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4TH MERIAL FORUM
HAVE WE GOT PCVD &
SWINE INFLUENZA UNDER
CONTROL?
The future of antibiotics use in Europe
Moderator: Dr Sophie Randoux
• The antibiotic hype and the consequences for pig production in Europe. Dr. D. Schillinger
• Limiting the use of antibiotics in the Pig industry: the Danish experience. Dr M. Andreasen
• PCVD control in 2012: how to design the best PCV2 vaccination programme? Dr R. Aerts
Limiting the use of Antibiotics in the Pig Industry: The Danish Experience Margit Andreasen
DVM, PhD, Chief Scientist
Merial Swine Forum 2012
Side 4
Denmark as a role model?
Side
Total sales, all animal species 9 European countries in 2009
0
20
40
60
80
100
120
140
160
180
NO SE FI DK UK CH CZ FR NL
mg
/PC
U*
*PCU population correction unit (Grave et al 2010)
EMA, 2011
Side
Events over time in Denmark
0
50
100
150
200
250
1990 1992 1994 1996 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
An
tib
ioti
cs i
n t
on
s
Theraputic Growth promoter (AGP)
Antibiotic use is for all livestock,
80 % are used in the pig production
Ban on AGPs
to finishers
Ban on
flouroquinolones
Ban on cephalosporins
+ Yellow card initiative Ban on AGPs
to weaners
Prescription
only
DANMAP Vetstat
Herd visit
agreements
Side
Vetstat Database Veterinary use of antimicrobials
7
Pharmacies Veterinarians Feedmills
Herd level
Agegroup
Indication
Active compound
Vetstat database
(Ministry Food and Agric.)
ADD
ADD pr. 100 animals pr. day
CHR-register;
no. animals
Side
ADD
• Average dose per day for a drug used for its main indication in a standard sized animal
• Used to measure the amounts of standard doses given
8
Side
Herds consumption can be followed closely by farmer and consultants
9
Example from www.vetstat.dk (code needed):
Side
Herds consumption can be followed closely on indication and active compound
10
Side
Antimicrobial consumption (2004-2009)
11
2009 vs. 2008:
11.5 % increase
DANMAP, 2010
Side
2010 Yellow card scheme We must decrease usage!
12
Side
Yellow card scheme Threshold limits 2010-12
13
9-month moving average by age-group
Sows Weaners Finishers
ADD pr. 100
animals pr. day
5,2 28 8
Appr. 10 % of farmers were above these limits
Side
Yellow card – course of events July 2010
”Information letters”
– 1249 farmers - close to or over permit limit
– Informed about herds 3 ADD- values
– Chance to correct mistakes in their registrations
November 2010
Goverment order
December 2010
”Warning letter” to
– Appr. 1100 farmers above permit limits
–Appr. 500 above limit; 600 data-mistakes
14
Side
15
9 months
Yellow Card
Restrictions on
water/feed medication
Inspection (DVFA)
5 months
Tightened
supervision
2nd Opinion
vet
Action plan
Charged supervision
and charged enforcement
orders/bans
Until below threshold
Red card
Eg. reduced
stocking
rate
Action plan includes
Laboratory diagnostics
Treatments
Change layout barn
Purchasing of animals
Management
Yellow card – what then?
Side
Future …
Every 2nd month, letters to new herds exceeding permit limits
Yearly new lower permit limits
– However, no down-regulation in 2012
16
Side
2000
4000
6000
8000
10000
12000
jan-
09
mar
-09
may
-09
jul-0
9
sep-
09
nov-09
jan-
10
mar
-10
may
-10
jul-1
0
sep-
10
nov-10
jan-
11
mar
-11
may
-11
jul-1
1
sep-
11
nov-11
Month
Consum
ptio
n (
kg)
The Yellow Card effect
25 % ↓
From 2010 to 2011: an increase in production of 810,000 pigs
Warning letter
Yellow Card Yellow Cards
Side
More prudent use of antimicrobials
0,0
500,0
1.000,0
1.500,0
2.000,0
2.500,0
3.000,0
3.500,0
4.000,0
4.500,0
5.000,0
jul-0
9
aug-
09
sep-
09
okt-0
9
nov-
09
dec-
09
jan-
10
feb-
10
mar
-10
apr-1
0
maj-1
0
jun-
10
jul-1
0
aug-
10
sep-
10
okt-1
0
nov-
10
dec-
10
jan-
11
feb-
11
mar
-11
apr-1
1
maj-1
1
Month
kg
acti
ve c
om
po
un
d
Figur 3
Water
Injective
Feed
Side
Reduction in treatment of weaners, gastrointestinal disease
19
Side
Use of vaccines has increased
20
+ 21 %
+ 31 %
+ 27 %
Side
Fluoroquinolones & cephalosporins • Fluoroquinolones banned since 2002
– Only allowed under certain conditions and only by the
veterinarian personally
– Challenge: no longer possible to eradicate A.
pleuropneumoniae
• Cephalosporins
– Voluntary ban from July 2010
– AIM: to reduce potential risk for resistance in human
pathogens
– Veterinarians have found alternative treatments
– Challenges:
• Sporadic cases where cephalosporins are the only
drug of choice (eg. some E. coli)
Side
0
20
40
60
80
100
120
140
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Ac
tiv
e c
om
po
un
d (
kg
)
Fluoroquinolones Cephalosporins
DANMAP, Vetstat
Use of cephalosporins and fluoroquinolones for pigs
Side
Limiting the use of antibiotics Impact on health
Side
Ban on AGPs Impact on health • Report from WHO (2003);
Impacts of antimicrobial growth promoter termination in Denmark (WHO/CDS/CPE/ZFK/2003.1)
• Weaners – Significant increase in antimicrobial treatments for
diarrhoea – Toxigenic E. coli and Lawsonia
• Finishers – Transient increase (7 months) in antimicrobial
treatments for diarrhoea – Lawsonia
Side
Impact on health - Productivity
Combating antimicrobial resistance – Time for joint action, Copenhagen March 14-15, 2012
0,0
0,5
1,0
1,5
2,0
2,5
3,0
3,5
4,0
4,5
5,0
'90 '92 '94 '96 '98 '00 '02 '04 '06 '08 '10
Mo
rtali
ty i
n p
erc
en
t
Finisher mortality, % Weaner mortality, %
Ban on AGPs
PMWS
Outbreak
Side
Impact on health - Productivity
Combating antimicrobial resistance – Time for joint action, Copenhagen March 14-15, 2012
Ban on AGP’s
show responsability
show responsability
0
100
200
300
400
500
600
700
800
900
1000
'90 '92 '94 '96 '98 '00 '02 '04 '06 '08 '10
Ga
in,
gra
ms p
er
da
y
2,70
2,75
2,80
2,85
2,90
2,95
3,00
3,05
3,10
Fe
ed
co
nv
ers
ion
ra
tio
kg
/kg
ga
in
Daily gain finishers Feed conversion ratio kg/kg
Ban on AGPs
Side
Ban on AGPs Impact on resistance
• Report from WHO (2003); Impacts of antimicrobial growth promoter termination in Denmark (WHO/CDS/CPE/ZFK/2003.1)
• AGP termination reduced the food animal reservoir of enterococci resistant to AGPs
• However, we do not know the effect on human health!
Examples from the WHO report
Side
Yellow Card Impact on resistance
• To early to say …
Side
Our success is due to several measures
• The unique Danish SPF health management system
• High level of management
• The co-operative system
• Immediate application of new production technology
• Vaccination strategies
• Use of other efficient antibiotics based on resistance patterns
Side
What’s in it for the farmer?
Better public accept
Side
Thank you for listening!