Evaluation of veterinary antimicrobial benchmarking systems at farm‐level in Europe: implications for the UK ruminant sector

Abstract

BackgroundA number of European countries currently conduct mandatory farm-level benchmarking for antimicrobial usage (AMU). This review describes the systems used, with emphasis on metric type and practical implications.MethodsThis report describes examples of four types of metrics used to measure AMU: count-based, mass-based, daily dose-based and course-based, each with its own advantages and disadvantages.ResultsThe Netherlands, Belgium, Denmark and Switzerland use daily dose-based metrics to benchmark AMU at farm-level, but each country diverges from the European Surveillance of Veterinary Antimicrobial Consumption methodology in its own way, including how the population ‘at risk’ is calculated. Germany operates a count-based system. Threshold AMU values have been specified at farm-level in the Netherlands, Belgium and Denmark, and action is required from producers to reduce AMU above these values. The Netherlands and Belgium also benchmark veterinarians.ConclusionsFor mixed species farms common in the UK and Ireland, splitting AMU by species is recommended. It is also recommended that high priority critically important antimicrobials are benchmarked separately to other antimicrobials. No one metric is optimum; however, for ruminant livestock a daily dose-based metric allows for country-specific adaptations which may allow a higher degree of precision at farm-level benchmarking in the UK and Ireland.

Small and Large Animal Veterinarian Perceptions of Antimicrobial Use Metrics for Hospital-Based Stewardship in the United States

“…In human medicine, a wide variety of AMU metrics exist for purposes of antimicrobial stewardship, many of which are similar to or equivalent to those used in our study ( 54 ). In animal agriculture, different metrics are used in different countries and systems ( 35 , 55 , 56 ), and an expansive body of literature has described and evaluated the advantages and disadvantages of these metrics ( 12 , 23 , 57 – 59 ). However, because herds of animals are treated on farms more often than individual animals, the metrics used on the farm setting may not translate well to the hospital setting.…”

“…of being able to visualize their antimicrobial prescribing patterns using different metrics. Antimicrobial stewardship initiatives involving the provision of periodic feedback to clinicians on their antimicrobial prescribing have been used successfully in human medicine (6,(30)(31)(32)(33)(34) and in animal agriculture (7,35,36). In veterinary hospitals, such initiatives are being proposed (37, 38).…”

Does the Use of Different Indicators to Benchmark Antimicrobial Use Affect Farm Ranking?

“…The benchmarking systems of a selection of European countries have been reviewed by others (22). The various AMU data collection systems may differ, for example, in how they define their DDD lists and/or in the weights they assign to species or production categories (14,22). Therefore, there are now several AMU indicators in use with none having universal acceptance (22,23).…”

“…The various AMU data collection systems may differ, for example, in how they define their DDD lists and/or in the weights they assign to species or production categories (14,22). Therefore, there are now several AMU indicators in use with none having universal acceptance (22,23). How an indicator influences farm ranking in a benchmarking system matters because farms may be above a threshold for acceptable use with one indicator but below it if a different one is used.…”

Reducing Antimicrobial Use and Dependence in Livestock Production Systems: A Social and Economic Sciences Perspective on an Interdisciplinary Approach

“…Besides animals, the use of inputs such as antimicrobials have been proven to influence AMR levels on farms (7) and are therefore a good base to formulate a regulation. In, for instance, Denmark, the Netherlands and Belgium, antimicrobial consumption is monitored at farm level for several species, which allows the benchmarking of farmers and/or veterinarians (61). But even if the farmer is responsible for the chosen inputs, some aspects may be beyond control, such as the cross-contamination of non-medicated feed with residues of antimicrobials in feed mills or transport trucks (45).…”