Feasibility study of veterinary antibiotic consumption in Germany--comparison of ADDs and UDDs by animal production type, antimicrobial class and indication.

BACKGROUND: Within a feasibility study the use of antibiotics in pigs and cattle was determined in 24 veterinary practices in Lower Saxony and on 66 farms in North Rhine-Westphalia in Germany. Focus was laid on the comparison of the Used Daily Doses (UDD) (dose per animal and day prescribed by the veterinarians) with the Defined Animal Daily Doses (ADD) (dose per animal and day calculated by means of recommended dosages and estimated live weights). RESULTS: For piglets and calves most of the UDD (50% and 46% of nUDD, respectively) were above the ADD (i.e. UDD/ADD-ratio above 1.25). Regarding sows, fattening pigs, dairy and beef cattle, most of the UDDs (49% to 65% of nUDD) were lower than the respective ADD (i.e. UDD/ADD-ratio below 0.8). In pigs, the UDDs of beta-lactams, fluoroquinolones and cephalosporins, and in cattle, those of macrolides and beta-lactams were often below the ADDs. Tetracyclines were frequently used above the recommended dose.Enteric diseases were more often treated below the recommended dose than respiratory diseases, possibly due to overestimation of the live weight (diarrhea in young animals, respiratory diseases in elder animals) and consequently overestimation of the recommended dose. CONCLUSION: Comparisons between UDD and ADD can be used to observe differences between antimicrobials and trends in the usage of antibiotics. But individual treatment comparisons of UDD and ADD must be interpreted carefully, because they may be due to lower live weights than estimated. Correlating such data with data on the occurrence of resistant bacteria in future may help to improve resistance prevention and control.

[Compilation of antibiotic use in farm animals via veterinary surgeries]. / Erfassung des Antibiotikaeinsatzes bei Lebensmittel liefernden Tieren in der tierärztlichen Praxis.

A feasibility study with 20 voluntarily participating veterinary surgeries was carried out in order to test, if the consumption of antibiotics in livestock can be determined systematically. Information about the statutory documents on the application of drugs of the participating surgeries were entered in a central database and analysed systematically. Surgeries that treat only livestock used significantly more antibiotics (number of treatment units per veterinarian) per veterinarian than surgeries that treat also small animals. The comparison of small and large surgeries showed that veterinarians in small surgeries treated fewer pigs and more cattle than their colleagues in large surgeries (number of treatment units per veterinarian). All in all, tetracyclines counted for more than 50% of all substances used (regarding the amount), followed by beta-lactams (25%) and sulfonamides incl. trimethoprim (11%). In poultry, polypeptides and beta-lactams were used most frequently. While cephalosporines were used only in cattle in a noteworthy frequency, fluoroquinolones were applied to poultry in almost 12% of all applications (application of one substance to one animal at one day). In total, it was shown, that harmonized documentation of consumption of antibiotics is feasible, but the relation of antibiotics to the treated population is problematic which has to be considered in the future.The number of applications is more suitable to assess the antibiotic use than the amount in kg, because the latter is dependent of the dosage. The impact of highly dosed substances like e.g. tetracyclines is overestimated by regarding the amount, while substances with low dosages are underestimated.

[Monitoring of antibiotic consumption in cattle on agricultural farms]. / Verbrauchsmengenerfassung von Antibiotika beim Rind in landwirtschaft- lichen Betrieben.

47 cattle farms with a total of 6500 cattle in one district of Northrhine-Westfalia took part in a study on the use of antibiotic substances on a voluntary basis. The veterinary application and dispensary documents (section 13 TAHAV) as well as respecting farmers' documents (ANTHV) served as data sources. All consumption data of a one-year-period (1 September, 2006 until 31 August, 2007) were entered into a central database. The amount (free substances in kg) of substances were highest for beta-lactams (48%) followed by sulfonamides inc. trimethoprim (17%) and tetracyclines (11%). All in all about 39 kg free antibiotic substances were applied.The analysis of the treatment frequency showed similar figures: beta-lactams were used in 35% of all cattle treatments, but tetracyclines were used only in 9% of the treatments. The highest number of therapies took place against udder diseases (45% of all free substances applied, 56% of all treatment units). The therapy frequency is the average number of applied treatment units (treatment days and number of substances) per age or production group within a certain time period and population. It corresponds basically to the DDD (Defined Daily Dose) of the Netherlands as well as to the ADD (Defined Animal Daily Dose) of Denmark, although these values cannot be compared directly because of different calculation methods. Within a period of 100 days every dairy calf in the study farms achieved 0.7, every dairy cow 0.9 (including teat sealer = one day) and every fattening cattle 0.01 treatment units averagely.

[Monitoring of antibiotic consumption in pigs on agricultural farms]. / Verbrauchsmengenerfassung von Antibiotika beim Schwein in landwirt- schaftlichen Betrieben.

The use of antibiotics in the course of one year (1 September, 2006 until - 31 August, 2007) was evaluated in 23 pig farms housing about 18,000 animals in one district in Northrhine-Westfalia. The veterinary application and dispensary documents (section13TAHAV) as well as respecting farmers' documents (ANTHV) served as data sources. Based on this data the amount of the used free substances, the number of treatment units as well as the therapy frequency were evaluated for each age group. Treatment frequency describes the average number of treatment days with one substance in a certain timeframe for a particular age group With the treatment frequency comparisons of antibiotic use can be made regardless of population size. It was shown in this study that piglets (suckling piglets) received about 6.1 antibiotic units per 100 days, fattening pigs about 4.6 units and sows 0.9 units per 100 days. All in all about 676 kg of free antibiotic substances were applied to the animals, especially tetracyclines (58%), sulfonamides/trimethoprim (16%), macrolides (13%) and beta-lactams (11%). These consumption figures do not reflect, however, the frequency of use in animal therapy. 34.7% of all applications performed in pigs were with makrolides, as opposed to only 25.1% with tetracyclines.This discrepancy in consumption levels when compared to the number of treatment units is due to the different dosages applied. With respect to the largest amount of drugs applied, these were used in the treatment of respiratory infections. But, most of the pigs were treated for skin disease.

Monitoring of antibiotic consumption in livestock: a German feasibility study.

Every application of antibacterial drugs in veterinary medicine may encourage selection for resistant bacteria. In Germany no valid data are available which would be suitable for a species specific estimation of drug consumption especially regarding food producing animals. Therefore, a representative monitoring of consumption of antibacterial drugs in food producing animals should be implemented. As a first step, a feasibility project was conducted to identify the technical preconditions and develop a concept for a regular monitoring system within Germany as a country with a non-central federal state system. The data were collected via the forms obligatory by German law concerning the treatment of animals and the delivery of animal drugs to the animal owners by the veterinarian. 24 veterinary practices and 65 farmers were visited, and all applications of antibiotics to farm animals during the course of one year (September 1, 2006 to August 31, 2007) were entered into a central database. A total of 95,584 records were collected and analysed statistically. Consumption of antibiotics was calculated in kg, but also the number of applications was analysed. The consumption of tetracyclines in kg reached 54.3% of all antimicrobial substances applied to pigs, but only 25.7% of all doses applied to pigs were tetracyclines. For the farms' data, the number of daily doses per animal year (DD(ay)) was estimated based on the number of daily doses recorded and on the number of animals kept in the farm. Correct and detailed data regarding the structures of the farms as well as of veterinary practices are necessary to estimate the consumption of antibiotics reliably. The proposed system is able to function as a monitoring system for antibiotic use in Germany, when the monitoring data are linked to the agricultural data (farm sizes) accounting for differences between German regional agricultural and animal husbandry structures. Furthermore, the results of the antibiotic use analyses may serve as basis to assess the results of the sales data of the pharmaceutical industry. Results are comparable to the outcome of respective systems in other European countries, e.g. the Netherlands and Denmark, and therefore it will contribute to a better understanding and development of strategies for the control of antimicrobial resistances on the European level.