Red Tractor change cuts highest priority antibiotics by 92% in study

Changes made to the Red Tractor assurance scheme standards for cattle and sheep last summer are driving further significant reductions in use of highest-priority critically important antibiotics (HP-CIAs) across the UK, suggests a new study released at the British Cattle Veterinary Association Congress this week (17-19 October).

Sales of fluoroquinolones and 3rd and 4th generation cephalosporins for UK farm livestock are already low, having fallen 57% and 38% respectively between 2013 and 2017. But analysis of veterinary records from 2,764 beef, sheep and dairy farms, carried out by Westpoint vet Tim Potter in association with Kingshay, found that following the introduction of the new standards, use of HP-CIAs on these farms fell by 92%.

Substituting HP-CIAs, which often require small amounts of active ingredient per treatment, with lower priority antibiotics requiring larger active ingredient dose rates, can push up overall antibiotic use; however, total sales of antibiotics to these farms also fell by 22% throughout the same period.

Red Tractor, which has a membership of over 35,000 beef, lamb and dairy producers across the UK, introduced the new requirements on antibiotic use to their ruminant standards in June 2018.

These include instructions that HP-CIAs are used only as a last resort under vet direction guided by sensitivity or diagnostic testing. Farms are also now required to collate their annual medicine usage and discuss use of HP-CIAs with their vet.

Tim Potter says the results of the study demonstrate the dramatic effect these new requirements have had.

“There was already an awareness of the importance of cutting back on prescriptions for the highest priority antibiotics,” he explains.

“Colistin, another HP-CIA, has almost no use in UK farm animals now. While use of fluoroquinolones and modern cephalosporins has also fallen, these are proving harder to replace and their rate of reduction has been slower.

“What this study shows is that the implementation of a formal hurdle to use of these more important antibiotics has driven behaviour change at farm level, by requiring the vet and farmer to have a conversation about their medicine regime.

“The result of these conversations appears to be reductions in HP-CIAs, helped by changes in management practices such as increased uptake of vaccination and disease eradication programmes,” adds Tim.

Richard Simpson of Kingshay, co-author in the study, says the other important element in the Red Tractor strategy has been the requirement for collation and review of antibiotic use by the vet.

“In our study, this increased the engagement of farmers on the topic of responsible use of antibiotics and ensured there was an overall reduction in use, not simply a substitution of alternative products for the HP-CIAs – as demonstrated by the fall in total sales.”

He says that in response to the increasing number of requests for medicines reviews and the integration of the reviews into the health planning process, Kingshay developed an antibiotic sales reporting service.

“The reports have proved a valuable tool for promoting farmer engagement,” explains Richard. “By providing a breakdown of the class of products used, vets have been able to provide tailored advice to farms on specific areas for improvement and the use of anonymised benchmarking has provided context to the data.”

Gwyn Jones, chairman of RUMA, says the success of the UK’s 48% overall reduction in on-farm antibiotic use between 2013 and 2017* has not just been about defining suitable targets, but also identifying ways to drive change – as illustrated in this study.

“Assurance schemes are a very good mechanism for this. With Red Tractor assurance accreditation covering 95% of dairy, 80% of finished beef and 60% of finished lamb production, it’s clear that following last year’s changes to their standards a lot more discussion is happening between farmer and vet.”

While the national effect of the changes to Red Tractor’s assurance standards won’t be fully known until the 2018 and even 2019 national antibiotic sales data are released, the results are extremely encouraging says Mr Jones.

“This is great news for the reputation of the UK industry – especially as we continue exploring future export opportunities for our meat and dairy.”

The analysis in the study found that in the six months leading up to June 2018 the average monthly volume of HP-CIAs sold was 1.8kg; from July 2018 to December 2018 the average monthly volume of CIAs sold was 0.15kg (147g) – a reduction of 92%. Total antimicrobial sales to those beef, sheep and dairy farms also fell over the same periods, from a mean of 110kg per month to 87kg per month. Looking at the individual months, the sales of HP-CIAs dropped from 1.4kg in May 2018 to 0.0004kg – just 0.4g – in December 2018, a decrease of over 99.9%.

The Veterinary Medicines Directorate will release the 2018 national antibiotic sales data on 29 October at the RUMA conference.