Guide to Antimicrobial Use in Animals

236 Pages·2008·2.37 MB·English

by  Luca Guardabassi

Guide to Antimicrobial
Use in Animals
Guide to Antimicrobial Use in Animals. Edited by Luca Guardabassi, Lars B. Jensen and Hilde Kruse
© 2008 Blackwell Publishing Ltd. ISBN: 978-1-4051-5079-8
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Guide to Antimicrobial
Use in Animals
Edited by
Luca Guardabassi
Department of Veterinary Pathobiology
Faculty of Life Sciences
University of Copenhagen
Denmark
Lars B. Jensen
National Food Institute
Technical University of Denmark
Denmark
Hilde Kruse
Department for Health Surveillance
National Veterinary Institute
Norway
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First published 2008 by Blackwell Publishing Ltd
ISBN: 9781405150798
Library of Congress Cataloging-in-Publication Data
Guide to antimicrobial use in animals/edited by Luca Guardabassi,
Lars Bogø Jensen, Hilde Kruse.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-1-4051-5079-8 (hardback : alk. paper)
ISBN-10: 1-4051-5079-3 (hardback : alk. paper)
1. Anti-infective agents in veterinary medicine. 2. Drug resistance
in microorganisms. I. Guardabassi, Luca. II. Jensen, Lars Bogø.
III. Kruse, Hilde.
[DNLM: 1. Anti-Infective Agents–therapeutic use. 2. Drug
Therapy–veterinary. 3. Animals, Domestic. 4. Anti-Infective
Agents–adverse effects. 5. Anti-Infective Agents–standards. 6. Drug
Resistance, Microbial. SF 918.A48 G946 2008]
SF918.A48G85 2008
636.089(cid:1)69041–dc22
2007036834
A catalogue record for this title is available from the British Library
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CONTENTS
Foreword vii
Preface ix
Acknowledgements xi
Contributors xiii
Chapter 1 Principles of prudent and rational use of antimicrobials in animals 1
Luca Guardabassi and Hilde Kruse
Chapter 2 Human health risks associated with antimicrobial use in animals 13
Lars B. Jensen, Frederick J. Angulo, Kåre Mølbak and Henrik C. Wegener
Chapter 3 Antimicrobial resistance risk assessment 27
Emma Snary and Scott McEwen
Chapter 4 Clinical importance of antimicrobial drugs in human health 44
Peter Collignon, Patrice Courvalin and Awa Aidara-Kane
Chapter 5 Geographical differences in market availability, regulation and
use of veterinary antimicrobial products 59
Angelo A. Valois, Yuuko S. Endoh, Kornelia Grein and Linda Tollefson
Chapter 6 Strategies to minimise the impact of antimicrobial treatment
on the selection of resistant bacteria 77
Peter Lees, Ove Svendsen and Camilla Wiuff
Chapter 7 Guidelines for antimicrobial use in swine 102
David G. S. Burch, C. Oliver Duran and Frank M. Aarestrup
Chapter 8 Guidelines for antimicrobial use in poultry 126
Ulrich Löhren, Antonia Ricci and Timothy S. Cummings
Chapter 9 Guidelines for antimicrobial use in cattle 143
Peter D. Constable, Satu Pyörälä and Geoffrey W. Smith
Chapter 10 Guidelines for antimicrobial use in horses 161
J. Scott Weese, Keith Edward Baptiste, Viveca Baverud and Pierre-Louis Toutain
Chapter 11 Guidelines for antimicrobial use in dogs and cats 183
Luca Guardabassi, Geoffrey A. Houser, Linda A. Frank and Mark G. Papich
Chapter 12 Guidelines for antimicrobial use in aquaculture 207
Peter R. Smith, Alain Le Breton, Tor Einar Horsberg and Flavio Corsin
Index 219
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FOREWORD
It is a pleasure to be invited to write a foreword for substances for the treatment of infectious disease. The
a book which will provide vital information for one breakthrough occurred in the 1930s when Gerhard
of the commonest activities in veterinary practice, the Domagk developed Prontosil and showed that it
prescription of antimicrobial agents. This is a process was effective in human streptococcal septicaemia.
which easily becomes routine, but can often lead to Although Prontosil was protected by patents, it was
suboptimal use and enhanced risk of generation of soon recognised that it was broken down in the body
antimicrobial resistance, not only amongst the patho- to release sulfanilamide, which was not patented, and
gens causing the current disease, but also in non- this opened the way for the development of the sul-
pathogenic microbes which may then act as reservoirs fonamides and their application in a wide variety of
of resistance genes. bacterial infections.
One of my heroes in the field of medicine is Ignac Although Lister is best known for his advocacy of
Semmelweis who recognised, in 1847, the value of phenol (carbolic acid), he also recognised that fun-
washing and disinfection in the control of puerperal gal extracts could inactivate infections and used them
fever, a cause of much death at that time in women to irrigate wounds. Thus Lister began to use what we
admitted to obstetrical wards with dystochia. He subsequently came to know as antibiotic some 60
was not aware of how his methods worked and his years prior to Alexander Flemming’s description in
disinfection methods were resented by busy clini- the British Journal of Experimental Pathology in 1929
cians; despite evidence that they were very effective in (2) of the antibacterial action of extracts of the mould,
reducing mortality, it was some time before they were Penicillium notatum. Although Flemming showed that
widely adopted. Indeed it was only after the existence his extract could be used to treat infection, he failed
of bacteria had been demonstrated by Louis Pasteur to obtain support enabling him to exploit his discov-
that surgeons began to recognise how infection ery. It was a decade later that the combined talents
occurred and started to develop efficient methods to of the biochemist, Ernest Chain and pharmacologist,
combat sepsis. Joseph Lister was at the forefront of Howard Florey, led to the development in the 1940s
this technology and his paper in The Lancet in 1867 of methods that could be used for the production of
(1) on ‘Illustration of the antiseptic system of treat- amounts useful in the treatment of human infection.
ment in surgery’ was a landmark in the use of antimi- Alexander Flemming reviewed the develop-
crobial agents in the battle against infection. ment and use of antimicrobials in a lecture entitled
By the early years of the 20th Century Lister’s dis- ‘Chemotherapy: yesterday, today and tomorrow’,
infection methods were rather discredited in surgery which he delivered in 1946 (3). He commented on
where the focus was now on asepsis. However, increas- the huge advances that had been made in the chemo-
ing numbers of substances were now being investi- therapy of bacterial infection during the past 10 years.
gated and developed for the treatment of established These advances continued apace and resulted in the
infections. Most significant amongst these studies wide range of antimicrobial agents which we now have
was the work of Paul Ehrlich and his development, in available. Flemming commented on the problem of
1909, of Salvarsan as an effective treatment for syphi- bacterial resistance and the promotion of such resis-
lis. He coined the term ‘chemotherapy’ and his work tance by the misuse of antimicrobials. He expressed
stimulated a search for other effective antimicrobial the hope that, as it became more widely available,
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viii Foreword
penicillin would not be abused as the sulfonamides The ample supporting material explaining and justi-
had been. Interestingly, he looked forward to the use fying the recommendations will also enable clinicians
of penicillin in veterinary medicine. and others using antimicrobial agents to make well-
Veterinary use of antimicrobials is now very sub- informed decisions. It is to be hoped that this book will
stantial in all fields of animal industry, in pets and become an essential reference in both small and large
in animal conservation. Veterinarians face the dual animal practice, helping veterinarians to optimise
problems of developing antimicrobial resistance and their antimicrobial treatment practices and protocols.
concerns from human medicine about the potential Were they still with us, I am sure that Semmelweis,
for animal use to drive this process and make human Lister and Flemming would join me in applauding its
products less effective. This is of course a two-way publication.
process, but veterinary treatment is already preju- David Lloyd
diced by the appearance of organisms such as multi- December 2007
resistant Staphylococcus aureus, Escherichia coli and
Pseudomonas aeruginosa. The appearance of multi-
resistant S. intermedius and its recognition now in References
both North America and in Europe is a particular
1. Lister, J. (1867). Illustration of the antiseptic system of
concern. With a lack of new and potent antimicrobi-
treatment in surgery. The Lancet, Sept. 21st, 1867, p. 354.
als in the pipeline we are facing a crisis which can only
2. Fleming, A. (1929). On the antibacterial action of cultures
be faced by much wiser use of the drugs that we have.
of a penicillium with special reference to their use in the
The Guide to Antimicrobial Use in Animals, there- isolation of B. influenzae. British Journal of Experimental
fore, arrives at a very opportune time, providing a Pathology 10: 226–36.
comprehensive analysis of the problems and solu- 3. Flemming, A. (1946). Chemotherapy: yesterday today and
tions relating to the veterinary use of antimicrobials. tomorrow. Reprinted in Fifty Years of Antimicrobials: Past
Perspectives and Future Trends (eds. Hunter, P.A., Darby,
The very approachable format allowing easy reference
G.K., Russell, N.J.) Cambridge University Press, Cambridge,
will make it convenient for use in veterinary practice.
1995, pp. 1–18.
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PREFACE
In 1968, the government of the UK appointed a Joint researchers. As a consequence of all these factors, the
Committee led by Professor Michael Swann to obtain debate on antimicrobial use in animals is often vigor-
information about the use of antimicrobial agents in ous and not always scientific and unbiased.
animal husbandry and veterinary medicine, to con- The present book was conceived to provide inde-
sider the implications for human and animal health, pendent advice and to promote continuing post-
and to make recommendations based on evidence graduate education on antimicrobial use in animals.
sought from published work, from public and private Prudent and rational antimicrobial use is a part of
organizations, professional bodies, trade associations, good veterinary practice and recognizing the human
research workers and other interested parties. This and animal health importance of antimicrobial agents
was the first historical attempt to provide guidelines and the need to preserve their efficacy has become
for antimicrobial use in animals, with particular focus an important aspect of the veterinary profession.
on the use of growth promoters in animal produc- The book represents an attempt to convert theoreti-
tion. In the report presented to parliament, the Joint cal notions of prudent and rational antimicrobial use
Committee emphasized the importance of independ- into a set of animal- and disease-specific guidelines for
ent information being available to the veterinary antimicrobial use covering both companion animals
profession. They wrote: ‘We were often conscious of and food-producing animals, including aquaculture.
the relative paucity of independent sources of advice, In order to ensure the necessary multidisciplinary
particularly of advice based on critical observation, expertise and the required independence and impar-
on the proper use of antibiotics and the dangers of tiality for this difficult task, the contributors were
misusing them. The availability of such independent selected from international experts from different
advice, and of vigorous professional discussion and backgrounds, including academics and researchers
continuing postgraduate education, can do nothing in the areas of veterinary clinical medicine, pharma-
but good and is an important factor in the mainte- cology, microbiology and epidemiology, members of
nance of responsible professional attitudes’. Forty national or international public health organizations,
years after the publication of the Swann report, there and farm consultants. In case of any controversies, the
is still a need for unbiased scientific advice on antimi- contributors made efforts to reach consensus or to
crobial use in animals. This topic is controversial due compromise between divergent positions.
to the complexity of antimicrobial drug resistance as The book is composed of six general chapters and
a biological phenomenon, the paucity of scientific six specific chapters on antimicrobial use in swine,
data on how to minimize the negative consequences poultry, cattle, horses, small animals and aquacul-
of antimicrobial therapy on resistance development, ture. The general principles of prudent and rational
and the difficulty in assessing the actual impact of antimicrobial use in animals introduced in Chapter 1
antimicrobial use in animals to resistance problems in form the basis of the guidelines presented in the
human medicine. The topic is also particularly subject book. Chapter 2 provides a thorough description and
to multiple opinions and divergence as it involves eth- presents evidence of the risks to human health asso-
ical issues on animal welfare and human health as well ciated with antimicrobial use in animals. Chapter 3
as economic interests by the pharmaceutical industry, emphasizes the importance of antimicrobial resist-
the food industry and various professional categories, ance risk assessment in developing policies and imple-
including farmers, veterinarians, pharmacists and menting guidelines on antimicrobial use in animals.
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x Preface
Chapter 4 summarizes the most serious resistance As such, the book targets veterinary practitioners,
problems in human medicine and provides up-to-date lecturers and students at veterinary universities and
classification of antimicrobial drugs based on their other interested readers. We hope that the book is
clinical importance in human medicine. Chapter 5 readable and enjoyable for such a broad audience
is an overview of the present legislation on antimi- and can serve as a reference on this important topic.
crobial use in animals in Australia, the USA, the EU A number of references are listed at the end of each
and Japan. Treatment strategies aimed at minimizing chapter for those interested in additional informa-
resistance development in animals are delineated in tion and greater depth in a particular topic. The use
Chapter 6. The following six chapters are dedicated to of tables has been maximized and the layout of the
specific animal groups and contain tables indicating chapters has been designed to ensure easy and rapid
the drugs of choice for treating common bacterial dis- consultation in veterinary practice. The editors trust
eases. Each of these chapters were given authority by that the guidelines presented in the book will be use-
a multidisciplinary team of experts in complementary ful in supporting decisions on antimicrobial use by
disciplines. The antimicrobial choices proposed in the veterinarians. Obviously, the guidelines should not be
tables are inspired by the need for preserving the effi- considered a limitation of clinical freedom or a sub-
cacy of clinically important antimicrobials and do not stitute for veterinary judgment, but rather a valuable
necessarily reflect the current trends in antimicrobial source of scientific advice that veterinarians can con-
prescription and usage. sult when taking decisions on antimicrobial use.
The final product is a practically oriented refer- The book ‘can do nothing but good’, Professor
ence on the use of antimicrobial agents in animals. Michael Swann would say.
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ACKNOWLEDGEMENTS
This book would have never been realized with- Lundegaard, Ansager Veterinary Hospital, Denmark;
out the contributions by 38 authors representing Jens Peter Nielsen and Karl Pedersen, University of
14 countries and 5 continents. We are indebted to all of Copenhagen, Denmark; Mark Papich, North Carolina
them for their excellent work. Their names and affili- University, USA; Satu Pyörälä, University of Helsinki,
ations are listed in the List of Contributors. A special Finland; Stefan Schwarz, Bundesforschungsanstalt
acknowledgement is due to Professor Ove Svendsen, für Landwirtschaft, Germany; Arnfinn Sundsfjord,
who passed away during the production of the book. University of Tromsø, Norway; Linda Tollefson, US
We will all miss him. Food and Drug Administration; Pier Louis Toutain,
The editors also wish to acknowledge the con- Ecole Nationale Vétérinaire, Toulouse, France; Neil
structive comments by many international experts Woodford, Health Protection Agency, UK; Olav
who kindly agreed to review the individual Østerås and Henning Sørum, The Norwegian School
manuscripts: Rohana Subasinghe, Food and of Veterinary Science.
Agriculture Organization of the UN; Morten The staff at Blackwell assisted us with their exper-
Sichlau Bruun and Inger Dalsgaard, Danish tise in the publication of this book. Special thanks to
Institute for Fisheries Research; Paula Fedorka-Cray, the Commissioning Editors Samantha Jackson and
USDAARS-Antimicrobial Resistance Research Unit; Justinia Wood, their assistants Adam Burbage and
Bruno Gonzalez-Zorn, Universidad Complutense Sophie Gillanders, and the Senior Production Editor
de Madrid, Spain; Erik Jacobsen and Henrik Casper Emma Lonie. Thanks also to the team at Newgen
Wegener, Danish Technical University; David Lloyd, Imaging Systems for the editing and production of
Royal Veterinary College, UK; Henrik Christian the book.
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