Editorial: Systematic reviews reveal a need for more, better data to inform antimicrobial stewardship practices in animal agriculture

Sargeant, Jan M.; O’Connor, Annette M.; Winder, Charlotte B.

doi:10.1017/s1466252319000240

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…Lack of trial replication, meaning several evaluations of the same outcome for the same intervention, was an additional major limitation of the body of literature available for this topic. In addition to the issues in the reporting of outcomes and the risk period for measurement of these outcomes, lack of trial replication rendered us unable to form a solid foundation of evidence, which is consistent with the previous observations from mastitis network meta-analyses (Sargeant et al, 2019). Although all the treatment protocols were connected within our network, some treatment protocols were only used in one (e.g., gentamicin) or two (e.g., cefquinome) comparisons meaning the evaluation of these products for effectiveness to cure IMI were not well-replicated.…”

Section: Summary Of Evidencesupporting

confidence: 57%

Relative Efficacy of Dry-Off Antimicrobial Treatments in Dairy Cattle to Cure Existing Intramammary Infections: A Systematic Review and Network Meta-Analysis

et al. 2021

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This systematic review and network meta-analysis aimed to estimate the relative efficacy of dry cow antimicrobial therapies, registered in Canada and/or the United States, to cure existing intramammary infections (IMI) in dairy cattle. The controlled trials examining all-cause cures of existing IMI present at dry-off were eligible. Five databases and four conference proceeding platforms were searched. The risk of bias at the level of the outcome was assessed using the Cochrane 2.0 risk of bias instrument (Cochrane, Denmark), and the overall confidence in the findings from the network meta-analysis was assessed using the Confidence in Network Meta-Analysis (CINeMA) platform. Of 3,743 articles screened for eligibility by the two independent reviewers, 58 trials were included in the Bayesian network meta-analysis for the all-cause cure of existing IMI from dry-off to calving. No antimicrobial treatment (non-active control) was associated with a decreased risk of a cure compared with all other currently labeled antimicrobials in Canada and the United States; however, lack of replication trials for some antimicrobial products created large credibility intervals and, therefore, we were unable to identify meaningful comparisons between the products. Poor reporting of trial features, heterogeneity in outcome measurements, and high risk of bias in some domains further contributed to this inability to compare antimicrobials. Continued improvement in the reporting of animal trials is required to make recommendations for antimicrobial products on the basis of efficacy.Systematic Review Registration:https://atrium.lib.uoguelph.ca/xmlui/bitstream/handle/10214/16236/Protocol_NMA_efficacy_dryoff_antibiotics_cure_IMI.pdf?sequence=3&isAllowed=y.

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Section: Summary Of Evidencesupporting

confidence: 57%

Relative Efficacy of Dry-Off Antimicrobial Treatments in Dairy Cattle to Cure Existing Intramammary Infections: A Systematic Review and Network Meta-Analysis

et al. 2021

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“…Enhancing antimicrobial stewardship should be considered a key goal for animal production (American Veterinary Medical Association, 2020), but a major challenge that remains is the means by which antimicrobial stewardship in animal agriculture is measured and reported. A recent series of systematic reviews was published assessing the efficacy of antimicrobial and non‐antimicrobial approaches to reduce disease across different food animal sectors (Sargeant et al, 2019). Of concern was the general finding that for many of the studies reviewed, there were problems with study design, reporting or data analysis, leading the authors to conclude ‘There is an urgent need for more and better data to inform antimicrobial stewardship practices in animal agriculture’.…”

Section: Discussionmentioning

confidence: 99%

Estimates of on‐farm antimicrobial usage in broiler chicken production in the United States, 2013–2017

Singer

Porter²,

Schrag

et al. 2020

Zoonoses and Public Health

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Antimicrobial use is a key selective force behind the emergence of resistant bacteria. Therefore, optimizing strategies for more efficacious and targeted antimicrobial use is an essential component of efforts to combat antimicrobial resistance. To bolster stewardship programmes in animal agriculture, processes are needed for the systematic collection of on‐farm antimicrobial use data. The objective of this study was to develop a system for collecting on‐farm antimicrobial use data from the US broiler industry and to have it be representative of the largest commercial broiler producers in the United States that comprise the vast majority of national broiler production. Participation was voluntary. Data were collected for the period 2013 through 2017 and are reported on a calendar year basis. Using statistics from USDA:NASS as a denominator, the data supplied by participating companies accounted for approximately 81.7% of broiler production in the United States in 2013 and increased to approximately 87.2% in 2017. The data that were submitted for 2017 are based on approximately 7,897,339,357 chicks placed, 7,541,449,430 chickens slaughtered and 48,225,124,865 pounds liveweight produced. The use of antimicrobials in the hatchery decreased substantially between 2013 and 2017; the approximate percentage of broiler chicks placed that received hatchery antimicrobials decreased from 93% in 2013 to 17% in 2017. Medically important in‐feed antimicrobial use decreased substantially. For example, in‐feed tetracycline use decreased approximately 95% between 2013 and 2017. Medically important water‐soluble antimicrobial use decreased substantially for most antimicrobials. Between 2013 and 2017, water‐soluble penicillin use decreased approximately 21%, water‐soluble tetracycline use decreased approximately 47%, and water‐soluble lincomycin use decreased approximately 28%. While a reduction in antimicrobial amounts used may be an important indicator of improved stewardship, reducing the need for antimicrobials through improved disease prevention should be considered a more important objective and a better indicator of overall flock health and optimal antimicrobial use.

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“…This variation becomes a problem in further systematic reviews and meta-analyses that require consistent definitions of eligible outcomes and length of follow-up so that data can be meaningfully synthesized and interpreted (Liberati et al, 2009). If we cannot compare the results of multiple studies due to this variation in reporting of outcomes and follow-up periods, then we cannot form a solid evidence base for decision-making (Sargeant et al, 2019). Consensus on one or more risk periods to evaluate CM and IMI outcomes in mastitis research, in addition to other investigator-determined outcomes, would enable the formation of a solid evidence base for decision-making related to udder health.…”

Section: Limitations Of the Body Of Evidencementioning

confidence: 99%

Modifiable management practices to improve udder health in dairy cattle during the dry period and early lactation: A scoping review

McMullen

Sargeant

Kelton

et al. 2021

Journal of Dairy Science

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The objective of this scoping review was to characterize all available literature on modifiable management practices used during the dry period that have been evaluated for their effects on udder health in dairy cattle during the dry period and the subsequent lactation. Five databases and two conference proceedings were searched for relevant literature. Articles published in or after 1990 were eligible for inclusion. Eligible interventions or exposures were restricted to modifiable management practices; however, antimicrobial and teat sealant products were enumerated but not further characterized, as systematic reviews have been published on this topic. Other modifiable management practices were reported in 229 articles. Nutrition (n = 79), which included ration formulation and delivery (n = 44) and vitamin and mineral additives (n = 35), was the most commonly reported practice, followed by vaccines (n = 40) and modification of dry period length (n = 27). Risk of clinical mastitis (CM) was the most commonly reported outcome (n = 151); however, reporting of outcome risk periods varied widely between articles. Cure of existing intramammary infections (IMI) over the dry period (n = 40) and prevention of new IMI over the dry period (n = 54) were most commonly reported with a risk period between calving and 30 d in milk. Future systematic reviews with meta-analyses could target management practices such as nutrition, vaccines, and dry period length to quantify their effects on improving udder health during the dry period and early lactation. However, the variation in reporting of time at risk for CM and other outcomes challenges the ability of future synthesis work to inform management decisions on the basis of efficacy to cure or prevent IMI and CM. Consensus on which core outcomes should be evaluated in mastitis research and the selection of consistent risk periods for specific outcomes in animal trials is imperative.

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Editorial: Systematic reviews reveal a need for more, better data to inform antimicrobial stewardship practices in animal agriculture

Cited by 11 publications

References 18 publications

Relative Efficacy of Dry-Off Antimicrobial Treatments in Dairy Cattle to Cure Existing Intramammary Infections: A Systematic Review and Network Meta-Analysis

Relative Efficacy of Dry-Off Antimicrobial Treatments in Dairy Cattle to Cure Existing Intramammary Infections: A Systematic Review and Network Meta-Analysis

Estimates of on‐farm antimicrobial usage in broiler chicken production in the United States, 2013–2017

Modifiable management practices to improve udder health in dairy cattle during the dry period and early lactation: A scoping review

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