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French Agency for Food, Environmental and Occupational Health & Safety

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Updated on 10/10/2017

Monitoring sales of veterinary antimicrobials

Keywords : Antibiotics, Antimicrobials, Veterinary medicinal products, Veterinary drugs, Antibiotic resistance, Antimicrobial resistance

Veterinary antimicrobial sales have been monitored annually by the Agency since 1999. Monitoring of these sales is based on the recommendations in Chapter 6.8 of the OIE's 2016 Terrestrial Animal Health Code "Monitoring of the quantities and usage patterns of antimicrobial agents used in food-producing animals.

Why should antimicrobial sales be monitored?

Veterinary antimicrobial sales are monitored in order to evaluate their use and the way antimicrobial therapy for different animal species is evolving (see the sales report for 2016).
Along with bacterial resistance monitoring, the information gathered through this national monitoring scheme is indispensable for assessing the risks related to antimicrobial resistance.
This data also make it possible to recommend measures for managing these risks and to monitor the effects of these measures.

 

How is monitoring conducted?

The monitoring of antimicrobial sales is based on an annual sales declaration by the laboratories that market them. This data can be cross-matched with other sources of information (declaration of turnover, prescription surveys, etc.).
The information gathered from laboratories covers 100% of authorised medicinal products. Off-label use of human commercial products and extemporaneous formulations that fall under the provisions of the Cascade approach (Article L. 5143-4 of the French Public Health Code) are not taken into account. Since 2009, laboratories have provided target species distribution data for most of the products declared. For some species, declarations can be confirmed using surveys of veterinary prescriptions and use by livestock farmers.

 

How should the results be interpreted?

The data supplied for antimicrobial sales volumes do not include the details of their use. This is because recent antimicrobials are more potent and require administration of lower doses. To assess the exposure of animals to antimicrobials, it is necessary to take into account the dosage and duration of treatment as well as evolutions in the animal population over time. The ALEA (Animal Level of Exposure to Antimicrobials) estimates the level of exposure of animals to antimicrobials. Consequently, a decrease in sales volume does not necessarily mean a decrease in the use of such products.
The national EcoAntibio plan set up in 2012 for veterinary medicine aims to reduce antimicrobial use (all classes taken as a whole) by 25% in 5 years and to sustainably maintain the available therapeutic arsenal.


What are the main trends that have been observed?

Sales volumes 

In 2016, the average total sales volume for antimicrobials was close to 530 tonnes, a reduction of 18.5% compared to the average for 2014 and 2015.

While 1311 tonnes of antimicrobials were sold in France in 1999, the figure was 910 tonnes in 2011, the EcoAntibio plan’s year of reference. The 530 tonnes recorded in 2016 reflect a reduction of 41.8% compared with 2011.

Exposure of animals to antimicrobials

Since monitoring began in 1999, the Animal Level of Exposure to Antimicrobials (ALEA) has declined by 31.4% in France.

In 2016, the ALEA fell by 20.5% compared with the average for 2014 and 2015.

When taking all animal species as a whole, overall exposure has declined by 36.6% in France over the last five years.
A drop in exposure to antimicrobials was observed for all species compared to 2011 (cattle -24.3%, pigs -41.5%, poultry -42.8%, rabbits -37.6%, cats and dogs -19.4%).

 

Are there any changes that justify the implementation of specific measures?

Third- and fourth-generation Cephalosporins and Fluoroquinolones are considered to be particularly important in human medicine because they are the only, or one of the few, alternatives for treating certain infectious human diseases. In keeping with European recommendations, these antimicrobials should therefore be reserved for second-line therapy only.
Since monitoring began in 1999, the observed overall decrease in the volume of antimicrobial sales can be explained by an increase in the use of these more recent and more potent compounds.
The French Act on the future of agriculture, food and forestry set a goal of a 25% reduction over three years of the use of these classes of antimicrobials, using 2013 as the reference year. This goal has been achieved and even exceeded: in 2016, exposure to Fluoroquinolones and latest-generation Cephalosporins fell by 74.9% and 81.3% respectively compared to 2013.
In addition, the November 2015 publication describing the first plasmid-mediated colistin resistance mechanism has led to reinforced surveillance being implemented for this antimicrobial. After an increase in colistin exposure up to 2007, it then remained relatively stable between 2008 and 2011, and has declined over the last five years. Exposure to this antibiotic fell by 55.1% compared to 2011 (when taking into account all species and administration routes globally).


What is the situation in France as compared to the other European countries?

Coordinated monitoring of antimicrobial sales for use in animal health on the European level was initiated in 2010 by the EMA (European Medicines Agency).

In 2015, France was ranked as the 12th heaviest consumer of the 30 participating countries (source ESVAC), with consumption well below the average for European countries (70.2 mg/kg vs 135.5 mg/kg).