Danish input into European recommendation on antimicrobial use

Thursday 18 Aug 16

Danish input has contributed to a recommendation that farmers in the EU reduce their use of medicines containing the antimicrobial colistin by more than half. Colistin is the last resort to treat certain diseases in humans. An expert from the National Food Institute, Technical University of Denmark, has participated in the working group of the European Medicines Agency, which has issued the recommendation based on the latest knowledge on colistin resistance.

At the end of 2015 in China researchers discovered a new resistance gene in E. coli bacteria found in animals, meat and humans. The gene leads to resistance to antimicrobials containing colistin. Since then a working group under the European Medicines Agency, EMA, has looked at whether European farmers should reduce their use of colistin-containing antimicrobials. Colistin is the last resort to treat certain infections in humans and as such belongs to the group of critically important antimicrobials.

New knowledge, new recommendation

The working group has gathered new, important knowledge on transferable resistance to colistin and on that basis has recommended a target that farmers should use a maximum of 5 milligrams of colistin per population correction unit, PCU. PCU is used as a term for the estimated total weight of all livestock and slaughtered animals in a country.

Reaching this target is expected to lead to an approximate 65% reduction in sales of colistin across the EU within four years.

EMA underlines that farmers should not achieve this reduction by simply increasing their use of other types of antimicrobials. The reduction should instead be achieved through other measures such as vaccination of livestock as well as improving the conditions for herds and preventing diseases.

There are major differences in colistin use between EU member states. Danish farmers e.g. are already well below the target, while other countries are significantly above. EMA encourages member states to set more ambitious targets for the use of colistin – ideally below 1 milligram per PCU.

One Health approach

EMA's working group includes experts from different research areas with expertise in human and veterinary medicine and health, epidemiology and food safety. An expert from the National Food Institute has contributed the institute’s knowledge on resistance problems, which has partly been gained over the institute’s ten years as European reference laboratory for antimicrobial resistance in foodborne bacteria.

This multidisciplinary approach is a good example of how to handle problems from a One Health perspective. One Health is based on the understanding that humans, animals and our shared environment and wellbeing cannot be assured in the long run unless we treat them as a whole.

Read more

Read the recommendation on EMA’s website: Updated advice on the use of colistin products in animals within the European Union: development of resistance and possible impact on human and animal health

Please also read about Denmark’s experience over the past 20 years in reducing the use of antimicrobial agents as well as antimicrobial resistance on the National Food Institute’s special topic portal about antimicrobial resistance.


  • Colistin-containing medicines have been available for more than 50 years to treat infections in both humans and animals.
  • Consumption has increased in recent years, which is partly due to an increased occurrence of resistance to other types of antimicrobials.
  • Today colistin is one of the five most commonly used antimicrobials for the treatment of animals in the EU. However, colistin consumption varies greatly from country to country.