Veterinary drugs: an update on antibiotic sales9 November 2012
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News of 09/11/2012
The analysis of the use of antibiotics in veterinary medicine in France is based on two complementary systems: periodic studies conducted on farms or with veterinary practitioners and the yearly monitoring of sales of veterinary medicinal products containing antibiotics. The results for 2011 of this monitoring report were published today. They show a decrease in the overall exposure of animals to antibiotics over the last five years and seem to confirm the positive impact of the various plans implemented recently on the responsible use of antibiotics.
· Sales volumes
In 2011, the volume for antibiotics sold totalled 913.6 metric tonnes, which is the lowest volume recorded since monitoring began. The results for 2011 confirm the reduction in sales volume observed over the preceding years (-31.2% since 1999, -31.1% over the last 5 years, -9.9% between 2010 and 2011).
Due to the different levels of activity and dosages of the various antibiotics, tonnage sales do not reflect antibiotic use perfectly. In fact, the more recent antibiotics are generally more highly active and require administration of lower doses. Therefore, to correctly assess animal exposure to antibiotics, it is especially important to take into account the duration of treatment as well as modifications in animal populations over time.
· Exposure of animals to antibiotics
While overall exposure rose from 1999 to 2007, since then a decrease in exposure has been observed. In 2011, animal exposure to antibiotics decreased by 3.7% compared to the preceding year. This general trend needs to be qualified with regard to the target species and the substance class. For cattle, pigs, rabbits, poultry and domestic carnivores, exposure to antibiotics has fallen over the last 5 years, with a clear drop in exposure for pigs and rabbits (down 28.8% and 26.0% respectively).
Between 2010 and 2011, exposure to antibiotics fell by 8.6% for pigs, by 6.9% for rabbits, by 4.0% for poultry, by 3.6% for cattle and by 1.5% for domestic carnivores.
· Focus on “critically important antibiotics”
Third and fourth generation cephalosporines and fluoroquinolones are considered to be particularly important in human medicine because they are the only, or one of the only, alternatives in the treatment of certain infectious human diseases. According to European recommendations, these "critically important antibiotics” should therefore be used only as second line curative treatments. As of 2006, in its report entitled Usage vétérinaire des antibiotiques, résistance bactérienne et conséquences pour la santé humaine (“Veterinary antibiotic use, bacterial resistance and consequences for human health”), the Agency warned of the need to reduce the preventive use of antibiotics and to monitor these two classes of antibiotics in particular, as well as the resistance phenomena linked to their use.
During the thirteen years in which monitoring has been taking place, the number of MAs for veterinary medicinal products containing fluoroquinolones or cephalosporins has increased. The level of exposure of animals to fluoroquinolones has almost doubled, and exposure to cephalosporins has increased 2.5 fold. Over the last 5 years, exposure to third and fourth generation cephalosporins has increased by 9.4% and exposure to fluoroquinolones has increased by 7%. Following a period in which animal exposure to these two antibiotic classes increased sharply, exposure seems to be levelling off, with a tendency toward stabilisation.
However, since results among the different sectors are not homogeneous, the initiatives in place need to be pursued. The voluntary restriction initiative conducted by the pork industry with regard to latest generation cephalosporins has clearly had the anticipated impact, since the estimated exposure of pigs to this antibiotic class decreased by 51.8% between 2010 and 2011. In contrast, for certain species such as cattle and domestic carnivores, exposure to latest generation cephalosporins increased between 2010 and 2011 by 8.5% et 33.9% respectively. ANSES therefore calls for veterinarians, in particular those in an urban setting, to be vigilant and to use these antibiotics with caution.
Poultry exposure to fluoroquinolones has increased from one year to the next (+6.9% between 2010 and 2011). Therefore initiatives to preserve the efficacy of these antibiotics should be reinforced in the poultry sector.
In France, numerous initiatives have been implemented since late 2010 to promote the cautious use of antibiotics:
- initiative by the pig sector on limiting the use of cephalosporins,
- charter on the appropriate use of medical treatments in rabbit production,
- information campaign on good practices and responsible use of antibiotics in numerous sectors,
- deployment of the Ecoantibio 2017 national veterinary medicine plan which aims to reduce use by 25% in 5 years,
- internal request by ANSES to assess the risks of antibiotic resistance emergence related to patterns of antibiotic use in the field of animal health,
Concomitantly, it appears that over the last 5 years, overall exposure of animals to antibiotics has decreased by 15.3%. Certain sectors (especially the pig and rabbit sectors) which have initiated plans to promote cautious use of antibiotics have observed sharper reductions in exposure to antibiotics.
These observations seem to confirm the positive impact of various initiatives conducted for encouraging the responsible use of antibiotics. However, the efforts which have been deployed need to be pursued.
Find out more
· Why monitor antibiotic sales?
The sales information gathered, along with information on the monitoring of bacterial resistance, is indispensable for assessing the risks linked to antibiotic resistance as well as for proposing risk management measures and for monitoring changes in practices and evaluating their effectiveness.
· How is monitoring conducted?
Monitoring is based on recommendations in the OIE guideline "Monitoring of the quantities and usage patterns of antimicrobial agents used in food producing animals". It is conducted conjointly with the SIMV (French Union for the Veterinary Medicinal Product and Reagent Industry). This monitoring is based on yearly declarations of antibiotic sales by the laboratories which market these products. This data can be compared with other sources of information (turnover, prescription surveys, etc.).
> The report (in French) "Suivi des ventes de médicaments vétérinaires contenant des antibiotiques en France en 2011"