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ANTIMICROBIAL
STEWARDSHIP OF IN-
FEED ANTIBIOTICS
Dr Stephanie Bullen BVBiol BVSc (Hons) MVS MVSc
National Lead – Animal Health & Fertility
1
WHO HAS HAD
SURGERY?
Saturday 3 September 2022
https://www.ocosperio.com/procedures/jaw
-surgery/lower-mandible-surgery/
Deaths
attributable to
AMR annually
now and by 2050
1. Knowledge of the dairy industry’s commitment to
antimicrobial stewardship.
2. Knowledge of the Australian antimicrobial importance
rating system (ASTAG) and where key ingredients sit.
3. Motivation to think about your role in AMS.
PURPOSE
THE FIVE ‘RS’ OF ANTIMICROBIAL STEWARDSHIP
7
RESPONSIBILITY
8
1. The dairy industry uses antibiotics responsibly, as little as possible, as much as
necessary, to protect the health and welfare of our animals.
2. All dairy farmers access antibiotics from a registered veterinarian.
3. All dairy farmers use antibiotics responsibly under veterinary direction.
4. Antibiotics that are of high importance to human Antimicrobial Resistance (AMR) in
Australia are only used to treat dairy livestock in exceptional circumstances where no
other alternatives exist.
AUSTRALIAN DAIRY INDUSTRY SUSTAINABILITY
FRAMEWORK (2030 TARGETS)
LOW
IMPORTANCE
MEDIUM
IMPORTANCE
HIGH
IMPORTANCE
Narrow spectrum penicillins
Yodimaspen
Mamyzin
Propercillin
Norocillin
Duplocillin
Tetracyclines
Alamycin 10
Mastalone
Oxymav
Engemcyin
Macrolides
Tylosin
Ionophores
Rumensin
Bovatec
1st generation cephalosporins
Maxalac DC
Cepravin DC
2nd generation cephalosporins
Maxalac LC
Antistaphylococcal penicillins
Noroclox LC
Orbenin Enduro DC
Bovaclox DC
Opticlox Eye Ointment
Sulfonamides
Trisoprim 480
Scourban
3rd generation cephalosporins
Excenel RTU
Exceed
Accent
Streptogramins
Eskalin
IMPORTANCE RATINGS
PRODUCT EXAMPLES
EU VETERINARY MEDICINE REGULATIONS
REDUCE
15
2022 ANIMAL HUSBANDRY
AND GENETICS SURVEY
16
DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN
ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)?
Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN
ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)?
Yes
National (n = 400) 14%
Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN
ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)?
Yes
National (n = 400) 14%
Victoria (n = 240) 15%
Tasmania (n = 30) 7%
NSW (n = 42) 10%
South Australia (n = 23) 23%
Western Australia (n = 30) 40%
Queensland (n = 27) 7%
Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN
ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)?
Yes
National (n = 400) 14%
Victoria (n = 240) 15%
Tasmania (n = 30) 7%
NSW (n = 42) 10%
South Australia (n = 23) 23%
Western Australia (n = 30) 40%
Queensland (n = 27) 7%
Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN
ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)?
Yes
National (n = 400) 14%
Victoria (n = 240) 15%
Tasmania (n = 30) 7%
NSW (n = 42) 10%
South Australia (n = 23) 23%
Western Australia (n = 30) 40%
Queensland (n = 27) 7%
Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
WHAT TYPE OF ANTIBIOTICS DO YOU USE? (n = 62)
70%
25%
15%
11%
7% 2%
Monensin
Virginiamycin
Tylosin
Lasolacid
Other
Unsure
FED FOR 294 DAYS
ON AVERAGE
Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
2020 NATIONAL DAIRY
FARMER SURVEY
23
IN THE LAST 12 MONTHS, HAVE YOU USED
VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 801)
Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
IN THE LAST 12 MONTHS, HAVE YOU USED
VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 801)
Yes No Unsure
Yes 8% 88% 4%
Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
IN THE LAST 12 MONTHS, HAVE YOU USED
VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*)
Low Medium High
<0.5t 0.5 – 1.5t >1.5t
Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
IN THE LAST 12 MONTHS, HAVE YOU USED
VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*)
Low Medium High
<0.5t 0.5 – 1.5t >1.5t
https://websvr.infopest.com.au/
Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
IN THE LAST 12 MONTHS, HAVE YOU USED
VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*)
Low Medium High
<0.5t 0.5 – 1.5t >1.5t
Yes 4% 5% 12%
No 87% 91% 83%
Not sure 8% 3% 5%
*Caution small subsample
Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
IN THE LAST 12 MONTHS, HAVE YOU USED
VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*)
Low Medium High
<0.5t 0.5 – 1.5t >1.5t
Yes 4% 5% 12%
No 87% 91% 83%
Not sure 8% 3% 5%
*Caution small subsample
Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
DAIRY ANTIMICROBIAL USE CONSULTANT
REFINE
31
FED FOR 294 DAYS ON
AVERAGE
REPLACE
33
34
1. Adequate fibre
2. Gradual adaptation to starch-rich feeds
3. Rumen buffers and alkalinising agents
… “A diagnosed disease.”
REVIEW
35
THE FIVE ‘RS’ OF ANTIMICROBIAL STEWARDSHIP
1. Knowledge of the dairy industry’s commitment to
antimicrobial stewardship.
2. Knowledge of the Australian antimicrobial importance
rating system (ASTAG) and where key ingredients sit.
3. Motivation to think about your role in AMS.
PURPOSE
THANK YOU
38
Dr Stephanie Bullen
stephanie.bullen@dairyaustralia.com.au
Ph: 0417 123 387
QUESTIONS
39

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5. Bullen SL Feedworks Antimicrobial stewardship September 2022.pptx

  • 1. ANTIMICROBIAL STEWARDSHIP OF IN- FEED ANTIBIOTICS Dr Stephanie Bullen BVBiol BVSc (Hons) MVS MVSc National Lead – Animal Health & Fertility 1
  • 3. Saturday 3 September 2022 https://www.ocosperio.com/procedures/jaw -surgery/lower-mandible-surgery/
  • 5. 1. Knowledge of the dairy industry’s commitment to antimicrobial stewardship. 2. Knowledge of the Australian antimicrobial importance rating system (ASTAG) and where key ingredients sit. 3. Motivation to think about your role in AMS. PURPOSE
  • 6. THE FIVE ‘RS’ OF ANTIMICROBIAL STEWARDSHIP
  • 7. 7
  • 9. 1. The dairy industry uses antibiotics responsibly, as little as possible, as much as necessary, to protect the health and welfare of our animals. 2. All dairy farmers access antibiotics from a registered veterinarian. 3. All dairy farmers use antibiotics responsibly under veterinary direction. 4. Antibiotics that are of high importance to human Antimicrobial Resistance (AMR) in Australia are only used to treat dairy livestock in exceptional circumstances where no other alternatives exist. AUSTRALIAN DAIRY INDUSTRY SUSTAINABILITY FRAMEWORK (2030 TARGETS)
  • 10.
  • 11. LOW IMPORTANCE MEDIUM IMPORTANCE HIGH IMPORTANCE Narrow spectrum penicillins Yodimaspen Mamyzin Propercillin Norocillin Duplocillin Tetracyclines Alamycin 10 Mastalone Oxymav Engemcyin Macrolides Tylosin Ionophores Rumensin Bovatec 1st generation cephalosporins Maxalac DC Cepravin DC 2nd generation cephalosporins Maxalac LC Antistaphylococcal penicillins Noroclox LC Orbenin Enduro DC Bovaclox DC Opticlox Eye Ointment Sulfonamides Trisoprim 480 Scourban 3rd generation cephalosporins Excenel RTU Exceed Accent Streptogramins Eskalin IMPORTANCE RATINGS PRODUCT EXAMPLES
  • 12.
  • 13.
  • 14. EU VETERINARY MEDICINE REGULATIONS
  • 16. 2022 ANIMAL HUSBANDRY AND GENETICS SURVEY 16
  • 17. DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)? Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
  • 18. DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)? Yes National (n = 400) 14% Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
  • 19. DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)? Yes National (n = 400) 14% Victoria (n = 240) 15% Tasmania (n = 30) 7% NSW (n = 42) 10% South Australia (n = 23) 23% Western Australia (n = 30) 40% Queensland (n = 27) 7% Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
  • 20. DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)? Yes National (n = 400) 14% Victoria (n = 240) 15% Tasmania (n = 30) 7% NSW (n = 42) 10% South Australia (n = 23) 23% Western Australia (n = 30) 40% Queensland (n = 27) 7% Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
  • 21. DOES THE FEED GIVEN TO YOUR MILKING COWS CONTAIN ANTIBIOTICS (E.G. ESKALIN, RUMENSIN, TYLOSIN)? Yes National (n = 400) 14% Victoria (n = 240) 15% Tasmania (n = 30) 7% NSW (n = 42) 10% South Australia (n = 23) 23% Western Australia (n = 30) 40% Queensland (n = 27) 7% Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
  • 22. WHAT TYPE OF ANTIBIOTICS DO YOU USE? (n = 62) 70% 25% 15% 11% 7% 2% Monensin Virginiamycin Tylosin Lasolacid Other Unsure FED FOR 294 DAYS ON AVERAGE Watson, P. & Watson, D., 2022. Animal Husbandry and Genetics Survey 2022, undertaken for Dairy Australia, Melbourne.
  • 24. IN THE LAST 12 MONTHS, HAVE YOU USED VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 801) Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
  • 25. IN THE LAST 12 MONTHS, HAVE YOU USED VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 801) Yes No Unsure Yes 8% 88% 4% Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
  • 26. IN THE LAST 12 MONTHS, HAVE YOU USED VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*) Low Medium High <0.5t 0.5 – 1.5t >1.5t Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
  • 27. IN THE LAST 12 MONTHS, HAVE YOU USED VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*) Low Medium High <0.5t 0.5 – 1.5t >1.5t https://websvr.infopest.com.au/ Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
  • 28. IN THE LAST 12 MONTHS, HAVE YOU USED VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*) Low Medium High <0.5t 0.5 – 1.5t >1.5t Yes 4% 5% 12% No 87% 91% 83% Not sure 8% 3% 5% *Caution small subsample Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
  • 29. IN THE LAST 12 MONTHS, HAVE YOU USED VIRGINIAMYCIN IN YOUR STOCK FEED? (N = 63*) Low Medium High <0.5t 0.5 – 1.5t >1.5t Yes 4% 5% 12% No 87% 91% 83% Not sure 8% 3% 5% *Caution small subsample Watson, P. & Watson, D., 2020. National Dairy Farmer Survey 2020, undertaken for Dairy Australia, Melbourne.
  • 32. FED FOR 294 DAYS ON AVERAGE
  • 34. 34 1. Adequate fibre 2. Gradual adaptation to starch-rich feeds 3. Rumen buffers and alkalinising agents … “A diagnosed disease.”
  • 36. THE FIVE ‘RS’ OF ANTIMICROBIAL STEWARDSHIP
  • 37. 1. Knowledge of the dairy industry’s commitment to antimicrobial stewardship. 2. Knowledge of the Australian antimicrobial importance rating system (ASTAG) and where key ingredients sit. 3. Motivation to think about your role in AMS. PURPOSE
  • 38. THANK YOU 38 Dr Stephanie Bullen stephanie.bullen@dairyaustralia.com.au Ph: 0417 123 387

Editor's Notes

  1. Staphylococcus aureus and Staphylococcus epidermidis account for 65% of orthopaedic infections. Of particular concern are MRSA, which are present on the skin and in the nose of around 5% of the population and account for 13-74% of Staph infections.
  2. AMR has been declared by the World Health Organisation as a global health emergency. It is responsible for an estimated 700 000 deaths annually, forecast to be 10 million by 2050. A review done in the UK, published in 2016 Estimates that if current trends continue ~10 million people may die as a consequence of AMR annually, surpassing the rate of cancer deaths currently. The joint World Health Organization (WHO), Food and Agriculture Organization (FAO) and World Organization for Animal Health (OIE) initiative ‘One Health’ is in ardent pursuit of prudent use of antibiotics in both human and animal medicine.
  3. •In food-producing animals almost 75% of AU is in-feed (APVMA, 2014) •SFMs have a critical role to play I really have three main goals for my presentation.
  4. RESPONSIBILITY – Shared responsibility between industry, individual farmers, their veterinarians and others who service the industry (stockfeed manufacturers) REDUCE – AMS involves reduction of AMS where appropriate, to minimise impact on health and welfare, for in feed medications this should involve optimal nutritional management to minimise the impact of ruminal acidosis. REFINE – It is important to ensure antibiotics are indicated, and if so, preferentially using those of lower importance ratings over those of higher ratings. REPLACE – Where possible, replace use of antimicrobials with alternatives (such as buffers and alkalinising agents). REVIEW – Practices should be regularly reviewed to determine appropriateness of AMU and opportunities to refine or reduce.
  5. Importantly, resistant organisms, and their genes can spread between humans and animals.
  6. The Importance Ratings and Summary of Antibacterial Uses in Human and Animal Health in Australia (Antibacterial Importance Ratings) aim to provide information to inform decision making about the registration and use of antibacterial medicines in Australia. The Antibacterial Importance Ratings were developed by the Australian Government with expert advice from the Australian Strategic and Technical Advisory Group on AMR (ASTAG).
  7. Important - There are a reasonable number of alternative antibacterials in different classes available to treat or prevent most human infections even if antibacterial resistance develops. Medium - There are some alternative antibacterials in different classes available to treat or prevent human infections, but less than for those rated as Low Importance. High - These are essential antibacterials for the treatment or prevention of infections in humans where there are few or no treatment alternatives for infections. These have also been termed “last resort” or “last line” antibacterials. The use of antibacterials with High ratings in animals will be considered appropriate when national stewardship guidelines are available, or in ‘exceptional circumstances’. WHO ratings slightly different – streptogramins are the equivalent of an orange (Highly Important) but macrolides critically important (red). Last reviewed in 2018, and prior to that 2014/2015. Cephalexin I was given after my surgery, specifically for the infections I mentioned previously – medium importance.
  8. Around 32% of milk produced, particularly in the south eastern dairying regions was exported in FY21 but this ranges from 30-50%. Therefore international markets and events have a major influence on Australian production.
  9. Australia’s major export markets are in Asia which reflects geographic proximity and direct restrictions to other major markets such as the European Union. Increased competition in key importing countries has also played a role in this competition. The global context outlined here is relevant to the Australian dairy industry for four key reasons: 1. Market and customer requirements – residues and impacts on food safety are a key priority for milk companies. As well, global food companies have announced their desire to reduce antibiotic use in their supply chains. 2. Government requirements – animal industries are increasingly under scrutiny for the type, amount and indication of antimicrobials used. 3. Animal health – maintaining access to effective drugs is critical to cow and calf health & welfare and therefore dairy farming livelihoods. 4. Community health – routine human infections are increasingly at risk of becoming untreatable as microorganisms develop resistance to today’s antimicrobials, i.e. this affects us all.
  10. Came into effect 28 January 2022 Must be a diagnosed disease – clinical examination or proper assessment. No more than one active For food producing animals and feeds containing antibiotics Prescription only valid for 5 days Treatment cannot exceed two weeks Cannot be used for prevention (prophylaxis) – this means cannot be used to compensate for poor animal husbandry Can be used for metaphalaxis (e.g. treatment of animals in close proximity) under certain conditions. Article 118 of the EU Veterinary Medicines Regulation1 asserts that restrictions applying to antimicrobials in the EU will also be applicable to animals or food of animal origin imported into the EU. Pressure from customers, overseas governments and international bodies It will be applicable in all EU countries from 28 January 2022.
  11. The 2022 Genetics and Animal Welfare Survey data is based on information collected from a total of 400 dairy farmers selected randomly from the Dairy Australia levy payer database stratified by region. Interviews were conducted during July and August 2022 using Computer Assisted Telephone Interviewing (CATI). The sampling margin for error for national results based on the entire sample is ±4.3% (at the 95% confidence level). The randomisation process was computer driven, using specially designed market and social research software.
  12. A
  13. Slightly larger survey of 800 farmers in 2021.
  14. Low <0.5 tonne/year Medium 0.5-1.5 tonne/year High >1.5 tonne/year
  15. Low <0.5 tonne/year Medium 0.5-1.5 tonne/year High >1.5 tonne/year
  16. Low <0.5 tonne/year Medium 0.5-1.5 tonne/year High >1.5 tonne/year
  17. Low <0.5 tonne/year Medium 0.5-1.5 tonne/year High >1.5 tonne/year
  18. Vet survey, 9 clinics representing 26% of industry – enables preliminary estimates of AMU 5 SFMs participating, initial estimates suggest there is very low use (by courses) of VM but unfortunately there were some companies who opted out.
  19. RESPONSIBILITY REDUCE REFINE REPLACE REVIEW
  20. •In food-producing animals almost 75% of AU is in-feed (APVMA, 2014) •SFMs have a critical role to play I really have three main goals for my presentation.