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Toolbox  –  Rational use

Food animals

In the Global Action Plan on Antimicrobial Resistance, Member States are urged to take action to optimize the use of antibiotics. For the animal sector, this includes phasing out use of antibiotics for animal growth promotion and to reduce routine use of antibiotics.

What is rational use of antibiotics?

Treatment with antibiotics is necessary for certain diseases in animals, in order to ensure survival, welfare, productivity and to reduce spread of disease. Rational use means to limit antibiotic use to when it is medically needed, and to use antibiotics appropriately – this includes choosing the right drug at the right dose and duration. There are various treatment guidelines available that can assist in such decision-making – both national and international ones. Ideally, treatment guidelines should be designed to national contexts and take factors like availability of antibiotics and levels of antibiotic resistance into account.

Livestock keeping is fundamental for livelihoods, economy and food and nutrition security, and this could be threatened if animal diseases are not treated when needed. To achieve sustainable use of antibiotics in the food animal sector several different factors must be taken into account  – including animal health, sustainability of production, availability of veterinary medicines such as antibiotics and vaccines, and socio-economic factors.

Mahidol University interviewed Dr. Anthony D So from ReAct about antimicrobial resistance, and the use of antibiotics in farm animals. He also shares his suggestions on potential target areas in the supply chain.

Healthier animals need less antibiotics

It is common that antibiotics are given to whole groups of animals routinely for growth promotion or to prevent or control disease outbreaks. In many cases, routine use of antibiotics is unnecessary and can be reduced by improving animal husbandry practices such as biosecurity. The long-term goal of rational use efforts should be to promote a transition to farming systems where routine use of antibiotics is not needed. Learn more in Prevent infection: Food animals.

Barriers to rational use

The use of antibiotics in food animal production creates a legitimate conflict of interest. On the one hand, farmers must make a living, and may perceive that routine antibiotic use is necessary for production. One the other hand, global reduction of antibiotic use is needed to limit antibiotic resistance. Farmers may hesitate to be more selective in their use of antibiotics due to fears of more disease and loss of productivity. In some cases, farmers are unaware that they are feeding their animals antibiotics, since antibiotics may be added to, for example, ready-made mixes of feed and vitamins that animals frequently are given.

The social biography of antibiotic use in smallholder dairy farms in India

Description: The study adds to the growing body of evidence related to the issue of antimicrobial consumption. It aimed to understand the practices and drivers related to non-prescribed and self-administered veterinary antibiotic usage.

Place: India.

Setting: Peri-urban dairy farms.

Finding: Low level of knowledge related to antibiotics among farmers, active informal service providers, direct marketing of drugs to the farmers, and easily available antibiotics (dispensed without appropriate prescriptions) were identified to be the possible drivers contributing to the misuse of antibiotics in the dairy farms.

In many countries, selling antibiotics is an important part of the income for animal health workers and pharmacists, and therefore there are weak incentives to discourage use. Similarly, animal health workers may be reluctant to not give antibiotics if there is a risk that the farmers will be dissatisfied. Furthermore, when the pharmaceutical market is unregulated with no requirements for prescriptions, costs or unavailability of veterinary advice may push farmers to use antibiotics.

Large variation between countries

Sales of antibiotics for veterinary use have decreased by 60% in some countries in Europe over the past decade. Sales of antibiotics for group treatment varied from less than 10% to more than 90% of total antibiotic sales for animals in different European countries in 2019 and 2020. In other words, there is a large potential for improvement in many countries.

Below are papers that discuss the current evidence for the negative consequences of antibiotic use in food animals and options for actions. Learn more about why and how antibiotics are used in food animal production in UNDERSTAND – Use and inappropriate use in animals and agriculture.

Selected Resources

Resource Description
WHO guidelines on use of medically important antimicrobials in food-producing animals Recommendations from WHO on antibiotic use in animals: Discusses current evidence base and urges farmers and the food industry to stop using antibiotics routinely to promote growth and prevent disease in healthy animals.
Guidelines for Infection Prevention and Appropriate Antimicrobial Use in the Animal Sector Guidelines developed by the Ministry of Agriculture, Animal Industry and Fisheries of the Republic of Uganda to optimize appropriate antimicrobial use practices, infection prevention practices, and recordkeeping of medicines used in farming. The documents are focused on five livestock production systems: cattle farming, fish farming, goat and sheep farming, pig farming, and poultry farming.
The Swedish experience – a summary on the Swedish efforts towards a low and prudent use of antibiotics in animal production Report. Sweden is one of the countries with the lowest use of antibiotics in food producing animals. This report summarizes how Sweden has managed to use antibiotics prudently, by focusing efforts to infection prevention, animal health and collaborations across sectors. Includes descriptions of important success factors and lessons learned.
Antibiotic Use & Food Animals Information portal. A collection of scientific articles relating to antibiotic use in food animals and antibiotic resistance.
Drivers, Dynamics and Epidemiology of Antimicrobial Resistance in Animal Production (PDF 1,5MB) Report that explains and discusses the development and spread of antimicrobial resistance and its relations with food production.
Antimicrobial Use in Livestock in Low-Income Countries Policy brief discussing antimicrobial use and resistance in livestock in low-income countries.
Review of Evidence on Antimicrobial Resistance and Animal Agriculture in Developing Countries Review providing available evidence on resistance in agri- and aquaculture in LMICs, highlighting the scarcity of most data and providing an overview of the gaps in knowledge.
Antibiotic resistance: mitigation opportunities in livestock sector development Opinion paper on rational use of antibiotics and the importance of good animal husbandry to counteract antibiotic resistance.
Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production Review that provides an overview of factors influencing farmers’ decision making and proposes priority actions against misuse of antibiotics.
Commissioned Paper for UK Review on AMR: A framework for costing the lowering of antimicrobial use in food and animal production (PDF 0,5 MB) Report giving an overview of the literature on costs of lowering antimicrobial use in food animal production and switching to alternative ways of production. Also proposes steps to be taken to counteract costs due to resistance, considerations for a costing framework and process for research agenda.

 

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Ministry of Agriculture, Animal Industry and Fisheries. Antimicrobial Resistance (AMR) in the Animal Sub-Sector. https://www.agriculture.go.ug/antimicrobial-resistance-amr-in-the-animal-sub-sector/ (2020).
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Chauhan, A. S. et al. The social biography of antibiotic use in smallholder dairy farms in India. Antimicrob Resist Infect Control 7, 60 (2018).
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European Medicines Agency. Sales of Veterinary Antimicrobial Agents in 31 European Countries in 2019 and 2020 :Trends from 2010 to 2020. (Publications Office, LU, 2021).
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World Health Organization - WHO. WHO guidelines on use of medically important antimicrobials in food-producing animals. Preprint at https://www.who.int/publications/i/item/9789241550130 (2017).
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Grundin, J., Blanco Penedo, I., Fall, N. & Sternberg Lewerin, S. ”The Swedish Experience” – a Summary on the Swedish Efforts towards a Low and Prudent Use of Antibiotics in Animal Production. https://pub.epsilon.slu.se/17781/ (2020).
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Antibiotic Resistance Action Center. Antibiotic Use & Food Animals. http://battlesuperbugs.com/science/antibiotic-use-food-animals (2020).
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Wall, B.A et al. Drivers, Dynamics and Epidemiology of Antimicrobial Resistance in Animal production. Preprint at http://www.fao.org/feed-safety/resources/resources-details/en/c/452608/ (2016).
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Poizat, A., Bonnet-Beaugrand, F., Rault, A., Fourichon, C. & Bareille, N. Antibiotic use by farmers to control mastitis as influenced by health advice and dairy farming systems. Preventive Veterinary Medicine 146, 61–72 (2017).
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Swedish International Agricultural Network Initiative - SIANI. Antimicrobial Use in Livestock in Low-Income Countries. Preprint at https://www.siani.se/publication/antimicrobial-use-livestock-low-income-countries/ (2016).
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Robinson, T. P. et al. Antibiotic resistance: mitigation opportunities in livestock sector development. animal 11, 1–3 (2017).
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Lhermie, G., Gröhn, Y. T. & Raboisson, D. Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production. Front Microbiol 7, 2114 (2016).
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So, A. D. et al. Commissioned Paper for UK Review on AMR: A framework for costing the lowering of antimicrobial use in food and animal production. Preprint at https://amr-review.org/sites/default/files/ReAct_CLF_Hopkins_UKAMRReview_CommissionedPaper.pdf (2016).
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European Centre for Disease Prevention and Control - ECDC, European Medicines Agency - EMA & European Food Safety Authority - EFSA. ECDC/EFSA/EMA First Joint Report on the Integrated Analysis of the  Consumption of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Humans and Food -Producing Animals. http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2015/01/news_detail_002260.jsp&mid=WC0b01ac058004d5c1 (2015).