Becca's blog - Antibiotics awareness day

November 18 marks European Antibiotics Awareness Day, a European health initiative which provides a platform and support for campaigns on the prudent use of antibiotics in countries throughout Europe.

In June AHDB published the 2021 eMB data and I couldn’t have been more pleased or proud. I said it then but want to repeat again just what an achievement it is, against some of the most challenging times, producers and vets have managed to reduce antibiotic use by another 17%, taking usage down to 84mg/kg PCU, which is a 69% reduction since 2015.

The use of HP-CIAs also remains very low – whilst we want to keep usage as low as possible, their use must be responsible and pig health must not be compromised, the data we have and review regularly doesn’t indicate this (hurrah!).

We are now two years into the second phase of RUMA targets, which for the pig sector was set by the Pig Health and Welfare Council’s AMU subgroup, a group which I sit on. The hours of discussion and consideration by this group, and in particular pig vet Richard Pearson, were worthwhile because we’re meeting these targets and responsible reductions continue.

A while ago RUMA was approached by the Food and Agriculture Organization of the UN (FAO) because they were keen to report on the experience of the UK livestock sector with a voluntary approach to antibiotic reductions – something pretty unique to us as most that have taken action have done so legislatively.

I was interviewed to provide context and experience for our sector along with others and, after plenty of delays because a publication like this has about 20 rounds of sign off, it was published this year (take a look here if you fancy a read). Don’t take for granted what you have achieved as producers and vets, because it is worthy of an FAO report and is out there for all the world to read.

As lovely as it is to share the ‘journey’ (a cringeworthy word to use but it has been!) the rationale for use to be more responsible has always been in recognition that irresponsible use can support the development of antimicrobial resistance (AMR), something which needs no help as mother nature is incredibly clever and most definitely one step ahead of us. It is important for animal health but also human health, so what has been happening on that side?

The pandemic did, understandably, shift how patients engage with NHS care but despite the pressure on the health of the nation, use of antibiotics in humans continued to decline in this country in 2020.

We do need to air on the side of caution looking at this because the most key organisms causing bloodstream infections (E. coli, Klebsiella pneumoniae, Klebsiella oxytoca, Pseudomonas spp., Enterococcus spp., Staph. aureus and Strep. pneumoniae) decreased in 2020. Whilst some of this was probably down to the lack of exposure to pathogens that the lockdown rules brought about (washing our hands more will have had an impact as biosecurity works for us as well as pigs!), lower healthcare activity and procedures may have reduced some of the pathogens you would expect to see more of. Resistance also declined in 2020, this was mainly driven by the reductions in the incidence of E. coli infections.

Prescribing rates shifted, increasing for in-patients, which sits in line with only those most sick being admitted to hospital and care becoming remote at GP level, it is evident the pandemic has changed things and so next years report will be more enlightening as it will help us understand what the ‘new normal’ post-pandemic looks like in human medicine.

We must reflect on what we have done and continue to do, but looking a bit wider we are in a different place to many nations, although this is noted with caution as comparisons should be considered carefully as we’re often comparing apples with pears.

The European Sales report (ESVAC) shows that overall aggregated sales of antibiotics  for all 31 countries reporting data in 2021 were 84.4 mg/PCU – a 4.9% decrease compared to 2020.

The difference across the 31 countries is considerable, with sales ranging from 2.5 mg/PCU to 296.5 mg/PCU, so there is plenty left to do even in Europe. However, the number of countries globally reporting quantitative data on antimicrobial use in animals increased from 89 to 118 in 2017 so we must acknowledge that even reporting is improving, and that is a fantastic place to start.

Without the eMB data, both at farm and national level, we wouldn’t have taken the steps we have as a sector to responsibly reduce antibiotic usage in the way you have delivered.