Europe makes progress in tackling antibiotic resistance

While evidence has been found that the plan to reduce antibiotic resistance in the European Union is making progress, another report published October 24 finds that there is a great deal of variation between EU member states in sales of antibiotics for farm animals.

argus456 | Bigstock.com
argus456 | Bigstock.com

While evidence has been found that the plan to reduce antibiotic resistance in the European Union is making progress, another report published October 24 finds that there is a great deal of variation between EU member states in sales of antibiotics for farm animals.

Covering the human and veterinary spheres, the publication of the Evaluation of the Antimicrobial Resistance Action Plan by the European Commission (EC) demonstrates the added value of regional action.

According to the report’s authors, among the positive impacts of its Action Plan are that it acts as a symbol of political commitment and stimulates action by member states. It also helps strengthen international cooperation, and provides a framework for research and development, and international monitoring and surveillance of antimicrobial resistance.

With the plan not due to be completed until the end of this year, it is too soon to draw firm conclusions about its effectiveness. However, for the agricultural sector, appropriate use of antimicrobials is widely expected to follow on from the legislative proposals on veterinary medicines and medicated feed, and the Animal Health Regulation.

Most EU countries have implemented actions in human medicine, according to the report. However, it highlights the differing approaches taken by the member states, and recommends that they are supported to reduce these differences in the use of antimicrobials and prevalence of infections as well as to inform citizens better about the consequences of the overuse of these medications.

Veterinary antibiotic sales in Europe down 2.4 percent

Just ahead of the EC’s report on the progress of its Action Plan, the European Medicines Agency (EMA) published its latest annual update on the sales of antibiotics for veterinary use in the EU. While data on horses are included in this data set, information on ionophore anticoccidial feed additives is not.

The report, Sales of Veterinary Antimicrobial Agents in 29 European Countries in 2014, covers sales in EU and European Economic Area countries and Switzerland for that year.

Comparisons between 2014 and earlier reports are difficult to make as some member states have made changes to their data collection systems. However, the “headline” figure reveals a fall in antibiotic use of 2.4 percent across the region between 2011 and 2014. Of the 24 countries providing comparable data, sales have reduce by 12 percent over the period.

The main indicator used in the report is milligrams of active ingredient sold per population correction unit — mg/PCU. This reveals a wide difference in overall sales ranging from 3.1-419 mg/PCU. Most widely used antibiotics were tetracyclines (33.4 percent of the total), penicillins (25.5 percent) and sulfonamides (11.0 percent). Of the active ingredients on the World Health Organization (WHO) list of critically important antimicrobials for human medicine, sales for food-producing animals of 3rd- and 4th-generation cephalosporins, fluoroquinolones and macrolides accounted for just 0.2 percent, 1.9 percent and 7.5 percent, respectively, of total sales. Polymyxins accounted for 6.6 percent of total sales, with colistin representing more than 99 percent of sales of that group of medications.

More study findings

Across all of the countries included in the survey, pharmaceutical forms for group treatment accounted for 91.6 percent of the total sales; premixes accounted for 42.1 percent, oral powders for 31.7 percent and oral solutions for 17.8 percent. There was wide variation in the proportion of sales of these products for group treatment – from 6 percent to 96 percent. Just over 80 percent of sales for group treatment contained just one active ingredient.

Sales of pharmaceutical forms for the treatment of individual animals made up 12 percent of the total sold; 7.6 percent were injectable preparations, 0.5 percent were intramammary preparations and 0.3 percent were oral pastes, boluses and intrauterine preparations.

Twenty-five countries provided data to the EMA for all the reporting years between 2011 and 2014. A fall in sales of more than 5 percent was observed in 10 of these countries. Tentative explanations offered for the decline include the implementation of responsible-use campaigns, changes in animal demographics, changes in systems for collecting data, restrictions of use, benchmarking, increased awareness of the threat of antimicrobial resistance, and/or the setting of targets. There was an increase of more than 5 percent in five countries during the reference period.

“The substantial decline in the sales of antimicrobials for food-producing species observed for some countries indicate that there is also a potential for a decrease in other countries,” the report’s authors conclude.

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