First Case Report on Quantification of Antimicrobial Use in Corporate Dairy Farms in Pakistan

Abstract

Intensive livestock farming has become indispensable to meet the rapidly increasing demand for animal-based nutrition in low- and middle-income countries (LMICs) where antimicrobials are frequently used for treatment and prophylactic or metaphylactic purposes. However, very little is known about the trends of antimicrobial use (AMU) in dairy animals in LMICs. The objective of this study was to quantify AMU in two large commercial dairy farms in Pakistan. A retrospective study was conducted at two large corporate commercial dairy farms located in Punjab province for the year 2018. AMU was calculated using three metrics: active ingredient (AI; kg) and milligrams per population unit (mg/PU; mg/kg), which quantifies the amount of AI used, and antimicrobial treatment incidence (ATI; DDDA/1,000 cow-days), which estimates the per-day number of treatments to 1,000 cows. Total on-farm AMU was found to be 138.34 kg, 65.88 mg/kg, and 47.71 DDDA/1,000 cow-days. Measured in ATI, aminoglycosides (11.05 DDDA/1,000 cow-days), penicillins (8.29 DDDA/1,000 cow-days), and tetracyclines (8.1 DDDA/1,000 cow-days) were the most frequently used antimicrobial classes. A total of 42.46% of all the antimicrobials used belonged to the critically important antimicrobials for human medicine as defined by the World Health Organization. Considerably high AMU was found compared to other farm-level studies across the world. This was the first study to quantify AMU in the dairy industry in Pakistan. Our results showed that corporate commercial dairy management practices are associated with increased antimicrobial consumption and highlight the need for antimicrobial stewardship programs to encourage prudent use of antimicrobials in commercial dairy.

Evaluating the antimicrobial use on dairy farms in Chiba Prefecture in Japan using the antimicrobial treatment incidence, an indicator based on Japanese defined daily doses from 2014–2016

“…This finding was consistent with the result of a previous study that examined dairy farms in the United States [38]. This study did not aim to Monitoring of antimicrobial use on dairy farms using a dosage-based metric is undertaken in many countries [6,11,17,37,46,50]. For example, in Belgium, the US and Pakistan, ATI, a metric identical to the metric used in this study is used to monitor antimicrobial use on dairy farms [6,46,50].…”

Veterinary consumption of highest priority critically important antimicrobials and various growth promoters based on import data in Pakistan

“…Our study also did not comprehensively measure all antimicrobials and focused exclusively on the CIA-HtP that were used on ten broiler and dairy farms in two provinces in Pakistan. There may be more critically important antimicrobials used on Pakistani farms; however, based on the present survey and previously published studies [ 8 – 10 ] we reasonably assume that the seven CIA-HtP we included in our study are the most frequently used ones. Furthermore, we were unable to ensure that we did not miss any feed additives that contain antimicrobials as we do not have a comprehensive list of all feed additives sold in Pakistan.…”

“…Ideally, nationally representative data should be collected at farm level which is the point of usage. Although a series of AMU studies have been carried out on broiler [ 8 , 9 ] and dairy farms [ 10 ] in Pakistan but the samples are not nationally representative and hence cannot be used to estimate the national veterinary AMC. Pakistan does not require wholesalers or distributors to report their sales data to the DRAP.…”

“…Pakistan is expected to be a large consumer of antimicrobials in the animal health sector because of its large animal population and emerging intensive livestock farming. Three farm-level studies, two from poultry [ 8 , 9 ] and one in the dairy sectors [ 10 ] in Pakistan have confirmed this assumption. These studies highlighted the excessive veterinary use of Critically Important Antimicrobials with Highest Priority (CIA-HtP) for human medicine such as quinolones, third- and fourth-generation cephalosporins and macrolides as characterized by the WHO [ 11 ] which is concerning due to the increased risk of accelerating AMR.…”

Epidemiology and molecular characterization of Staphylococcus aureus causing bovine mastitis in water buffaloes from the Hazara division of Khyber Pakhtunkhwa, Pakistan

“…Antibiotic use in food-producing animals is unregulated in Pakistan, with the actual usage unknown. A few studies have looked at commercial farms and determined that antibiotic use in cattle is above international averages, with beta-lactams, aminoglycosides and tetracyclines amongst the classes most commonly chosen [ 63 , 64 ]. Aminopenicillins, in particular, are commonly used for the treatment and prevention of bovine subclinical mastitis, with as high as 36.5% of market milk samples containing beta-lactam residues above the permissible level [ 65 , 66 ].…”