with regard to reporting adverse effects within the framework of the veterinary pharmacovigilance scheme, with continued communications campaigns and promotions in the industrial sectors, as well as targeted initiatives in the context of both initial and continued veterinary training.
For more information
- View the report: “Sales survey of Veterinary Medicinal Products containing Antimicrobials in France – 2012: Volumes and estimated exposure of animals to antimicrobials”
- View the report: “Résapath: French Surveillance Network for Antimicrobial Resistance in Pathogenic Bacteria of Animal Origin” (only in French)
- View the report: “Veterinary Pharmacovigilance: The French pharmacovigilance system and the main events of 2012 with regard to adverse reactions”
- Our close-up on Antimicrobial resistance