Academic Farmer Veterinarianskstockgrowers.com/SG2014/_PDF/AGM/Rosengren.pdfMaking us vulnerable… • concern is big • Ceftiofur resistant S. Heidelburg • Direct risk relatively

Academic

Farmer

Veterinarian

Govern-ment

Business owner

Pharma-ceutical

Consumer

public perception

regulation

on-farm decision

RESISTANCE

treatment failure

toxic alternatives

longer illness

increased mortality

increased cost

Resistance ≠ Residue

Antibiotic residues are a chemical issue.

Antibiotic resistance is a biological phenomenon.

Bacteria are not killed or inhibited by an antibiotic.

Acquired versus Intrinsic resistance

Antimicrobial Resistance

DEFINITION

• The ability of a microorganism to withstand the effect of a normally active concentration of an antimicrobial agent

v

v

v

Antimicrobial Resistance

DEFINITION

• The ability of a microorganism to withstand the effect of a normally active concentration of an antimicrobial agent

ISSUE

• Increasingly reported phenomenon

• Threatens advancements in human & veterinary medicine

• Societal resource

all antibiotic use causes resistance …and we have resistance

access to antibiotics is a privilege

… and society is questioning them

efficacy depends on responsible use

… and there are no new products coming

Agricultural Antibiotic Use Is…

• uses 80% of all antibiotics

• The claims…

VDD Antibiotic prioritization according to risk to human health

Serious human infections

Limited alternatives Examples of drugs used in beef cattle

I Yes Yes Ceftiofur (Excenel® ) Enrofloxacin * (Baytril®) Danofloxacin (A180)

II Yes No Tulathromycin (Draxxin®) Penicillin

III No - Sulfonamides Tetracyclines Florfenicol (Nuflor ®/ Resflor®) Neomycin Tilmicosin (Micotil, Pulmotil, Tilmovet)

IV Not applicable

Not applicable

Ionophores

Antimicrobial Usage Statistics

• CAHI provides Kg Active sold

• No data on a per-animal or species basis (population adjusted estimates)

• On-farm is the only collection point

• Tetracyclines & Ionophores predominate

• Limited use of Class I antibiotics – Cephalosporins

– Fluoroquinolones

– extra-label not recommended

Agricultural Antibiotic Use Is…

The claims…

• uses 80% of all antibiotics

Response

• most use is unrelated to drugs used in human medicine

Agricultural Antibiotic Use Is…

• uses 80% of all antibiotics

• creating superbugs & making us vulnerable to diseases once cured

• The claims…

Making us vulnerable…

• Urgent Threat = 3

• Serious Threats = 12

• 3 related to foodborne exposure

• 1 related to animal contact

• Concerning Threats = 3

• Prioritized bacteria

CDC 2013. Antibiotic Resistance Threats in the United States.

Clinical Salmonella Isolates Beef 2011

0 10 20 30 40 50 60 70

Tetracycline

Sulfa

Chloramphenicol

TMP-Sulfa

Streptomycin

Nalidixic Acid

Kanamycin

Gentamicin

Cefoxitin

Azithromycin

Ampicillin

Ciprofloxacin

Ceftriaxone

Ceftiofur

Amoxicillin-Clavulanic acid

E. coli Abattoir Surveillance 2011

0 10 20 30 40 50 60 70 80

Tetracycline

Sulfa

Chloramphenicol

TMP-Sulfa

Streptomycin

Nalidixic Acid

Kanamycin

Gentamicin

Cefoxitin

Azithromycin

Ampicillin

Ciprofloxacin

Ceftriaxone

Ceftiofur

Amoxicillin-Clavulanic acid

Chicken Pork Beef

Making us vulnerable…

• concern is big • Ceftiofur resistant S. Heidelburg

• Direct risk relatively small

• Campylobacter , Fluoroquinolones & Dairy heifers

• 1 case every 13 years (USA)1

• Salmonella, Fluoroquinolones & Dairy Cattle

• 1 case every 293 years (USA)1

• Campylobacter & Macrolides 2

• Pork - 1 in 82 million

• Poultry and beef lower

hazard probability

risk

1. Hurd. Foodborne Pathog Dis. 2010 Nov;7(11):1305-22 2. Hurd. Risk Anal. 2008 Jun;28(3):695-710.

http://www.ncbi.nlm.nih.gov/pubmed/20707726http://www.ncbi.nlm.nih.gov/pubmed/18643826http://www.ncbi.nlm.nih.gov/pubmed/18643826http://www.ncbi.nlm.nih.gov/pubmed/18643826

Agricultural Antibiotic Use Is…

The claims…

• creating superbugs & making us vulnerable to diseases once cured

The response

• Most hazards are NOT agriculture related

• Safe food handling and preparation mitigates majority of risk

• It is a long journey from the farm to the fork

Agricultural Antibiotic Use Is…

• uses 80% of all antibiotics

• creating superbugs & making us vulnerable to diseases once cured

• being used to make animals grow faster

• The claims…

Why do we use antibiotics?

Why do we use antibiotics?

• Production systems are predictable

• Preventive medications are often proactive

• Livestock populations heavily skewed to young and vulnerable populations

Growth Promotion Claims

Voluntary Changes

• Removal of growth promotion labels in USA and Canada

• 3 year process

• Increased veterinary oversight

Anticipated outcome

• Harmonization of labels

• Reduction in need for extra-label usage

Agricultural Antibiotic Use Is…

The claims…

• being used to make animals grow faster

Response

• Sick animals need medicine

• Industry has voluntarily reacted

Stewardship or Regulation

Surveillance

Extra Label

Critically important

Canada’s livestock antimicrobial access regulations are among the most permissive in developed nations

Access to antimicrobials is a privilege. Not a right.

Stewardship responsible planning and management of a shared

resource

Raise healthy animals

Reducing antibiotic

use is a win for…

• vaccination

• hygiene

• animal flow

Appropriate Use

• Use antibiotics:

• licenced in Canada

• according to label whenever possible

• Seek veterinary prescriptions & oversight

• CVMA Prudent use guidelines

• Class I antibiotics have recommended against extra-label use

Leadership & Responsibility

• Strong movement towards increasing veterinary oversight

• More stringent requirements of and recording by veterinarians

• Prohibit extra-label use of class I

Quality Assurance programs

• every major commodity

• many are mandatory

• Focuses

• VCPR

• Prescriptions and protocols

• DIN

• Withdrawal times

Be engaged & speak out

• Industry takes food safety seriously

• Industry is actively collaborating with government

• Sick animals need medicine

• It is a long way from the farm to the fork

• Producers understand stewardship

Stewardship = An ethic that embodies responsible planning and management of

resources

Judicious

Involved