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Multifaceted approach needed to reduce antimicrobial use, say EMA and EFSA

THERE is no ‘one-size-fits-all’ solution to the challenge of reducing antimicrobial use in animals, and success will depend on integrated, multifaceted approaches, taking account of local livestock production systems and involving all relevant stakeholders. These are among the conclusions reached following a review of measures taken in the European Union to reduce the need to use antimicrobial agents in animal husbandry, carried out by the European Medicines Agency (EMA) and the European Food Safety Authority (EFSA). The EMA and EFSA conducted the review following a request in 2015 from the European Commission. Publishing their joint scientific opinion on January 24, the two organisations made a number of specific recommendations centred around the theme ‘reduce, replace and rethink’. Noting that some EU member states have successfully implemented strategies to reduce the use of antimicrobials in foodproducing animals, the EMA and EFSA say that such strategies have included the setting of national reduction targets, the benchmarking of antimicrobial use, the implementation of controls on prescribing, and restrictions on the use of specific critically important antimicrobials, together with improvements to animal husbandry and disease prevention and control measures. However, they say that, due to the number of factors that contribute to antimicrobial resistance (AMR), the impact of any single measure is difficult to quantify, although there is evidence of an association between reduced antimicrobial use and reduced AMR. The EMA and EFSA recommend that the use of antimicrobials in animals should be reduced to the minimum that is necessary to treat infectious diseases. They say that animals suffering from bacterial infections should only be treated with antimicrobials on the basis of a veterinary diagnosis and prescription. They recommend that antimicrobials deemed as critically important in human medicine should only be used in animals as a last resort. The organisations also say that, other than in exceptional cases, the use of antimicrobials to prevent diseases in animals should be phased out in favour of alternative measures. Among the alternative measures suggested are the use of vaccines, probiotics, prebiotics, bacteriophages and teat sealants. ‘However, reducing the use of antimicrobials and finding alternatives is not enough,’ say the EMA and EFSA. ‘There is a need to rethink the livestock system by implementing farming practices that prevent the introduction and spread of the disease into farms and by considering alternative farming systems which are viable with reduced use of antimicrobials. Education and awareness of AMR should be addressed to all levels of society but in particular to veterinarians and farmers.’