UK Veterinary Antibiotic Resistance and Sales Surveillance

104 Pages·2013·2.07 MB·English

UK Veterinary Antibiotic
Resistance and Sales Surveillance

UK-VARSS 2012

Veterinary Medicines Directorate
Government Department for the Environment, Food and Rural Affairs
Woodham Lane, New Haw, Addlestone, Surrey. KT15 3LS
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Editor in Chief:

Professor S. Peter Borriello
Veterinary Medicines Directorate
Woodham Lane
New Haw
Addlestone
Surrey. KT15 3LS

Authors:

1. Sales Data Report

Authors
 Renee Sheehan

 Dr Samantha Walker
 Suzanne Eckford

All of the Veterinary Medicines Directorate

2. Antibacterial Susceptibility Report

Principal Authors
 Chris J. Teale,

 Anne Ridley and
 Catherine M. Tallentire

Contributors

 Sarah Easthope
 Jeff Jones,
 Jon Rogers
 Gavin Watkins
 Susanna Williamson

All of the Animal Health and Veterinary Laboratory Agency
Woodham Lane
New Haw
Addlestone
Surrey. KT15 3NB

Layout:

Veterinary Medicines Directorate (VMD) and
Animal Health and Veterinary Laboratories Agency (AHVLA).

UK-VARSS 2012 – November 2013
Text and tables may be cited only with reference to these
reports: UK-VARSS 2012. UK Veterinary Antibiotic

Resistance and Sales Surveillance Report. The combined

report is available from www.vmd.defra.gov.uk

Acknowledgement:

This combined report is issued by the Veterinary Medicines
Directorate.
The ‘Sales of Antimicrobial products authorised for use as
veterinary medicines in 2012’ report is produced by the

Veterinary Medicines Directorate.

The ‘Antibacterial Susceptibility of Veterinary Pathogens

2009-2011 from England and Wales’ report is produced by
AHVLA in collaboration with the VMD.
The veterinary antibiotic resistance and sales data
monitoring programme is funded by the Veterinary
Medicines Directorate.

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UK Veterinary Antibiotic Resistance and Sales
Surveillance Report

This report is published under the acronym UK-VARSS 2012 by the Veterinary
Medicine Directorate (an executive agency of Defra).

This is the first report to combine UK data on antimicrobial sales for animal use
(2008-2012) together with England and Wales data on the antibiotic
susceptibility of veterinary pathogens and food-borne pathogens (2009-2011).
In following years our intention is to have greater integration of these two
reports, and to reflect user feedback on the design and presentation of the
information to ensure the data presented are of maximal value. To this end a
set of Powerpoint slides of tables and figures from the antibiotic sales report is
available at the end of the report.

For both sales and resistance surveillance we have used the Heads of
Medicines Agencies (HMA) definition of antimicrobials and antibiotics
(www.hma.eu/fileadmin/dateien/Veterinary_medicines/00-HMA_Vet/02-
HMA_Task_Force/03_HMA_vet_TF_AMR/2012_11_HMA_agreed_AB_AM_defi
nitions.pdf) which have also been adopted by EPRUMA
(http://www.epruma.eu/component/downloads/downloads/76.html).

For the resistance data, resistance has been defined based on human clinical
breakpoints. The intent, in the future, is to move towards agreed animal species
clinical breakpoints. However, even for future reports, we will retain human
clinical breakpoints for food-borne pathogens due to their relevance for human
medicine.

Professor S.P. Borriello

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SALES OF ANTIMICROBIAL
PRODUCTS AUTHORISED FOR USE
AS VETERINARY MEDICINES
IN THE UK IN 2012

2013

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Table of Contents

LIST OF TABLES AND FIGURES ................................................................................. 6
NEW LOOK ANNUAL REPORT .................................................................................... 8
SUMMARY .................................................................................................................. 10
ANTIBIOTIC SALES IN THE CONTEXT OF LIVESTOCK AND ANIMAL
DEMOGRAPHICS ................................................................................................... 13
Adoption of the European Population Correction Unit (PCU) ................................... 13
Analysis of Sales by Animal Species PCU ............................................................... 14
Antibiotic Sales and Livestock Reared for Slaughter ............................................... 16
Analysis of Intramammary Products Sales by UK Dairy Herd .................................. 18
ANTIBIOTIC SALES DATA ......................................................................................... 21
Total Sales and Sales by Antibiotic Chemical Group for Food and Non-Food
Animals .................................................................................................................... 21
Sales by Route of Administration ............................................................................. 25
Sales by Animal Species Indication ......................................................................... 26
SALES OF ANTIMICROBIALS OTHER THAN ANTIBIOTICS .................................... 30
ANNEX 1: SALES DATA CAVEATS .......................................................................... 31
ANNEX 2: EUROPEAN SURVEILLANCE OF VETERINARY ANTIMICROBIAL
CONSUMPTION (ESVAC) ...................................................................................... 32
ANNEX 3: SALES FLUCTUATIONS POSSIBLE EXPLANATION .............................. 33
ANNEX 4: GLOSSARY OF TERMS ........................................................................... 34
ANNEX 5: CONTRIBUTORS AND PARTICIPANTS .................................................. 37
HOW CAN WE IMPROVE THIS REPORT? ................................................................ 39

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LIST OF TABLES AND FIGURES

Table 1. Numbers of Livestock in 2008-2012 by species

Table 2. Population correction unit (PCU) in 1,000 tonnes for 2008- 2012.

Table 3. Live weight (in ‘000 tonnes) of animals slaughtered for food use
2008–2012

Table 4. Total live weight (‘000 tonnes) of animals slaughtered for food use
and total antibiotic product sales for food-producing animals only
(tonnes active ingredient) 2008-2012

Table 5. Sales in kg of active ingredient and (millions of tubes) of antibiotic
intramammary products 2008–2012

Table 6. Sales (grams active ingredient) of antibiotic intramammary products
per dairy cow 2008–2012

Table 7. Numbers of individual antibiotic products sold in 2008-2012 by
reporting group of products

Table 8. Sales (tonnes active ingredient) of total antibiotic products by
chemical grouping 2008–2012 and total sales 2006-2012

Table 9. Sales (tonnes active ingredient) of antibiotic products by sub-
chemical grouping 2008-2012

Table10. Sales (tonnes active ingredient) of total antibiotics by route of
administration 2008–2012

Table11. Sales (tonnes active ingredient) of antibiotics 2008-2012, in the
categories of food animals only, non-food animals only and combined
food and non-food animals

Table12. Sales (tonnes active ingredient) of total antibiotics for food-producing
animals only by animal species 2008–2012

Table13. Sales (kg active ingredient) of total antibiotics for non-food-producing
animals only by animal species 2008–2012

Table14. Sales (tonnes active ingredient) of antiprotozoals in the UK 2008-
2012

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Figure 1. Milligrams of active ingredient sold for food producing animals per
population correction unit (PCU) for 2008- 2012

Figure 2. Milligrams of active ingredient of critically important antibiotics sold for
food producing animals per population correction Unit (PCU) for
2008-2012

Figure 3. Sales of antibiotic intramammary products (grams active ingredient)
per dairy cow in the national herd 2008–2012

Figure 4. Sales (tonnes active ingredient) of total antibiotic products by
chemical group 2008–2012

Figure 5. Sales of total antibiotics (tonnes active ingredient) by route of
administration 2008–2012

Figure 6. Sales for animal use of antibiotic products (tonnes active ingredient)
2008–2012

Figure 7. Total sales (tonnes active ingredient) of veterinary antibiotics by
antibiotic class for food-producing animals only 2008–2012

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NEW LOOK ANNUAL REPORT

Foreword

There has been long-standing reporting in the UK of total sales of antimicrobials
(antibiotics, anti-fungals and anti-protozoals) as a surrogate measure of
antimicrobial use.
However, there are serious limitations with this approach and therefore caution
must be applied to any reported figures, particularly when extrapolating to
represent antimicrobial consumption in any given species. The populations of
each animal species are an important denominator: the greater the number of
animals, the greater the potential need for antimicrobial treatment. As a
consequence, for example, a small decrease in sales concurrent with a
decrease in animal numbers would not necessarily be indicative of a change in
use; whereas a small increase in sales concurrent with a large increase in
animal numbers would indicate a change in patterns of use.
Equating sales data as a measure of use is further complicated for the following
reasons. First, sales figures in general over-estimate use, as not all of the
antimicrobials sold will be used. There is natural wastage resulting from pack-
sizes that do not meet dose need, and from drug expiry. It is also the case that
a proportion of the antimicrobials sold in the UK are used for medicated feeds
which are exported. The calculations used in this report assume that all
veterinary antimicrobials sold in the UK are administered in their entirety to
animals within the UK. However, some antimicrobials are imported into the UK
for specific purposes, and some antimicrobials for humans may under the
provision of cascade prescribing be used to treat animals under certain
circumstances (see Annex 1: Sales Data Caveats). Currently, no adjustment is
made within the sales data collection methodology to account for these figures,
and therefore this represents a potential under-estimate of actual antimicrobial
use.
Second, the food-producing animal population against which antimicrobial
consumption is judged is based on a single point in time “census”. While these
figures can be considered reflective of the total annual cattle population, they
are less so for other animal species. The figure is least representative for
poultry raised for meat where the total number at any given time would
represent a small percentage of total raised over a year. In consequence the
average antimicrobial use per “head” of food-producing animal is an over
estimate in general, and particularly so for poultry.
In the EU Surveillance of Veterinary Antimicrobial Consumption (ESVAC)
report, an attempt has been made to further refine the data analysis to take into
consideration the fact that larger animals require larger doses, (similar to human
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adults needing more than children), and that greater sales of antimicrobials may
not necessarily reflect more profligate use when comparing data from countries.
Differences in antimicrobial use between countries, or variation in use in a given
country over time, may also be reflective of differences in type (as well as
number) of animals. A calculation has therefore been developed to estimate
the weight of the animal receiving an antimicrobial at the most likely time of
administration. This factor, the Population Correction Unit, is now used across
EU Member States and is currently the best approximation of use, extrapolated
from sales data, for changes within a country over time and comparison
between countries. We have now adopted this form of analysis as the primary
approach in the UK national report.
It is clear that there are a number of assumptions used in the calculations within
this report that reduce the reliability of the reported findings, in particular when
trying to attribute use to any particular species. For example, some
formulations of antimicrobials are authorised, and sold with indications, for use
in more than one species, e.g. pigs or poultry. It is not possible to ascertain
from sales data in which species the product was used.
All of the above limitations of the data and necessary extrapolations argue
strongly for a system of prescription data collection. Consideration is being
given at the European level for this proposal, and it is an advance that we
support.

There are many caveats to be taken into account when considering sales data
analysis; regarding animal demographics, the use of antibiotic sales data to
represent actual use, and the attribution of antibiotic products to use in a
particular species. As such great caution should be taken when interpreting
tables and figures for representativeness of actual use in particular animal
species or by livestock sector.

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SUMMARY

This is the fifteenth in a series of reports designed to provide information about
the sales of veterinary antimicrobial products in the UK. The data for this report
have been calculated using the same methods developed and used since 2002.

Summary of the main points and changes to the report

(all weights of antimicrobial products are expressed as tonnes of active
ingredient (a.i) unless otherwise stated)

The main points and changes presented in this year’s report are:
 Total sales of active ingredient, (mg), sold for food producing animals per
population correction unit, (PCU) have been included for the first time in
this report. The PCU is the unit of measure used in the EU to compare
sales as related to animal populations and demographics. This figure
was 55 mg/PCU for 2012, lower than but differing little from the five year
mean of 57 mg/PCU.
 For critically important antibiotics (for human use), the PCU figures for
2012 are 6.3 mg for macrolides, 0.35 mg for fluoroquinolones and 0.2 mg
for 3rd/4th generation cephalosporins. These figures have remained fairly
stable over the five year period.
 In 2012, 60 g of active ingredient was sold for each tonne of live weight
animal slaughtered, which is in line with previous years.
 For the first time in this report sales of intramammary antibiotics per dairy
cow in the national herd have been reported. In 2012 this equated to 2 g
of active ingredient per dairy cow. This figure ranges from 1.7 g to 2.1 g
during 2008-2012.
 Total sales have varied little over a “normalised” five year period (2006-9
and 2012), with variation of 6% between highest and lowest sales years.
Sales for 2012 were 3% higher than the 2006-12 seven year mean. The
“normalised” five year period is shown because of atypically high and low
sales figures for 2010 and 2011 respectively.
 In 2012, 86% of antibiotics active in products authorised only for food
producing animals were for use in a combination of pigs and poultry.
 In 2012, 349 kg more fluoroquinolone antibiotics were sold than in 2011.
This equates to the same percentage in total sales in 2011 and 2012
(0.6%).
 Sales of 3rd and 4th generation cephalosporins increased in 2012 by 162
kg. This equates to the same percentage in total sales in 2011 and 2012
(0.3%).
 With respect to administration type, medicated feeding stuff for food-
producing animals accounted for 60% of veterinary antibiotic products
sold, most of which are sold for use in pig and poultry farming.
 Sales of coccidiostats in 2012 totalled 301 tonnes, an increase of 24
tonnes from 2011.
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