An efficient cephalosporin stewardship programme in French swine production

Abstract

By 2010, systems set up to monitor the antimicrobial resistance of pathogenic bacteria and antimicrobial usage identified a sustained increase regarding third‐ and fourth‐generation cephalosporin resistance in French pig production. This sector mobilised and collectively committed to responsible action in the following months. This led to a multi‐professional voluntary stewardship programme that was started in 2011. A consensus of veterinary opinion led to the definition of restrictive rules on the prescription of the third‐ and fourth‐generation cephalosporins targeted by the antimicrobial stewardship programme (ASP). All pig sector professionals, including farmers, were informed. Existing monitoring systems for usage and resistance were supplemented by data from the records of veterinarians' cephalosporin deliveries and from individual pig farm surveys investigating antimicrobial usage. The second step, from 2014, entailed regulatory measures that consolidated the programme by setting quantitative reduction objectives and specifying the terms and conditions for prescribing and dispensing a list of critical antimicrobial molecules including cephalosporins. All the data sources confirmed a significant fall of more than 90% in cephalosporin usage in the French pig production sector between 2010 and 2016. Monitoring systems recorded that the resistance of commensal and pathogenic Escherichia coli isolates also tended to decrease over the same period. The stewardship programme proved highly effective in reducing usage and containing resistance, illustrating the efficiency of a well‐defined multi‐professional strategy.

Behavior-change interventions to improve antimicrobial stewardship in human health, animal health, and livestock agriculture: A systematic review

“…Three studies assessed pre- to post-intervention changes in animal health status and productivity and documented either no change or an improvement in mortality, animal weight gain, or feed conversion ratio associated with the intervention (28,32,33). One study that implemented a voluntary AMS program among pig farmers in France documented a 90% reduction in cephalosporin usage between 2010 and 2016 and demonstrated a reduction in drug-resistance among commensal and pathogenic Escherichia coli isolates sampled during the same period (31).…”

“…Only 11 studies conducted in the animal health or agriculture sector met our study's inclusion criteria, and given heterogeneity across the study types, outcomes, and types of statistics reported, a metaanalysis was not possible. Seven of the studies (63.6%) assessed the impact of interventions among foodproducing animals including swine (n=3), poultry (n=1), dairy cows (n=2), and calves (n=1) (28)(29)(30)(31)(32)(33)(34). Four studies (36.4%) assessed interventions in companion animals (35)(36)(37)(38) Overall AMU decreased significantly (p value < 0.05) for all but one study which implemented an online stewardship tool among calf farmers in Switzerland (29).…”

A participatory approach for building ex ante impact pathways towards a prudent use of antimicrobials in pig and poultry sectors in France

“…These different socio-economic and ethical facets of the AMU issue are therefore connected and this is why it is relevant to consider them together and to include all this diversity of actors in the outcome targeted. To our knowledge, this is also the first time that an intervention that aims to improve AMU would target changes at the level of meat end users and not only at the level of AM users [ 43 , 46 ].…”

Mobile colistin resistance (MCR), extended-spectrum beta-lactamase (ESBL) and multidrug resistance monitoring in Escherichia coli (commensal and pathogenic) in pig farming: need of harmonized guidelines and clinical breakpoints

“…On the other hand, E. coli is commonly used as an indicator bacteria on the "One-Health" surveillance of antimicrobial resistance (AMR) by the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC) (EFSA (European Food Safety Authority) and ECDC (European Centre for Disease Prevention and Control), 2019). On top of that, there is a global consensus on the need for efficient antimicrobial stewardship programs in pigs to reduce the selection of resistant bacteria (Verliat et al, 2021;Bosman et al, 2022;Vilaró et al, 2022). Here, we aimed to gain knowledge on the diagnosis and clinical difficulties in the veterinary sector when providing the best antibiotic therapy option.…”