European food-producing animal farms have finally begun to reduce antibiotic use, according to estimates by ECDC(European Centre for Disease Prevention and Control), EFSA(European Food Safety Authority) andEMA (European Medicinal Agency).
The 30.6.21 report of the three aforementioned independent agencies — charged with overseeing public health, food safety, and animal health and welfare — offers for the first time a hopeful sign with respect to the phenomenon of antibiotic resistance. (1)
Research and development of functional feeds, as well as increased attention to good hygienic practices, have enabled farmers in the EU to embark on a virtuous path that needs, however, to be recognized and valued, on both the political and mercantile fronts.
ECDC, EFSA, EMA. 2021 report on antibiotics and antibiotic resistance
ECDC, EFSA and EMA, in the 164-page report 2021, present updated data on antibiotic consumption and the development ofantimicrobial resistance (AMR) in Europe. Thanks to the elaborations of the five monitoring networks under the three agencies-EARS-Net, ESAC-Net, FWD-Net (ECDC), Scientific Network for Zoonosis Monitoring Data (EFSA), ESVAC Network Sales (EMA)-and the contributions of an international group of experts.
The ‘Analysis of antimicrobial consumption and resistance‘-in its third edition, JIACRA III, covering the period 2016-2018-reveals for the first time an overall reduction in antibiotic use on farms in the EU, comparing with surveys conducted in the previous two biennia (JIACRA I, 2011-2012, and JIACRAII, 2013-2015). (2) Although there are significant variations, from country to country and by class of antibiotics.
Humans and animals on farms, consumption of the various classes of antibiotics
The use of antibiotics of the same class on humans and animals on farms is a major risk factor for AMR. And it is therefore that the reg. EU 2019/6 on veterinary medicines, among other things, introduced a special pharmacovigilance system (Section V). (3) Regarding the different classes of antibiotics used, the JIACRA III report notes the following:
– the use of polymyxins (which include colistin), increasingly used in hospitals to treat multi-resistant infections, has nearly halved in food-producing animals,
– aminopenicillins, third- and fourth-generation cephalosporins and quinolones (fluoroquinolones and other quinolones) have been used more in humans than in food-producing animals,
– polymyxins (colistin) and tetracyclines, conversely, have been used more in farm animals than in humans.
E.coli and Campylobacter, resistant strains
The previous 9.4.21 report by ECDC and EFSA, as noted, had indicated the widespread resistance of Campylobacter and E.Coli, in farm animals, to different classes of antimicrobials. The report under review, in confirming the correlation between antibiotic consumption–by humans and livestock–and the development of strains of bacteria resistant to multiple classes of antibiotics, points out that:
– consumption of carbapenems, third- and fourth-generation cephalosporins, and quinolones (fluoroquinolones and other quinolones) are associated with resistance to these antibiotics in Escherichia coli infections. In humans, as in food-producing animals,
– Humans and animals share the problem of antimicrobial resistance of the bacteria Campylobacter spp.
One Health, scenario
The One Health approach-i.e., ‘holistic’ risk assessment and management for public health, animal health and welfare, and environmental protection (4,5)-is confirmed to be the way forward in addressing the problem of antibiotic resistance. The European Union’s favor towards this approach is confirmed by the cooperation between the agencies ECDC, EFSA and EMA.
WHO(World Health Organization)-in its report 29.4.19 ‘No time to waste‘ (6)-has, after all, highlighted antibiotic resistance as one of the most serious threats to public health on a planetary level. The levels of antimicrobial resistance detected in individual strains of bacteria therefore require the implementation of an effective strategy to counter the highlighted risks. Which retain great relevance, despite the small advances mentioned above.
Antibiotic resistance, scenario and perspectives in Italy
Italy established in 2017 the National Plan to Combat Antimicrobial-Resistance-pending renewal as its targets were defined to 2020 (7)-and the Harmonized Monitoring Plan on Antimicrobial Resistance Zoonotic and Commensal Bacteria 2021 (8). The AIFA (Italian Medicines Agency) report 24.11.19, on the other hand, points out that antibiotic consumption by humans in Italy is still (dangerously) above the EU average.
The positive sign is the research and development, right in Italy, of functional feeds based on algae, microalgae and florotannins(Algatan). The use of such compounds and increased attention to good hygiene practices has enabled several farms-poultry and pig farms, in particular-to minimize and even avoid the use of antibiotics. (9) But the demand for ‘antibiotic-free’ animal products, from the large-scale retail trade (GDO), is still weak. Although consumers have already shown their interest in this direction.
Dario Dongo and Giulia Torre
Notes
(1) ECDC, EFSA,EMA. Third joint inter-agency report on integrated analysis of consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals in the EU/EEA, JIACRA III. 2016-2018. 2021. ISBN 978-92-9498-541-5. doi:10.2900/056892. https://www.ema.europa.eu/en/documents/report/ema/ecdc/efsa-third-joint-report-integrated-analysis-consumption-antimicrobial-agents-occurrence_en.pdf
(2) EMA (European Medicinal Agency). Analysis of antimicrobial consumption and resistance (JIACRA reports). https://www.ema.europa.eu/en/veterinary-regulatory/overview/antimicrobial-resistance/analysis-antimicrobial-consumption-resistance-jiacra-reports
(3) Giulia Torre, Dario Dongo. Antibiotic resistance, veterinary medicines, and animal welfare. The ABCs of the new rules. GIFT (Great Italian Food Trade). 22.01.20, https://www.greatitalianfoodtrade.it/sicurezza/antibiotico-resistenza-medicinali-veterinari-e-benessere-animale-l-abc-delle-nuove-regole
(4) Dario Dongo. One Health. Animal, human, planetary health and welfare. What can we do? GIFT (Great Italian Food Trade). 2.6.21, https://www.greatitalianfoodtrade.it/consum-attori/one-health-salute-e-benessere-animale-umano-planetario-cosa-possiamo-fare
(5) Dario Dongo, Andrea Adelmo Della Penna. One Health and antibiotic resistance, a solution at hand. GIFT(Great Italian Food Trade). 10.2.21, https://www.greatitalianfoodtrade.it/salute/one-health-e-antibiotico-resistenza-una-soluzione-a-portata-di-mano
(6) Sabrina Bergamini, Dario Dongo. Antibiotic resistance, no time to waste. WHO report. GIFT (Great Italian Food Trade). 11.5.19, https://www.greatitalianfoodtrade.it/sicurezza/resistenza-agli-antibiotici-non-c-è-tempo-da-perdere-rapporto-oms
(7) Ministry of Health (2017). National Plan to Combat Antimicrobial Resistance (PNCAR) 2017-2020. https://www. salute.gov.it/portale/documentazione/p6_2_2_1.jsp?lingua=italiano&id=2660
(8) Ministry of Health. Harmonized monitoring plan on antimicrobial resistance of zoonotic and commensal bacteria 2021. Cattle and pigs. https://www.izslt.it/crab/wp-content/uploads/sites/8/2020/12/Piano-AMR_2021.pdf
(9) Dario Dongo, Andrea Adelmo Della Penna. Antibiotic-free poultry farming, the Italian way. GIFT(Great Italian Food Trade). 12/14/20, https://www.greatitalianfoodtrade.it/progresso/avicoltura-senza-antibiotici-la-via-italiana
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
Graduated in law, master in European Food Law, she deals with agro-food, veterinary and agricultural legislation. She is a PhD in agrisystem.
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