Post on 16-Feb-2021
Academic
Farmer
Veterinarian
Govern-ment
Business owner
Pharma-ceutical
Consumer
public perception
regulation
on-farm decision
RESISTANCE
treatment failure
toxic alternatives
longer illness
increased mortality
increased cost
Resistance ≠ Residue
Antibiotic residues are a chemical issue.
Antibiotic resistance is a biological phenomenon.
Bacteria are not killed or inhibited by an antibiotic.
Acquired versus Intrinsic resistance
Antimicrobial Resistance
DEFINITION
• The ability of a microorganism to withstand the effect of a normally active concentration of an antimicrobial agent
v
v
v
Antimicrobial Resistance
DEFINITION
• The ability of a microorganism to withstand the effect of a normally active concentration of an antimicrobial agent
ISSUE
• Increasingly reported phenomenon
• Threatens advancements in human & veterinary medicine
• Societal resource
all antibiotic use causes resistance …and we have resistance
access to antibiotics is a privilege
… and society is questioning them
efficacy depends on responsible use
… and there are no new products coming
Agricultural Antibiotic Use Is…
• uses 80% of all antibiotics
• The claims…
VDD Antibiotic prioritization according to risk to human health
Serious human infections
Limited alternatives Examples of drugs used in beef cattle
I Yes Yes Ceftiofur (Excenel® ) Enrofloxacin * (Baytril®) Danofloxacin (A180)
II Yes No Tulathromycin (Draxxin®) Penicillin
III No - Sulfonamides Tetracyclines Florfenicol (Nuflor ®/ Resflor®) Neomycin Tilmicosin (Micotil, Pulmotil, Tilmovet)
IV Not applicable
Not applicable
Ionophores
Antimicrobial Usage Statistics
• CAHI provides Kg Active sold
• No data on a per-animal or species basis (population adjusted estimates)
• On-farm is the only collection point
• Tetracyclines & Ionophores predominate
• Limited use of Class I antibiotics – Cephalosporins
– Fluoroquinolones
– extra-label not recommended
Agricultural Antibiotic Use Is…
The claims…
• uses 80% of all antibiotics
Response
• most use is unrelated to drugs used in human medicine
Agricultural Antibiotic Use Is…
• uses 80% of all antibiotics
• creating superbugs & making us vulnerable to diseases once cured
• The claims…
Making us vulnerable…
• Urgent Threat = 3
• Serious Threats = 12
• 3 related to foodborne exposure
• 1 related to animal contact
• Concerning Threats = 3
• Prioritized bacteria
CDC 2013. Antibiotic Resistance Threats in the United States.
Clinical Salmonella Isolates Beef 2011
0 10 20 30 40 50 60 70
Tetracycline
Sulfa
Chloramphenicol
TMP-Sulfa
Streptomycin
Nalidixic Acid
Kanamycin
Gentamicin
Cefoxitin
Azithromycin
Ampicillin
Ciprofloxacin
Ceftriaxone
Ceftiofur
Amoxicillin-Clavulanic acid
E. coli Abattoir Surveillance 2011
0 10 20 30 40 50 60 70 80
Tetracycline
Sulfa
Chloramphenicol
TMP-Sulfa
Streptomycin
Nalidixic Acid
Kanamycin
Gentamicin
Cefoxitin
Azithromycin
Ampicillin
Ciprofloxacin
Ceftriaxone
Ceftiofur
Amoxicillin-Clavulanic acid
Chicken Pork Beef
Making us vulnerable…
• concern is big • Ceftiofur resistant S. Heidelburg
• Direct risk relatively small
• Campylobacter , Fluoroquinolones & Dairy heifers
• 1 case every 13 years (USA)1
• Salmonella, Fluoroquinolones & Dairy Cattle
• 1 case every 293 years (USA)1
• Campylobacter & Macrolides 2
• Pork - 1 in 82 million
• Poultry and beef lower
hazard probability
risk
1. Hurd. Foodborne Pathog Dis. 2010 Nov;7(11):1305-22 2. Hurd. Risk Anal. 2008 Jun;28(3):695-710.
http://www.ncbi.nlm.nih.gov/pubmed/20707726http://www.ncbi.nlm.nih.gov/pubmed/18643826http://www.ncbi.nlm.nih.gov/pubmed/18643826http://www.ncbi.nlm.nih.gov/pubmed/18643826
Agricultural Antibiotic Use Is…
The claims…
• creating superbugs & making us vulnerable to diseases once cured
The response
• Most hazards are NOT agriculture related
• Safe food handling and preparation mitigates majority of risk
• It is a long journey from the farm to the fork
Agricultural Antibiotic Use Is…
• uses 80% of all antibiotics
• creating superbugs & making us vulnerable to diseases once cured
• being used to make animals grow faster
• The claims…
Why do we use antibiotics?
Why do we use antibiotics?
• Production systems are predictable
• Preventive medications are often proactive
• Livestock populations heavily skewed to young and vulnerable populations
Growth Promotion Claims
Voluntary Changes
• Removal of growth promotion labels in USA and Canada
• 3 year process
• Increased veterinary oversight
Anticipated outcome
• Harmonization of labels
• Reduction in need for extra-label usage
Agricultural Antibiotic Use Is…
The claims…
• being used to make animals grow faster
Response
• Sick animals need medicine
• Industry has voluntarily reacted
Stewardship or Regulation
Surveillance
Extra Label
Critically important
Canada’s livestock antimicrobial access regulations are among the most permissive in developed nations
Access to antimicrobials is a privilege. Not a right.
Stewardship responsible planning and management of a shared
resource
Raise healthy animals
Reducing antibiotic
use is a win for…
• vaccination
• hygiene
• animal flow
Appropriate Use
• Use antibiotics:
• licenced in Canada
• according to label whenever possible
• Seek veterinary prescriptions & oversight
• CVMA Prudent use guidelines
• Class I antibiotics have recommended against extra-label use
Leadership & Responsibility
• Strong movement towards increasing veterinary oversight
• More stringent requirements of and recording by veterinarians
• Prohibit extra-label use of class I
Quality Assurance programs
• every major commodity
• many are mandatory
• Focuses
• VCPR
• Prescriptions and protocols
• DIN
• Withdrawal times
Be engaged & speak out
• Industry takes food safety seriously
• Industry is actively collaborating with government
• Sick animals need medicine
• It is a long way from the farm to the fork
• Producers understand stewardship
Stewardship = An ethic that embodies responsible planning and management of
resources
Judicious
Involved