A five step process is used here to guide work on rational use of antibiotics in food animals: Engage, Assess, Plan, Implement and Evaluate. Guidelines set by national-level authorities may exist and when possible should be consulted and incorporated, and interventions should always be adapted to the local situation.
A key to success is to identify which actors to involve and reach in the effort. This could for example be farmers, veterinarians, paraprofessionals, extension workers, nutritionists, and consultants from government and academia, depending on the end goal. A stakeholder analysis tool can be used to help identify stakeholders and their level of interest and power to influence. It is useful to assemble a team of relevant people to plan and coordinate the work and find ways to motivate and help farmers to take action. An important component is to have a continuous dialogue with the identified stakeholders involved in or affected by the work.
Assess the situation
A wide range of animal species are kept as food animals, and they are held in different animal husbandry systems. Any rational use initiative at the individual farm level has to be adjusted to the local situation at the actual farm.
A challenge for the farmer is to determine the most important factors that first should be addressed. An initial step can be to analyze the current use of antibiotics and the animal health situation at the farms with the help of veterinarians, husbandry experts or other relevant professionals. A base-line assessment also makes it possible to evaluate progress and set targets.
Plan the work
The long-term goal of rational use efforts should be a transition to sustainable farming systems where routine use of antibiotics is not needed. The multi-professional team should plan which interventions to use and how to evaluate progress. Setting aims and objectives will help the team know where to focus its energy and how to direct its resources. A good plan will cover which actions need to be taken by who and when, as well as what resources are needed and how to measure progress. The plan can include risk assessments, a monitoring and evaluation framework and a communication plan.
A combination of strategies and tools (a multifaceted approach) is best to reach sustainable results. Some possible areas to focus on are to:
- Improve animal health through better hygiene, biosecurity routines, and animal husbandry in farms. Infection prevention measures, including vaccines, reduce disease so that less antibiotics are needed. Learn how in PREVENT INFECTION – Food animals.
- Monitor antibiotic use and resistance. See MEASURE – Antibiotic resistance; Consumption and; Appropriate use.
- Perform audits and feedback.
- Provide support for treatment decisions through diagnostics and guidelines.
- Train and educate animal health professionals and farmers. See RAISE AWARENESS – Training manuals and courses. Awareness raising and education is important if rational use interventions are to be accepted and implemented properly. At farm level, it has been shown that increasing farmers’ awareness of good farming practices and biosecurity is important.
- Raise awareness in the community on the use of antibiotics in food animals and agriculture and the consequences. Consumers can drive change in the food industry. See RAISE AWARENESS for guidance and materials to set up an awareness raising campaign.
Specific strategies and tools for reducing antibiotic use in farms (for different types of animals) are provided under Interventions.
No matter how much planning is done, it is difficult to know how well an implementation will go in real life. Unforeseen problems can arise and the needs or resources can rapidly change. By piloting an intervention, the study group can test the impact of theory put into practice and make adaptations as necessary.
Pilot projects can be scaled up in time, size or breadth of their reach. The length of time can be extended, or a project can be implemented in additional farms or cooperatives. Challenges may arise when scaling up interventions that did not exist in the original iteration. As with any implementation, the context and setting should always be considered and adjustments made appropriately.
Evaluating the work is important to see if goals are being reached and can identify areas for improvement for scale-up and replication. It is also important to encourage improvement and promote learning from experience without fear of negative consequences.
Communication of results give feedback to collaborating partners and interested stakeholders. Communication methods and content need to be tailored to the audience, and reporting should be transparent to promote confidence. Positive progress should be acknowledged and public recognition should be made of the contributions and successes of all partners involved in the work. Affirmation of hard work will provide incentive for stakeholders to continually improve and be involved in the process.
In MEASURE, you can access tools and resources to help determine the impact of interventions and conduct studies on a variety of topics that relates to rational use. Includes specific information for animal settings:
- Burden of antibiotic resistance
- Antibiotic resistance
- Consumption of antibiotics
- Appropriateness of use
- Quality of antibiotics
- KABP – Knowledge, attitudes, behaviors and perceptions
Guidelines and standards
|CODEX ALIMENTARIUS International Food Standards: Antimicrobial Resistance||Standards for the responsible use of antimicrobials in food-producing animals. The “Code of practice to minimize and contain antimicrobial resistance” (CAC/RCP 61-2005) describes the responsibilities for regulatory authorities, veterinary pharmaceutical industry, wholesalers, retailers, veterinarians and farmers. “Guidelines for Risk Analysis of Foodborne Antimicrobial Resistance” (CAC/GL 77-2011) gives guidance on assessing the risk to human health from foodborne antibiotic resistant bacteria, and determining appropriate management strategies to control those risks. Available in English, French and Spanish.|
|WHO list of critically important antimicrobials for human medicine||Assessment from WHO of which antimicrobials are of highest importance to human health. Substances are categorized into three groups: critically important, highly important, and important.|
|Guidelines for the prudent use of antimicrobials in veterinary medicine (2015/C 299/04)||Guidelines from the European Commission that provide authorities, farmers and veterinarians with recommendations and practical examples for development and implementation of strategies to promote the prudent use of antimicrobials in veterinary medicine. Available in a number of languages.|
|OIE Terrestrial Animal Health Code||Chapter 6.10: Responsible and prudent use of antimicrobial agents in veterinary medicine.|
|Guide to Prudent Use of Antimicrobial Agents in Dairy Production||The objective of this guide is to promote prudent use practices based on science, and taking into account parameters which are relevant and essential to dairy farming. Also available in French and Spanish. Dairy production.|
|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. Aquaculture.|
|OIE Aquatic Animal Health Code||OIE guide to development and harmonisation of national antimicrobial resistance surveillance and monitoring programmes for aquatic animals. Chapter 6.2: Principles for responsible and prudent use of antimicrobial agents in aquatic animals.|
|Community Toolbox, chapter 7: Encouraging Involvement in Community Work||Guidance. The Community Toolbox aims to offer people engaged in local and community work a depository of tools and advice for building healthier communities. Chapter 7 for example covers: The importance to involve all people affected by the problem (section 7) and Identifying and analyzing stakeholders (section 8).|
|Community Toolbox, chapter 6, section 1: Developing a plan for communication||Guidance for how to develop a communication plan for good, consistent, clear communications both internally and externally.|
|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 on Implementation of the Antimicrobial Strategy in South Africa: One Health Approach & Governance||Example implementation guideline. ‘How to’, step-by-step guide for South African healthcare and veterinary workforce to enact the national strategy, addressing the governance framework at different levels of the health system.|
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