Correct use of veterinary drugs and withdrawal period: the case of Anti Microbial Resistance (AMR) Jorge Pinto Ferreira, DVM, MS, PhD Establishment of a risk-based food safety control system in the dairy value chain in Ukraine November 18, 2016
AMR: How big is really the problem? Use of vet drugs, withdrawal period and AMR 2
We have been fighting it for some time Sept. 12, 1994 May 20, 2016 Use of vet drugs, withdrawal period and AMR 3
And we were warned Use of vet drugs, withdrawal period and AMR 4
It is not really just about AB`s that we are talking about Use of vet drugs, withdrawal period and AMR 5
AMR: a perfect One Heath issue Marco Domino, Reuters Zohra Bensemra, Reuters Goran Tomasevic, Reuters Use of vet drugs, withdrawal period and AMR 6
What is the environment? Ghenghesh et al. 2009: 60 DVDs rented: - Tripoli (Libia) - 35 (58.3%): Staphylococcus aureus - 4 (11.4%): MRSA! Use of vet drugs, withdrawal period and AMR 7
The arctic is really far or not Use of vet drugs, withdrawal period and AMR 8
Representing is easy; Quantifying... Fig.1, EFSA Journal 2015; 13 (2):4036 Use of vet drugs, withdrawal period and AMR 9
When did this problem start? It is a natural biological phenome. D`Costa et al. 2011. Nature, vol. 477, page 457 Bhullar et al. 2012. PlosOne, Vol. 7, Issue 4, e34953 Use of vet drugs, withdrawal period and AMR 10
Are We Born with it? news.softpedia.com Resistance, first weeks of life Mother-child transmission Use of vet drugs, withdrawal period and AMR 11
USE = R? Use of vet drugs, withdrawal period and AMR 12
USE = R? Use of vet drugs, withdrawal period and AMR 13
(Mis) use in Humans... India: any antibiotic can be bought w/o prescritpion (Saradamma et al., 2000, Soc Sci Med., 50 (6): 891-903) Beijing: 98% children with flu = AB (Yezli & Li, 2012, Int J Antimicrob Agents, 40 (5): 389-397) ~50% of the prescriptions are incorrect (Werner et al., 2011, BMC Infect Dis, 11:187) Use of vet drugs, withdrawal period and AMR 14
Use of AB`s in food animals production... Between 2010 and 2030, the global consumption of antimicrobials will increase by 67% For Brazil, Russia, India, China, and South Africa, the increase in antimicrobial consumption will be 99% Use of vet drugs, withdrawal period and AMR 15
What is the correct use (in animals)? Withdrawal period: time required after administration of a drug to an animal needed to assure that drug residues in the marketable milk (and/or meat) is below a determined Maximum Residue Limit (MRL). Use of vet drugs, withdrawal period and AMR 16
The correct use, and the withdrawal period Sometimes, it is not that straightforward... Healthy animals vs hepatic lipidosis Abcesses Drugs interaction Dosis and adminitration route Dilution effect Body condition Abortions Use of vet drugs, withdrawal period and AMR 17
Show me the data... Use of vet drugs, withdrawal period and AMR 18
Quantifying antimicrobial use: simple version Slide credits: Jeroen Dewulf, U Gent Use of vet drugs, withdrawal period and AMR 19
...and the not so simple... Collineau et al., 2016, Zoonoses and Public Health Use of vet drugs, withdrawal period and AMR 20
«USE» of antimicrobials in the EU P.S: It takes at least three to four years to establish a valid baseline for the data on sales! Use of vet drugs, withdrawal period and AMR 21
AMR: it is really multifactorial... Use of vet drugs, withdrawal period and AMR 22
Is the solution, to stop using ABs? Use of vet drugs, withdrawal period and AMR 23
Fitness cost? Once resistant, always resistant. Trindade et al., 2009. PlosOne, Vol. 5, Issue 7, e1000578 Sørum et al., 2006. Applied and Environmental Microbiology, Vol. 72, No.1, p. 516-521 Use of vet drugs, withdrawal period and AMR 24
New drugs = problem solved? There remains no evidence the drugs meet unmet medical need, adress AMR, or are more effective than pre-exisiting ABs. History has a way of repeating itself Use of vet drugs, withdrawal period and AMR 25
Take home messages: AMR is one of the biggest public health threats; If not controlled, the way we live will be significantly affected. Any use will eventually lead to resistance. Each one of us can make a small but significant difference. Now is the time! Use of vet drugs, withdrawal period and AMR 26
Establishment of a risk-based food safety control system in the dairy value chain in Ukraine Annual international conference Correct use of veterinary drugs and withdrawal period: the case of AMR Thank you. jorge.pinto-ferreira@safoso.ch Use of vet drugs, withdrawal period and AMR 27
Any questions? Establishment of a risk-based food safety control system in the dairy value chain in Ukraine November 18, 2016