This section focuses on tools and strategies for achieving prudent antibiotic use at the farm level. It is intended to support efforts assisting farmers to improve antibiotic use practices.
Efforts to reduce antibiotic use in food-producing animals can be done at different levels: from restricting or minimizing certain use (such as for growth promotion or prophylactic use) to removal of most antibiotic use. Efforts can also be focused on making sure use is as appropriate as possible. Some example areas to work on to improve practices are:
- Educating animal health professionals and farmers
- Infection prevention
- Optimizing antibiotic treatment
- Record keeping
- Waste management
Education and knowledge
Increasing knowledge among actors that provide antibiotics to animals is an important step towards optimizing antibiotic use. Farmers and animal health personnel must learn to identify which diseases that should be treated with antibiotics and how to correctly use these medicines. In countries where over-the-counter sale of antibiotics is allowed, farmers frequently get treatment advice from pharmacists or companies. Safe-guarding that these actors have proper knowledge is therefore also meaningful. When educating, one must ensure that all information payed forward is adapted to the recipient, and factors like education level and literacy need to be considered.
For training manuals, education materials and courses, see RAISE AWARENESS – Education and training materials.
Training farmers in rational drug-use improves their management of cattle trypanosomosis:
Description: 444 cattle farmers were divided into a test group and a control group (randomized, controlled trial). The test group got an 8-page picture booklet with information on the diagnosis and treatment of bovine trypanosomosis (sleeping sickness). The booklet was adapted to the local context and covered signs of disease, correct treatment, and instructions on how to prepare and administer the drugs. Knowledge of farmers, clinical outcomes in cattle, and herd health was assessed before, at 2 weeks and 5 months after the intervention.
Place: 46 villages in southern Mali.
Setting: Cattle farmers, low literacy level.
Finding: Providing easy-to-understand information on correct treatment of sleeping sickness significantly improved farmers knowledge and practices. Drug use was more appropriate and there were fewer side effects in cattle. Knowledge decreased over time and therefore needs to be reinforced continually — for example through drug pack inserts or leaflets at point of sale. The short follow-up period made it difficult to estimate longer-term trends in cattle health. (Note: article is not open access).
Close link to infection prevention
Improved animal health is often facilitating optimization of antibiotic use. Improved health is commonly a result of good hygiene practices, good nutrition, biosecurity, use of vaccines and optimized housing conditions. The level of animal health is a result of a wide range of factors, which can be grouped as animal specific, husbandry system-dependent and management-dependent. For more information, see PREVENT INFECTION – Food animals.
Relationship between biosecurity and antibiotic use
Description: A study that correlated biosecurity with production characteristics (observational, retrospective study). Biosecurity scores were calculated with the Biocheck.UGent tool and correlated with daily weight gain, feed conversion rate, mortality, prevalence of Salmonella infections and antibiotic treatment incidence.
Setting: Pig farms, farrow to finish.
Finding: Better biosecurity correlated with improved productivity and health, such as higher daily weight gain and lower incidence of antibiotic treatment. (Note: article is not open access)
Even though some diseases require antibiotic treatment, many diseases, including viral infections and non-infectious diseases, do not. When antibiotic treatment is needed, the choice of drug must depend on the clinical diagnosis and, whenever possible, be based on the results of microbiological susceptibility tests. Introducing or improving treatment guidelines for relevant diseases can help farmers in this process. Some additional aspects of appropriate antibiotic use are:
- Using an antibiotic that is as narrow-spectrum as possible
- Avoiding antibiotics that are critically important in human medicine (if possible)
- Using the correct dose for the correct period of time
- Respecting withdrawal times
Withdrawal period and antibiotic residues
When food producing animals are treated with antibiotics, the animal products contain antibiotic residues the first time period after treatment. Depending on the type of antibiotic, the length of this period vary, which is something the farmer must be informed about. Animals for meat production should not be slaughtered during this time period and milk from lactating animals should not be consumed. It is therefore called withdrawal period. Milk obtained during the withdrawal period should either be discarded or given to calves. Milk from cows with mastitis should not be consumed by either humans nor animals.
Keeping veterinary records help to keep track of animal health, antibiotic use and withdrawal times. They can also be used to identify areas for improvement: Could antibiotic use have been avoided or more prudent?
Useful data to record is: Name of antibiotic, date of treatment, animal treated, dose, length of treatment, indication (diagnosis), route of administration, name of prescriber/source of antibiotic, withdrawal time and name of person giving the treatment.
Regular analysis of veterinary records can help to:
- Identify animal health problems that need to be addressed
- Assess antibiotic use practices, for example
- Use of critically important antibiotics and for which indication
- Non-therapeutic use, such as use as growth promoter and routine use to prevent or control diseases during certain risky periods (for example weaning of piglets)
- Support implementation and evaluation of corrective actions to counteract animal health problems and inappropriate antibiotic use
Making sure that medicinal and animal waste products are taken care of in the correct way is also important in work to optimize antibiotic use. After treatment with antibiotics, there are wastes that contain active substances. Used syringes, needles and medicine bottles should be burned or disposed of through other safe means. In some cases, systems for collection may be arranged through pharmacies who can provide safe alternatives for disposal.
When animals, or humans, are treated with antibiotics, urine and feces will contain antibiotic residues as well as bacteria (some of which may be resistant) that contribute to environmental contamination. Waste products should be properly handled or disposed of before for example being used as manure on crops.
It may be difficult to decide on which interventions will work best. Important guiding questions to consider are:
- Is there evidence to support the use of the intervention?
- Has the intervention been used in a similar context?
- How might the intervention need adaptation to this setting?
- Are sufficient resources available?
- Is approval required for implementation?
- What type of training will be needed?
- What issues does this intervention uniquely address?
- How will this intervention help overcome identified barriers?
Resources below have been separated into the following tables:
Educational resources can be found in RAISE AWARENESS – Education and training.
In MEASURE, you can access tools and resources to conduct studies on a variety of topics that relates to rational use, and to help determine the impact of interventions. Includes specific information for animal settings.
|Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis||Systematic review on the effect of interventions restricting antibiotic use in food animal production. Provides evidence that restricting use lowers the presence of antibiotic resistant bacteria in the animals. The appendix lists all studies (2MB) included in the review and provides a quality assessment.|
|Keeping veterinary medicine records||Template and instructions on how to keep veterinary medicine records. Includes an example format on record keeping (word document). Guidance for England, but can be used for inspiration/adapted for other contexts.|
|Guidelines for the use of antibiotics in production animals (PDF 1,1 MB)||Example guideline. An example of a guideline for antibiotic use in production animals (cattle, pigs, sheep and goats). This one is developed by the Swedish Veterinary Association. Describes common diseases, diagnostics and treatment.
|AACTING Guidelines||Guidelines intended to assist establishment or revision of farm-level AMU monitoring systems. Particularly relevant for use in countries with established medicines registrations and regulations. An overview of existing monitoring systems in countries can be found here .|
|The Veterinary Benchmark Indicator (VBI)||Country example and methodology. Benchmarking approach used in the Netherlands that focuses on usage of antibiotics on farms. The benchmarking classifies farms and veterinarians into “target, “signaling” and “action” zones. This page contains the original report (PDF, 0.8 MB) on the benchmarking and a report with revisions made to it (PDF, 2.2 MB). The annual reports contain the latest updates to the benchmarking thresholds (by the Netherlands Veterinary Medicines Institute, SDa)
|Alternatives to Antibiotics in Animal Agriculture||Article that provides an overview of alternative products that could be used to reduce the need for antibiotics in animal agriculture.|
|Prudent and efficient use of antimicrobials in pigs and poultry||Review: A thorough review presented at the London Swine Conference 2013, including evidence of a whole range of interventions that could be used by pig producers to reduce the threat of antibiotic resistance in human and porcine pathogens.|
|FAO case study series: Tackling antimicrobial use and resistance in pig production||Country examples describing work towards more prudent use of antibiotics in food animals. The first case study describes the Danish campaign to reduce antibiotic use in pig production. Includes monitoring of antibiotic use, initiatives made and lessons learned. Available in English, Spanish and Chinese.
|Guide to Prudent Use of Antimicrobial Agents in Dairy Production||Guide intended to promote prudent use practices based on evidence, and taking into account parameters which are relevant and essential to dairy farming. Also available in French and Spanish.|
|Improving biosecurity through prudent and responsible use of veterinary medicines in aquatic food production||Guideline from FAO that discusses the use of veterinary medicines in aquaculture and gives examples of good practice and disease prevention measures.|
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