Antibiotic Usage Pattern in Broiler Chicken Flocks in Germany.

In this work, antimicrobial usage data from 2,546 commercial broiler chicken flocks originating from 37 farms are presented. Antimicrobial usage data at the flock level were based on mandatory documentation of antibiotic treatments in livestock in Germany, collected retrospectively for the time period of 2013-2018. The data encompasses all antimicrobial treatments during the fattening period of each flock, starting with the placement of day-old chicks at the barn. The aim of this analysis was to investigate antibiotic usage patterns in broiler chicken flocks in Germany, temporal trends in treatment frequency, the proportions of different antimicrobial classes and the weights of the broiler chickens at the time of treatment. The median treatment frequency over all flocks was six, and veterinary medicinal products belonging to nine different antimicrobial classes were used. Overall, the most frequently used classes were aminoglycosides (25.6%) and lincosamides (25.6%), followed by polypeptides (21.4%) and beta-lactams (16.2%). Over the 6 years evaluated, a considerable increase in the relative usage of lincosamides and aminoglycosides was observed. Compared to the first year of data collection, the percentage of treatments with fluoroquinolones, macrolides and polypeptides decreased in consecutive years. The median age of the broiler chickens at the time of treatment was 5 days, which corresponded to a median body weight at the time of treatment of 111 g, with substantial differences among various antimicrobial classes. We showed that in Germany, the median weight of broiler chickens at the time of treatment was substantially lower than the standard weight of broilers of 1,000 g proposed by the European Surveillance of Veterinary Antimicrobial Consumption. The median weight at treatment is very much influenced by the frequency of age-specific diseases. As different antimicrobial classes are used to combat these diseases, variations in the weight at treatment may have a considerable impact on the estimated treatment indicators. Additionally, a decrease in the relative usage of the highest-priority critically important antimicrobials, such as fluoroquinolones, macrolides and polypeptides, was shown, which might be the consequence of increasing awareness of the antibiotic resistance situation as well as of antibiotic monitoring and benchmarking systems currently running in Germany.

Standardization of Therapeutic Measures in Antibiotic Consumption Monitoring to Compare Different Livestock Populations.

Using sales data, information on antimicrobial consumption in animals is collected cumulatively across the European Union and member countries of the European Economic Area, which is documented and reported by every country and published within annual reports by the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC). These serve to perform cross-border comparisons of antimicrobial consumption, despite their ambiguity due to the different units and key figures used. To improve comparability, the European Medicines Agency has introduced the population correction unit (PCU), which represents the biomass of a livestock population and is related to antibiotic consumption. However, the PCU does not consider the variability of how a livestock population is composed structurally regarding the proportions of production types contained therein. To achieve better comparability between the different geographical areas, we therefore applied a system of standardization in different examples and in real antimicrobial consumption data. This was done by quantifying the consumption of antibiotics by livestock in exemplary regions and countries (Denmark, Germany, France) by means of the active substance used (mg/kg) and subjecting it to a direct and indirect standardization procedure to identify and measure differences in consumption in relation to the composition of livestock demographics. The consideration of livestock demographics results in substantial effects when comparing antimicrobial usage in livestock. To achieve a more compelling comparability in the context of monitoring antibiotic consumption in livestock populations, we recommend using an indirect standardization method, to control potential confounding effects caused by different livestock demographics. This assumes that animal populations can be structured accordingly well. Correspondingly, detailed information on antimicrobial usage by species should be available for this type of stratification.

Used Daily Dose vs. Defined Daily Dose-Contrasting Two Different Methods to Measure Antibiotic Consumption at the Farm Level.

Tackling the problem of rising antibiotic resistance requires valid and comparable data on the use of antimicrobial drugs in livestock. To date, no harmonized monitoring of antimicrobial usage in animals is available, and there is no system to assess usage data throughout Europe, thus hampering a direct comparison between different European countries. Most of the currently applied monitoring systems are based on sales data. Placement of sales data in relation to the population at risk requires overall assumptions about the weights of the animals treated and the doses applied. Only a few monitoring systems collect data in which the number of treated animals is reported exactly and does not need to be estimated. To evaluate the influence of different calculation methods on the standardizing procedure of antibiotic usage and benchmarking of farms, the treatment frequency for several farms (broiler, suckling piglets, and fattening pigs) was calculated in the following two different ways: first, based on the Used Daily Dose (TFUDD), and second, based on the Defined Daily Dose (TFDDD). To support this evaluation, consumption data from the Veterinary Consumption of Antibiotics Sentinel (VetCAb-S) project in Germany were used as example data. The results show discrepancies between both outcomes depending on the calculation method applied. In broiler holdings, the median values of TFDDD were 20.89% lower than the median values of TFUDD. In suckling piglets and fattening pig holdings, the median values of TFDDD were increased 77.14% and 16.33%, respectively, which may have serious implications for the benchmarking of farms. Furthermore, this finding reflects that the calculation procedure also has an impact on the comparison between populations. Therefore, UDD-based calculations should be preferred to run monitoring systems with a benchmark mission. If, in contrast, the DDD approach is chosen to compare antimicrobial usage between populations, additional considerations should be made to adjust for the addressed discrepancies.