European antibiotic report links antibiotic use and resistance

A European report issued this week (27 July), analysing use of antibiotics and occurrence of resistance in bacteria from humans and food-producing animals, confirms UK farm animal use is comparatively low against many of its European neighbours. But it also highlights the potential for more responsible use in both humans and animals to reduce antibiotic resistance.

The report, the second of its kind produced jointly by the European Centre for Disease Control (ECDC), the European Food Safety Authority (EFSA) and the European Medicines Agency (EMA), indicates that in 2014, UK antibiotic use for humans was about average within Europe (Europe: 124mg/kg; UK: 129mg/kg) but 60% below average in animals (Europe: 152mg/kg; UK: 62mg/kg).

UK farm animal use of the highest-priority Critically Important Antibiotics was also very low, particularly colistin, where average consumption by farm animals in the UK was significantly below the European average.

Resistance to fluoroquinolones in Salmonella and Campylobacter bacteria from humans is identified in the report to be related to consumption of fluoroquinolones in animals – ratifying one of the priorities of the UK poultry meat sector in achieving a 72% reduction in fluoroquinolone use between 2012 and 2016. However, it is stressed that resistance is complex, and factors other than the amount of antibiotics used can influence the level of resistance found.

The report also notes a clear link between total antibiotic consumption and the occurrence of antibiotic resistance in both humans and farm animals. This suggests that measures to encourage responsible use should target all classes of antibiotics to reduce the risk of ‘co-selection’, where use of one type of antibiotic produces resistance to another.

John FitzGerald, Secretary General of RUMA, welcomed the report, but said the situation was likely to change rapidly as awareness grew of the contribution farming can make in a One Health approach to antibiotic stewardship.

He said: “The UK’s most recent Veterinary Antimicrobials Resistance and Sales Surveillance (VARSS) report on 2015 sales data saw a 10% drop in antibiotics sales into food-producing animals compared with the previous year.

“This, alongside significant reported reductions in usage in the poultry and pig sectors – released via the recent British Poultry Council Antibiotic Stewardship Report and AHDB’s e-Medicine Book data – will have changed the picture again.”

He added the report underlines the importance of the most recent falls in use and the need for further reductions in use across the board. Those in farming needed to be aware that changing their use of antibiotics could not only help manage the global risk of antibiotic resistance, it could lower the risk of drug-resistant infections developing among UK livestock.

“However, as highlighted in an EFSA/EMA report produced earlier this year, each local situation in each country needs its own multifaceted approach.

“There has been a tendency for critics to promote alternative farming systems or demand blanket implementation of rules in other countries, when what we actually need is to reduce use in a sustainable way that safeguards animal welfare,” added Mr FitzGerald.

The report says its conclusions are in line with those of the first report published in 2015. However, the availability of better quality data has allowed for a more sophisticated analysis.

It is expected that the VARSS report analysing 2016 sales data for food-producing animals, due for issue later this year, will show further reductions. A new One Health report comparing sales of antibiotics in the UK for humans and animals, also using 2016 data, is due to be issued after that.