Skip to content. | Skip to navigation

There is a newer version of this site available at https://amrls.umn.edu/antimicrobial-resistance-learning-site
Sections

Personal tools

You are here: Home / Public Health / IV. The Global Health Impact Of Antimicrobial Resistance In Animal Populations / National and International AMR Programs

National and International AMR Programs

Today, AMR is no longer considered a new  health threat like it was when first observed in the 1950. Many national and international agencies are taking action to mitigate AMR and keep antibiotics effectively working to  maintain the health of human and animal populations. 

 

a. Monitoring antibiotic usage 


Denmark has become an international leader in the fight against AMR.  Antibiotic sales for humans and animals are monitored annually, as are rates of AMR in bacteria from people, food animals, and food products by the Danish Integrated Antimicrobial Resistance Monitoring and Research Program (DANMAP).  The component that monitors antibiotic usage in veterinary practice is VetStat, which collects data from pharmacies, veterinarians and feed mills48.  The data flow is shown in the figure below49 along with an example of trends in antimicrobial consumption and resistance50.

 

Humans Food Food animals

 

Trends in erythromycin resistance

 

Consumption of prescribed
 
 
In the U.S., sponsors of applications for new animal drugs containing an antimicrobial active ingredient are now required to submit an annual report to the Food and Drug Administration on the amount of each such ingredient in the drug that is sold or distributed for use in food-producing animals.  Each report submitted to the FDA must specify (1) the amount of each antimicrobial active ingredient by container size, strength, and dosage form; (2) quantities distributed domestically and quantities exported; and (3) a listing of the target animals, indications, and production classes that are specified on the approved label of the product 54. The 2009 domestic sales and distribution data reported by drug class of antimicrobial drugs approved for use in food-producing animals were as follows: 

 

Table 2. Antimicrobial drugs and drug classes approved for use in food-producing animals: 2009 sales and distribution data reported by drug class54

Antimicrobial Class Antimicrobial drugs under this class Annual Totals (kg*)
Aminoglycosides Apramycin, Dihydrostreptomycin, Efrotomycin, Gentamicin, Hygromycin B, Neomycin, Spectinomycin, Streptomycin  339,678
Cephalosporins Ceftiofur, Cephairin  41,328
Ionophores Laidlomycin, Lasalocid, Monensin, Narasin, Salinomycin, Semdruamicin  3.740,627
Lincosamides Lincomycinm Pilrimycin  115,837
Macrolides Carbomycin, Erythromycin, Oleandomycin, Tilmicosin, Tulathromycin, tylosin  861,985
Penicillins Amoxicillin, Ampicillin, Cloxacillin, Hetacillin, Penicillin   610,514
Sulfas Sulfachlorpyridazine, Sulfadimethoxine, Sulfamerazine, Sulfamethazine, Sulfaquinoxaline, Sulfathiazole   517,873
Tetracyclines Chlortetracycline, Oxytetracycline, Tetracycline   4,611,892
Not independently reported Aminocoumarins (Novobiocin), Amphenicols (Florfenicol), Diaminopyrimidines (Ormetoprim), Glycolipids (Bambermycin), Pleuromutilins (Tiamulin), Polypeptides (Bacitracin, Polymixin B) Quinoxalines (Carbadox), Streptogramins (Virginiamycin)   2,227,366



Note: * kg = kilogram of active ingredient. Antimicrobials which were reported in International Units (i.e., penicillins and polypeptides) were converted to kg. 

However, monitoring the total pounds of antibiotics used per year encourages us to equate the AMR pressure from all types of antibiotics, whereas it is much more important to conserve the efficacy of those antibiotics that are most important for human health (See "Examples of Antimicrobials Important in Human Medicine Being Used for Animal Treatment, Metaphylaxis or Growth Promotion", a side bar link found on the Public Health Introduction page).  For example, the impact of a pound of tetracycline should in no way be equated with the impact of a pound of 3rd generation cephalosporin or fluoroquinolone.


A review by Sarmah37 summarized a list of animal antibiotics registered for use as growth promoters and/or feed efficiency in Australia, European Union (EU), Canada and the USA (Table 3).

 

Table 3. Animal antibiotics registered for use as growth promoters/feed efficiency in Australia, EU, Canada, and the USA37

ANTIBIOTIC GROUP

COUNTRIES USING

ANTIBIOTIC

USAGE

Arsenicals

Australia

3-Nitro-arsonic acid

Pigs, poultry

USA

Arsenilic acid, Roxarsone, cabarsone

Poultry

Poultry

Aminoglycosides

Canada

Neomycin

Cattle

Elfamycine

USA

Efrotomycin

Swine

Glycolpids

Canada

Babermycin

Breeder, turkey

USA

Babermycin

Swine , poultry

Ionophores/Polyethers

Australia

Lasalocid, Monensin,

Narasin

Salinomycin

Cattle

Cattle

Pigs, cattle

Canada

Lasolocid sodium

Monensin

Narasin

Salinomycin sodium

Cattle

Cattle

Swine

Swine, cattle

European Union

Monensin

Salinomycin

Cattle

Pigs

USA

Monensin, Lasalocid

Cattle

Lincosamides

Canada

Lincomycin hydrchloride

Breeder

Macrolides

Australia

Kitasamycin

Oleandomycin

Tylosin

Pigs

Cattle

Pigs

Canada

Erythromycin

Tylosin

Breeder, broiler

Sheep

USA

Erythromycin

Oleandomycin

Tylosin

Tiamulin

Lincomycin

Cattle

Chicken, turkey

Cattle, swine, chicken

Swine

Swine

Oligosaccharides

EU

Avilamycin

Pigs, chickens, turkeys

Penicillins

Canada

Penicillin G potassium

Penicillin G procaine

Chicken, turkey

Chicken, turkey, sheep

USA

Penicillin

Arsanilic acid

Poultry

Poultry

Polypeptides

Australia

Bacitracin

Meat, poultry

Canada

Bacitracin

Chicken, swine, turkey, chicken

Quinoxalines

Australia

Olaquindox

Pigs

Canada

Carbadox

Swine

USA

Carbadox

Swine

Streptogramins

Australia

Virginiamycin

Pigs, poultry

Sulfonamides

Canada

Sulfamethazine

Swine, catlte

USA

Sulfamethazine

Sulfathiazole

Cattle, swine

Swine

Tetracyclines

Canada

Chlortetracycline

Oxytetracycline

Chicken

Turkey, swine, cattle, sheep

USA

Tetracycline

Chlortetracycline

Oxytetracycline

Swine

Cattle, swine, poultry

Cattle, swine

 

b. Agencies Involved in AMR monitoring


Some countries have national agencies charged with monitoring antimicrobial usage and rates of AMR in food animals, food and/or people.  Examples of such national agencies include:


There are also international collaborations that monitor AMR of specific pathogens, such as the WHO Global Salm-Surv, an international Salmonella surveillance program for Salmonella surveillance, serotyping and AMR testing throughout the world.

 

c.  WHO Recommendations for Mitigating AMR in Animals


The World Health Organization (WHO), developed the WHO Global Strategy for Containment of Antimicrobial Resistance52.  Key recommendations to address the need for mitigating AMR were listed as follows:  

  • Increase awareness of the antibiotic resistance problem
  • Improve surveillance of antibiotic resistance
  • Improve antibiotic use in people
  • Regulate antibiotic use in animals
  • Encourage new product development
  • Increase resources to curb antibiotic resistance in the developing world
  • Increase funding for surveillance, research and education



Of particular interest for veterinarians is the recommendation to regulate antibiotic use in animals.  The experts further identified key stakeholders and each of their respective potential contributions to support this particular recommendation:

National and municipal organizations:

  • Increase awareness of the antibiotic resistance problem
  • Regulate antibiotic prescriptions
  • Restrict growth promoter use in animals
  • Regulate antibiotic use in animals [Note: this means veterinary prescriptions]
  • Set risk standards for resistance
  • Consider human and non-human uses simultaneously
  • Monitor advertising


Veterinarians:

  • Promote the prudent use of antibiotics in animals
  • Develop local guidelines for antibiotic use


Food animal producers:

  • Improve farm hygiene
  • Reduce use of antibiotics as growth promoters
  • Improve animal husbandry


Researchers

  • Conduct a risk-benefit analysis of growth promoter use
  • Evaluate the environmental impact of antibiotic use
  • Evaluate food processing and distribution methods.


The significance of the emergence and continued spread of AMR is met with skepticism by some stakeholders.  Some argue that there is not sufficient evidence to prove that AMR may some day bring animal and human medicine back to pre-antibiotic days, and that restrictive regulations on antimicrobial usage are therefore unnecessarily harmful to the animal industries. What is indisputable, however, is that excessive antibiotic usage is known to exert selective pressure on bacterial populations, that gene swapping among bacteria does occur, and an that an expanding number of people, animals and animal products transverse the globe much more quickly than ever before.  In addition, development of newer antibiotics has reached a plateau and novel antibiotics are rarely being introduced in the market today.  Together, these factors put us all at risk for increasing global AMR problems in future years.  Evidence of the trend toward increasing rates of AMR is clear from reports in the literature regarding  many previously susceptible pathogens.  Taking action at this critical point in our history is important to avoid wasting the efficacy of antibiotics for frivolous purposes whenever good disease control alternatives exist.  Veterinarians must do their part to preserve antibiotic efficacy for future generations of people and animals alike.

 

 

Document Actions