Abstract
Using sales data, information on antimicrobial consumption in animals is collected cumulatively across the European Union and member countries of the European Economic Area, which is documented and reported by every country and published within annual reports by the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC). These serve to perform cross-border comparisons of antimicrobial consumption, despite their ambiguity due to the different units and key figures used. To improve comparability, the European Medicines Agency has introduced the population correction unit (PCU), which represents the biomass of a livestock population and is related to antibiotic consumption. However, the PCU does not consider the variability of how a livestock population is composed structurally regarding the proportions of production types contained therein. To achieve better comparability between the different geographical areas, we therefore applied a system of standardization in different examples and in real antimicrobial consumption data. This was done by quantifying the consumption of antibiotics by livestock in exemplary regions and countries (Denmark, Germany, France) by means of the active substance used (mg/kg) and subjecting it to a direct and indirect standardization procedure to identify and measure differences in consumption in relation to the composition of livestock demographics. The consideration of livestock demographics results in substantial effects when comparing antimicrobial usage in livestock. To achieve a more compelling comparability in the context of monitoring antibiotic consumption in livestock populations, we recommend using an indirect standardization method, to control potential confounding effects caused by different livestock demographics. This assumes that animal populations can be structured accordingly well. Correspondingly, detailed information on antimicrobial usage by species should be available for this type of stratification.
Highlights
The monitoring and surveillance of antimicrobial usage (AMU) is essential for identifying factors that drive the development of antimicrobial resistance in humans and animals, one of the major issues defined by the World Health Organization that threatens global health [1]
To achieve a better comparability between the consumption of antibiotics in different geographical areas regarding their different populations and corresponding exposure [17], we applied the systematics of direct and indirect standardization in example data and subsequently transferred these to real AMU data from a German antibiotic monitoring sentinel (VetCAb-S) as well as to AMU-data derived from national reports from Denmark [18] and France [19]
The population correction unit (PCU) figure is a harmonized average weight in kilograms of all animals at the time of treatment multiplied by the number of animals based on national statistics [7]
Summary
The monitoring and surveillance of antimicrobial usage (AMU) is essential for identifying factors that drive the development of antimicrobial resistance in humans and animals, one of the major issues defined by the World Health Organization that threatens global health [1]. For Europe, there is no binding legislation with regard to the implementation of monitoring programs at the national level Different countries use their own specifications with regard to collection and evaluation of AMU data at the farm level and the definition of standard weights and populations [2]. The AACTING network has issued guidelines to provide useful support when designing or revising farm-level AMU monitoring systems [5]. At this point, if data are available, they are usually not standardized internationally and are not unambiguously comparable due to the differences in calculation methods and units [6]
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