The development of resistance to antibiotics has become, over the last decade, a major concern in terms of human and animal health. Thus, in 2011, the ministry in charge of agriculture initiated a national plan to reduce the use of antibiotics in veterinary medicine for the period 2012-2017, called Ecoantibio 2017, in order to coordinate and potentiate the efforts of all actors involved in the fight once morest antibiotic resistance.
Within this framework, ANSES issued an internal request in order to conduct an assessment of the risks of the emergence of antibiotic resistance linked to the methods of use of antibiotics in the field of animal health, in the various animal productions (ruminants, pigs, poultry, rabbits and fish), as well as in horses and pets.
ANSES’s work
ANSES organized its work in three stages.
The first consisted of identifying the methods of use of antibiotics in the various animal productions. To do this, the Agency had tools and systems for monitoring the use of antibiotics and monitoring antimicrobial resistance in animal health, which it had implemented many years ago.
The second aimed to assess the risks of antibiotic resistance associated with veterinary medicine practices for livestock and companion animals.
The third stage focused on the formulation of recommendations aimed at reducing, avoiding or eliminating risky practices in veterinary medicine.
Agency conclusions and recommendations
Unfavorable benefit-to-risk ratio of the use of antibiotics for preventive treatment
If the antibiotic treatment curative constitutes the most appropriate solution for treating sick animals, other methods of using antibiotics are implemented in farms. The treatment preventive is that applied to healthy animals exposed to a risk factor for the infectious disease. It can be individual or collective.
The treatment metaphylactic is applied both to clinically sick animals and to animals of the same group which are still clinically healthy, but with a high probability of being infected due to close contact with the sick animals.
The Agency’s experts pointed out that during a preventive treatment, the risk of inducing resistance in the bacteria of the commensal flora is present in all the animals treated, whereas the therapeutic benefit is dependent on the effective elimination of the pathogenic bacterium whose presence is only suspected. The risk-benefit ratio of preventive treatments therefore appears to be unfavorable in terms of the risk of resistance to antibiotics, except for certain specific uses.
Metaphylactic treatment, well suited to animals reared in groups, is considered by experts to be a more relevant modality, insofar as it can improve the risk-benefit ratio compared to preventive treatment, provided that its modalities are specified. of application.
Monitoring tools
The awareness of the sectors and their desire to commit to the prudent use of antibiotics have led ANSES to recommend the implementation of long-term monitoring tools for practicescloser to the administration of antibiotics in farms, by animal species, by sector and type of productionin addition to existing tools.
In addition, the Agency emphasizes the importance of including live animals and products of animal origin from farms in other countries in the antimicrobial resistance monitoring plans.
With regard to the control of risky practices in veterinary antibiotic therapy, ANSES recommends:
- to abandon the use of antibiotics for prevention;
- to reserve the use of latest generation antibiotics (cephalosporins and fluoroquinolones of 3th et 4th generations), to particular situations to be clearly identified in advance by sector, and to be strictly supervised;
- favor the use of narrow-spectrum antibiotics, precisely targeting the target bacteria.
Furthermore, ANSES emphasizes the need to assess the impact of the measures put in place to combat antibiotic resistance through surveys and appropriate monitoring tools. It also recalls that the fight once morest antibiotic resistance also involves making tools available to better target antibiotic treatments and developing alternatives to the use of these molecules.
The work relating to this internal request also highlighted the need to improve knowledge of the mechanisms of development and dissemination of antibiotic resistance, of the circulation of resistance genes in the environment and in animal and human populations, as well as factors inducing different methods of antibiotic use and their impact on antibiotic resistance.
It is also necessary to encourage the definition of indicators allowing the use of antibiotics in a more targeted manner, in particular by improving antibiograms in veterinary medicine.
