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Becca's blog: Celebrating antibiotic progress, but with more to be done

22nd Nov 2019 / By Rebecca Veale

This has been World Antibiotics Awareness Week. It started with EU Antibiotics Awareness Day, which aimed to raise awareness about the challenge that antimicrobial resistance (AMR) poses but also what responsible use looks like.

I thought it was a great opportunity to congratulate pig producers. We might not be at the end of our journey, but a good distance has been travelled and the 2018 eMB data, RUMA report and VARSS report (published by the VMD in October 2019) shows this.

Collectively all livestock producers have reduced usage to 29.5mg/kg, which is a 53% reduction in just four years.

VARSS graph

And the pig usage data shows a 60% reduction from 2015 to 2018. Basically you’ve done a really good job in being responsible with antibiotics!

AB graph

 

Last week, the author of the O’Neill report and historically quite a critic of the use of antibiotics in agriculture, Lord O’Neill couldn’t have praised us more at the annual lecture held by the Colston Research Society. What he did call for was the development of rapid diagnostics and some PR about the serious issue that AMR poses globally – both of which would be beneficial for producers and consumers.

As I’ve mentioned before, at the PHWC AMU sub group we’ve started work on the next phase of targets and there is a lot to consider as we explore what they will look like. There’s a lot of change ahead, including the loss of zinc oxide and the legislative change for veterinary medicines and medicated feeds, and so this isn’t a snap decision, we’re exploring the data and detail which will affect the use of antibiotics in pigs.

But this week isn’t just about pigs, it is about the whole One Health agenda – so what are others doing?

Well, not every other sector has data, so for dairy, beef and sheep they are working on this. eMB ruminants is underway but, as with all kinds of databases, this is far more complicated in reality.  

The poultry sector data shows an increase in antibiotic usage this year. They are currently explaining why they hit their lowest level and then use increased in order to manage disease and maintain animal welfare – a conversation we need to listen to and consider for when we hit our lowest level of use.

In the human health field there are a lot of initiatives in the various trusts that make up our healthcare system. You may have seen or heard the ‘Keep Antibiotics Working' campaign with the red and white pills singing put together by Public Health England. It might be a bit cheesy but it gets the message across. If I’ve seen it on the TV and heard it on the radio then lots of others will too.

Watch the Public Health England Keep Antibiotics Working video

The very complex nature of our healthcare system means that bringing about change is challenging. And the risk is that when it goes wrong people will die, so the stakes are pretty high.

Initiatives are diverse and include collaborations between different teams in hospitals to improve the treatment of patients, compliance with prescribing guidelines, standardising infection prevention and control and collaboration between the community and healthcare professionals.

The human health sector has reduced the number of prescriptions for antibiotics written by GPs by nearly 17% since 2014 and dentist prescriptions are also down 25% in the last five years. But, and it is a big but, resistance has increased and it is estimated that there were 60,788 antibiotic resistant severe infections in 2018 (English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report). The plans they have to address this are imperative, one includes engagement with student medics which seems a sensible step forward.

Progress has been made, and there is a long way to go for some, but for now, let’s just say well done and celebrate the journey to date!

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