Photo: National Food Institute, Technical University of Denmark

Antimicrobial use in animals has decreased four years in a row

Food, fish and agriculture Food safety Bacteria and microorganisms Genes and genomes

The use of antimicrobials in animals in Denmark fell in 2017. This is one of the findings of the annual DANMAP report for 2017. Antimicrobial consumption has now decreased four years in a row.   

In 2017, the total antimicrobial consumption (in kilos) in Danish animals was approximately 3% (3.4 tonnes) lower than in 2016, which is in line with the trend seen in the previous three years. Overall, the veterinary antimicrobial use has decreased approximately 14% from 2013 to 2017, which is equivalent to a reduction of more than 16 tonnes of antimicrobials.

This is one of the findings of the annual DANMAP report for 2017 from Statens Serum Institut – the Danish national institute of public health – as well as the National Veterinary Institute and the National Food Institute at the Technical University of Denmark.

Lower consumption in pig production

The decrease in the total use of antimicrobials is primarily due to Danish pigs receiving 4% less antimicrobials in 2017 than the year before, when measured in doses and adjusted for the number of pigs produced per year. Behind the overall reduction is a decrease of 5-6% in the use in sows, piglets and finishers, and an increase of about 1% in weaners.

Pig production in Denmark constitutes approximately 85% of the country’s meat production and around 74% of the total veterinary-prescribed antimicrobials in Denmark are used in pigs

Differentiated yellow card scheme has significant effect

Since 2010, Denmark has had a ‘Yellow Card’ scheme. Under the scheme, pig farmers who exceed the consumption thresholds set by the authorities, receive a yellow card and an order to reduce use of antimicrobials in the herd. From 2016, the use of tetracycline and antimicrobials that are critically important in the treatment of disease in humans count significantly more in a herd’s antimicrobial account.

Under the new rules, the use of tetracyclines is multiplied by 1.5. Consequently, the use of tetracyclines has decreased by a third (from 22,453 kilo in 2016 to 15,212 kilo in 2017). Colistin use is multiplied by 10, which has resulted in an almost zero use of colistins in pig herds after the first quarter of 2017. Meanwhile, there have been smaller increases in the use of other types of antimicrobials.

"The effect of the adjusted Yellow Card scheme is clearly reflected in the consumption statistics. The change has led to a general reduction in consumption and to a shift away from the use of the types of antimicrobials, which the Yellow Card scheme is focused on reducing."
Senior Academic Officer Birgitte Borck Høg

"The effect of the adjusted Yellow Card scheme is clearly reflected in the consumption statistics. The change has led to a general reduction in consumption and to a shift away from the use of the types of antimicrobials, which the Yellow Card scheme is focused on reducing," Birgitte Borck Høg says.

Increased use of antimicrobials in mink

In contrast to the use of antimicrobials in pigs, consumption in mink has increased over a number of years. In 2017, it increased by about 800 kilograms, which is equivalent to a 15% increase compared with 2016. The use of antimicrobials in mink in 2017 is the highest registered since 2004. Mink consumed around 6% of the total veterinary-prescribed antimicrobials in 2017.

The National Veterinary Institute did not observe an increase in samples to test for diseases in mink in 2017, which could otherwise have explained the increased consumption.

Continued decrease in the consumption of most critically important antimicrobials

Consumption of critically important antimicrobials – such as cephalosporins and fluoroquinolones – was still very low in the animal production in 2017. This is mainly due to the fact that the Danish Veterinary and Food Administration has had a very restrictive approach to the use of fluoroquinolones in production animals for many years, and that Danish pork and cattle producers are voluntarily phasing out the use of 3rd and 4th generation cephalosporins completely.

Consumption of third and fourth generation cephalosporins in companion animals also fell in 2017. As such, use of this type of antimicrobial has decreased steadily since 2010.

”It is positive to note that consumption continues to fall. If the types of antimicrobials, which are last resort drugs in the treatment of humans, are to remain effective in human medicine, it is vital that veterinarians only prescribe these, when all other options have been exhausted. It is particularly important to restrict the use of these antimicrobials in the treatment of pets, which often come into close contact with humans,” Birgitte Borck Høg says.

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Since 1995, the DANMAP programme has monitored the use of antimicrobials in humans and animals in Denmark, and the occurrence of antimicrobial resistance in bacteria in animals, people and foods. The organizations behind DANMAP are Statens Serum Institute as well as the National Food Institute, the National Veterinary Institute. The National Food Institute and Statens Serum Institute have prepared the DANMAP report.

You can download the DANMAP report from DANMAP’s website.

FACTS ABOUT ANTIMICROBIAL RESISTANCE

Treatment with antimicrobials is intended to kill pathogenic bacteria. Unfortunately, antimicrobials may also cause the bacteria to develop resistance antimicrobials, in the process.

Resistant bacteria can be transmitted between humans, animals and food and bacteria can transmit resistance to each other. However, resistant bacteria are better at surviving if antimicrobials are present. Therefore, it is important to have an overall focus on using as few antimicrobials as possible for the treatment of both animals and humans.

Bacteria know no borders and antimicrobial resistance in a country can cause problems outside of its borders. Excessive use of antimicrobials in both animals and humans is a global problem.

Narrow and broad spectrum antimicrobials

Not all antimicrobials are the same. Some have a narrow spectrum and affect only specific types of bacteria. They are used when you know which bacteria are causing the disease.

Others are broad spectrum and affect numerous groups of bacteria at the same time. They are used to treat diseases, before knowing which bacteria cause the disease. However, they often also kill useful and harmless bacteria such as bacteria from the intestine and may lead to the emergence of resistant bacteria.

Critically important antimicrobials

Not all antimicrobials are equally important in the treatment of humans. WHO has declared a number of antimicrobials to be ’critically important’, because they are the only or one of only a few antimicrobials, which can be used to treat serious or life-threatening resistant infections in humans.

These types include third and fourth generation cephalosporins, fluoroquinolones, macrolides and colistin. Denmark has added carpabenems to that list.