Antimicrobial stewardship is a growing concern for those in the animal agriculture industry, although the way it is now defined may not be the best approach, said Food Forward principal Michelle Kromm, DVM, MPH, MAM and CACPV.
Michelle KrommCourtesy Food Forward
“For a lot of us, that’s the equation,” Kromm said. “I personally think we are stuck in a box.”
True stewardship involves much more than antimicrobial use, she said.
Care and preventative measures matter
“We need to change our beliefs on what stewardship is and is not,” Kromm said. “Stewardship is not measuring the total quantity of antimicrobials used over a period of time. Stewardship is what we do as producers and veterinarians to avoid the use of antibiotics.”
Kromm said measurement of antimicrobial use does need to be part of the equation, but rather than it defining your stewardship, it should inform it.
She uses an analogy of an iceberg, and the measured amounts of antibiotics used are similar to that of the top of the iceberg that is above water. It is what is most easily visible, but other aspects of stewardship, like the part of the iceberg that is beneath the surface is not as visible. However, it is a much larger part.
What producers and veterinarians do to prevent the use of antimicrobials represents the majority of the bottom of the iceberg. Those measures include what producers are doing to prepare their facilities before the animals are born, how manure is managed, the cleaning and disinfection of facilities, the cleanliness and purity of the water supply and lines, the ventilation of barns, and the farm’s vaccine program.
“Under the surface is where the majority of the good stuff is,” she said. “We don’t really have established metrics to show all of that.”
Communicating stewardship practices
Most of Kromm’s career has been centered around the turkey industry. Prior to founding Food Forward in 2021, she worked for nearly 10 years for Hormel Foods subsidiary Jennie-O Turkey Store, where she spent the final three years there as the vice president of animal health and welfare.
It was during that time when she found herself in conversations with various stakeholders in the food community that she realized the need for the greater agriculture community to redefine antimicrobial stewardship.
And part of the challenge is that perhaps agriculture has “struggled to have a big enough voice” in the greater One Health conversations about antimicrobials. Those not directly involved in agrifood production often fail to see that bigger picture.
When people are not on a turkey farm every day, she said as an example, they do not easily relate on the decisions producers and veterinarians need to make when birds in the flock get sick, and what is the best way to treat them.
But when they understand everything producers do to prevent those birds from getting sick, they realize that even if antimicrobials are used when they do become ill, stewardship practices are still used.
Stewardship varies by species
Often the turkey industry is unfairly compared to the broiler industry, which she said sets “the gold standard” for the present definition of antimicrobial stewardship.
A much larger percentage of the U.S. broiler flock is raised in a no antibiotics ever (NAE) system, so some might think that the turkey industry is not practicing stewardship as well as the broiler industry.
“From a turkey perspective, it’s very difficult when you’re doing some initial engagement with the folks that maybe have a slightly better understanding of how chickens are raised than they do turkeys,” she said. “In general, they’re coming into the conversation with the expectation that it can’t be that hard to raise NAE turkey.
“It’s challenging because the dogma is that we have the numbers, and we feel like we have to defend our numbers.”
One of the bigger challenges that the turkey industry faces that contributes to a comparative higher level of antimicrobial use is there are fewer preventative medicines on the market for them. That, in turn, gives the turkey industry fewer alternatives for antibiotics.
She does not fault the animal health companies for not putting more emphasis on turkey vaccines, though, because she understands that the broiler industry is much larger, and it makes more economic sense to develop and market chicken vaccines and medicines.
Governmental approval processes for vaccines are also a factor.
Avian metapneumovirus is an example of a lack of vaccines as it has recently been affecting turkey flocks across the northern U.S. and Canada. A vaccine for that disease is widely available in Europe, but that has not been the case in the U.S., she said.
And in instances such as the present avian metapneumovirus outbreak, which was not as problematic in prior years, an agrifood company or farm might actually use more antibiotics than the prior year, giving some people the impression that their antimicrobial stewardship under the old definition is faltering, when in reality, it likely is not, she said.
Antibiotic use does not equal lower welfare
Another benefit to bringing preventative measures into the definition of antimicrobial stewardship is that when people gain that knowledge, they are less apt to jump to the conclusion that animals raised without antibiotics are better cared for than those that are judiciously treated with antibiotics.
“There’s a perception that NAE turkeys had a better life, and I think if we are able to better communicate and educate, and broaden our understanding around antimicrobial stewardship, it levels the playing field to some degree where turkeys and chickens, regardless of what package they end up in, live very similar and good lives,” Kromm said. “Some might end up getting sick and require therapeutic treatment, but in general for 80-90% of them, their lives are lived exactly the same,” she said.
