Antimicrobial stewardship

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Definition: Maintaining the efficacy of antimicrobials so that infections in humans and animals remain treatable is of critical importance. This priority looks at industry use of antibiotics and surveillance programs to detect resistance to them.

Indicators


The context

Antimicrobial stewardship is quickly becoming one of the most prevalent discussions surrounding animal health. Preserving the effectiveness of antimicrobials to protect human and animal health by promoting responsible antimicrobial use is at the very core of strong stewardship. Continuous improvement of industry practices is fundamental to the ongoing success of the Australian red meat sector to demonstrate our ongoing leadership and commitment to animal and human health.

Just like people, when an animal’s immune system is overwhelmed by pathogenic agents, such as bacteria, they become ill. When this occurs, a vet can prescribe medicine to treat the infection and aid the immune system to heal the animal. Antimicrobials are one of a number of tools available to farmers and feedlot managers to help ensure the health and welfare of animals in their care. The term ‘antimicrobial’ refers to medicines that act to selectively kill or inhibit the growth of microorganisms, such as bacteria. Antibiotics are a group of antimicrobials used against bacteria. Antimicrobials generally rely on a functional immune system to work effectively.

Antimicrobial resistance (AMR) occurs when the bacteria causing people or livestock to be ill is resistant to antimicrobial treatment. This can be caused by overuse or inappropriate use of antimicrobials and can also occur naturally. Concerns about AMR, coupled with fewer new antimicrobial technologies being discovered, means action is needed to protect the effectiveness of antimicrobials currently available.

Antimicrobial resistance has become a concern for both medical and livestock policymakers, medical professionals, veterinarians, producers and the general community.

The Australian Pesticides and Veterinary Medicines Authority (APVMA) has maintained a cautious approach to the registration of antimicrobial agents for use in livestock in Australia. This has resulted in a limited number of antimicrobials available for use in beef cattle. Australia is a world leader in minimising antibiotic use in farm animals. Despite this, it remains essential to ensure that antimicrobials continue to be preserved for future use.

The Australian Government released the first National Antimicrobial Resistance Strategy 2015-2019 in June 2015. The livestock sector played an important role in its development and continues to play an important role in achieving the strategy’s vision. The next national AMR strategy is expected to be released this year.

The Australian industry is also involved in the ad hoc Codex Intergovernmental Task Force on Antimicrobial Resistance.


Industry position

The appropriate use of antimicrobials is a shared responsibility between the veterinarian and the farm or feedlot. Vets are responsible for prescribing antimicrobials compliant with regulations. Farmers and lot feeders reduce the need for antibiotics by protecting animal health. They are also responsible for using antibiotics appropriately in accordance with vet instructions. Both veterinarians and beef businesses play a critical role in lowering the likelihood of AMR developing.

This approach promotes the improved management of livestock to reduce the likelihood of immune system failure, but importantly recognises the importance of utilising the most effective antimicrobial agents available to treat livestock.

The industry supports all feedlots to report on their antimicrobial use from 2020. There is currently work underway to understand the on-farm use.


What the data is telling us

A survey undertaken in 2013 demonstrated a very low prevalence of antimicrobial resistance (AMR) in bacteria in Australian cattle production systems.

Previous AMR testing did not identify any resistance in critically important or highly important antimicrobials such as tigecycline, daptomycin, vancomycin, third-generation cephalosporins and linezolid. However, resistance was identified for important antimicrobials. These antimicrobial categories are explained in the figure below.

This research found that the cattle industry’s low levels of antimicrobial resistance can be attributed to comprehensive controls around antimicrobial use enforced by the industry. Nevertheless, continued monitoring of the effects of all antimicrobial use is required to support Australia’s reputation as a supplier of safe and healthy food.

In 2018 the Australian Lot Feeders’ Association voluntarily established Antimicrobial Stewardship Guidelines. Despite the guidelines being optional, in just 12 months 39% of the industry have antibiotic stewardship plans in place. This has been verified through 300 independent audits. These audits also showed a 72% awareness of the guidelines amongst feedlots.


Snapshot of activity

Activity to tackle antimicrobial resistance can be found across the value chain. Producers and feedlots are taking action to steward antimicrobials with the support of regulators and the veterinarian community.

Livestock Production Assurance program

The Livestock Production Assurance (LPA) program is the Australian livestock industry’s voluntary on-farm assurance program covering food safety, animal welfare and biosecurity. It provides evidence of livestock history and on-farm practices when transferring livestock through the value chain. An LPA National Vendor Declaration (NVD) is industry best practice for all livestock movements, including property to property, through saleyards, direct to feedlots and to processors. Every NVD signifies that cattle within a consignment are not within a withholding period or export slaughter intervals as set by APVMA or SAFEMEAT, following treatment with any veterinary drug or chemical.

World-class accreditation and assurance programs

The National Feedlot Accreditation Scheme (NFAS) is an independently audited (by AUS-MEAT Limited) industry assurance scheme that underpins the quality, safety and integrity of grainfed beef. The scheme supports correct antimicrobial use through documented procedures for livestock identification, biosecurity, chemical storage, inventory management, labelling, administration to animals and export slaughter interval and withholding period compliance. Beef labelled under the GF (Grainfed) or GFYG (Grainfed Young Beef) or GFF (Grainfed Finished) ciphers must have been sourced from an NFAS-accredited feedlot with appropriate delivery documentation.

Antimicrobial Stewardship Guidelines

The Australian Lot Feeders’ Association (ALFA) took the lead in 2018 and joined with MLA to develop Antimicrobial Stewardship Guidelines for the feedlot industry. This tool will assist in arming feedlot managers with practical information on best practice stewardship of antimicrobials. These guidelines set out a framework for antimicrobial stewardship practice in feedlots known as the 5Rs - Responsibility, Reduce, Replace, Refine and Review.

The Australian feedlot sector is seen as a low user of antimicrobials in the context of intensive animal industries. Maintaining this position is essential to preserving not only human and animal health, but also consumer confidence in our sector. ALFA has been overwhelmed with the number of feedlots that have voluntarily adopted stewardship plans with the support of their vets. It demonstrates the industry’s recognition of the importance antimicrobial stewardship plays in today’s world.

The Antimicrobial Stewardship Guidelines complement the well-established bodies and systems that service the feedlot industry to ensure the integrity of grainfed beef.

Dedicated veterinarians

The feedlot industry is serviced by a dedicated group of registered veterinarians. These highly trained individuals make regular visits to feedlots to assess beef cattle health and welfare. All scheduled antimicrobials used in feedlots are prescribed by veterinarians. The antimicrobial will be labelled by the veterinarian in addition to the manufacturer’s label and information insert, which contains directions for use, storage, precautions, restraints, withholding periods, disposal and other important information.


The 5R principles of antimicrobial stewardship that are outlined in ALFA's Antimicrobial Stewardship Guidelines.

The 5Rs are - Responsibility, Reduce, Replace, Refine and Review.


Surveillance project
In 2013, a survey demonstrated the low prevalence of antimicrobial resistance (AMR) in bacteria in Australian cattle production systems. An update of this surveillance project is currently underway with samples being collected across Australia, and will be completed in 2020. Reporting will become progressively available from mid-2019. The results will be compared to see if there have been any changes from the result of the 2013 survey and to inform the design of future surveillance.

Trusted traceability systems

The National Livestock Identification System (NLIS) ensures traceability of cattle throughout their lives, and can be used to identify other livestock they may have come into contact with. This includes when an animal arrives at, and is dispatched from, a feedlot. This program is critical to maintaining identity and antimicrobial treatment records on individuals in the feedlot, ensuring correct administration of antimicrobials and that export slaughter intervals and withholding period requirements are met.

Prudent regulation and oversight

The Australian Pesticides and Veterinary Medicines Authority (APVMA) approves all antimicrobials for use in beef cattle. All antimicrobials undergo a rigorous pre-approval process under which the safety to animals, humans and environment is assessed, and residues in edible beef products are monitored. The APVMA publishes withholding periods for all antimicrobials and maintains a list of export slaughter intervals for products used in cattle.

The National Residue Survey (NRS) conducted by the Department of Agriculture and Water Resources randomly samples beef products at Australian abattoirs for antimicrobial residues. Over the last decade, compliance in the cattle program has been high (99.9–100%).

Definition: Maintaining the efficacy of antimicrobials so that infections in humans and animals remain treatable is of critical importance. This priority looks at industry use of antibiotics and surveillance programs to detect resistance to them.

Indicators


The context

Antimicrobial stewardship is quickly becoming one of the most prevalent discussions surrounding animal health. Preserving the effectiveness of antimicrobials to protect human and animal health by promoting responsible antimicrobial use is at the very core of strong stewardship. Continuous improvement of industry practices is fundamental to the ongoing success of the Australian red meat sector to demonstrate our ongoing leadership and commitment to animal and human health.

Just like people, when an animal’s immune system is overwhelmed by pathogenic agents, such as bacteria, they become ill. When this occurs, a vet can prescribe medicine to treat the infection and aid the immune system to heal the animal. Antimicrobials are one of a number of tools available to farmers and feedlot managers to help ensure the health and welfare of animals in their care. The term ‘antimicrobial’ refers to medicines that act to selectively kill or inhibit the growth of microorganisms, such as bacteria. Antibiotics are a group of antimicrobials used against bacteria. Antimicrobials generally rely on a functional immune system to work effectively.

Antimicrobial resistance (AMR) occurs when the bacteria causing people or livestock to be ill is resistant to antimicrobial treatment. This can be caused by overuse or inappropriate use of antimicrobials and can also occur naturally. Concerns about AMR, coupled with fewer new antimicrobial technologies being discovered, means action is needed to protect the effectiveness of antimicrobials currently available.

Antimicrobial resistance has become a concern for both medical and livestock policymakers, medical professionals, veterinarians, producers and the general community.

The Australian Pesticides and Veterinary Medicines Authority (APVMA) has maintained a cautious approach to the registration of antimicrobial agents for use in livestock in Australia. This has resulted in a limited number of antimicrobials available for use in beef cattle. Australia is a world leader in minimising antibiotic use in farm animals. Despite this, it remains essential to ensure that antimicrobials continue to be preserved for future use.

The Australian Government released the first National Antimicrobial Resistance Strategy 2015-2019 in June 2015. The livestock sector played an important role in its development and continues to play an important role in achieving the strategy’s vision. The next national AMR strategy is expected to be released this year.

The Australian industry is also involved in the ad hoc Codex Intergovernmental Task Force on Antimicrobial Resistance.


Industry position

The appropriate use of antimicrobials is a shared responsibility between the veterinarian and the farm or feedlot. Vets are responsible for prescribing antimicrobials compliant with regulations. Farmers and lot feeders reduce the need for antibiotics by protecting animal health. They are also responsible for using antibiotics appropriately in accordance with vet instructions. Both veterinarians and beef businesses play a critical role in lowering the likelihood of AMR developing.

This approach promotes the improved management of livestock to reduce the likelihood of immune system failure, but importantly recognises the importance of utilising the most effective antimicrobial agents available to treat livestock.

The industry supports all feedlots to report on their antimicrobial use from 2020. There is currently work underway to understand the on-farm use.


What the data is telling us

A survey undertaken in 2013 demonstrated a very low prevalence of antimicrobial resistance (AMR) in bacteria in Australian cattle production systems.

Previous AMR testing did not identify any resistance in critically important or highly important antimicrobials such as tigecycline, daptomycin, vancomycin, third-generation cephalosporins and linezolid. However, resistance was identified for important antimicrobials. These antimicrobial categories are explained in the figure below.

This research found that the cattle industry’s low levels of antimicrobial resistance can be attributed to comprehensive controls around antimicrobial use enforced by the industry. Nevertheless, continued monitoring of the effects of all antimicrobial use is required to support Australia’s reputation as a supplier of safe and healthy food.

In 2018 the Australian Lot Feeders’ Association voluntarily established Antimicrobial Stewardship Guidelines. Despite the guidelines being optional, in just 12 months 39% of the industry have antibiotic stewardship plans in place. This has been verified through 300 independent audits. These audits also showed a 72% awareness of the guidelines amongst feedlots.


Snapshot of activity

Activity to tackle antimicrobial resistance can be found across the value chain. Producers and feedlots are taking action to steward antimicrobials with the support of regulators and the veterinarian community.

Livestock Production Assurance program

The Livestock Production Assurance (LPA) program is the Australian livestock industry’s voluntary on-farm assurance program covering food safety, animal welfare and biosecurity. It provides evidence of livestock history and on-farm practices when transferring livestock through the value chain. An LPA National Vendor Declaration (NVD) is industry best practice for all livestock movements, including property to property, through saleyards, direct to feedlots and to processors. Every NVD signifies that cattle within a consignment are not within a withholding period or export slaughter intervals as set by APVMA or SAFEMEAT, following treatment with any veterinary drug or chemical.

World-class accreditation and assurance programs

The National Feedlot Accreditation Scheme (NFAS) is an independently audited (by AUS-MEAT Limited) industry assurance scheme that underpins the quality, safety and integrity of grainfed beef. The scheme supports correct antimicrobial use through documented procedures for livestock identification, biosecurity, chemical storage, inventory management, labelling, administration to animals and export slaughter interval and withholding period compliance. Beef labelled under the GF (Grainfed) or GFYG (Grainfed Young Beef) or GFF (Grainfed Finished) ciphers must have been sourced from an NFAS-accredited feedlot with appropriate delivery documentation.

Antimicrobial Stewardship Guidelines

The Australian Lot Feeders’ Association (ALFA) took the lead in 2018 and joined with MLA to develop Antimicrobial Stewardship Guidelines for the feedlot industry. This tool will assist in arming feedlot managers with practical information on best practice stewardship of antimicrobials. These guidelines set out a framework for antimicrobial stewardship practice in feedlots known as the 5Rs - Responsibility, Reduce, Replace, Refine and Review.

The Australian feedlot sector is seen as a low user of antimicrobials in the context of intensive animal industries. Maintaining this position is essential to preserving not only human and animal health, but also consumer confidence in our sector. ALFA has been overwhelmed with the number of feedlots that have voluntarily adopted stewardship plans with the support of their vets. It demonstrates the industry’s recognition of the importance antimicrobial stewardship plays in today’s world.

The Antimicrobial Stewardship Guidelines complement the well-established bodies and systems that service the feedlot industry to ensure the integrity of grainfed beef.

Dedicated veterinarians

The feedlot industry is serviced by a dedicated group of registered veterinarians. These highly trained individuals make regular visits to feedlots to assess beef cattle health and welfare. All scheduled antimicrobials used in feedlots are prescribed by veterinarians. The antimicrobial will be labelled by the veterinarian in addition to the manufacturer’s label and information insert, which contains directions for use, storage, precautions, restraints, withholding periods, disposal and other important information.


The 5R principles of antimicrobial stewardship that are outlined in ALFA's Antimicrobial Stewardship Guidelines.

The 5Rs are - Responsibility, Reduce, Replace, Refine and Review.


Surveillance project
In 2013, a survey demonstrated the low prevalence of antimicrobial resistance (AMR) in bacteria in Australian cattle production systems. An update of this surveillance project is currently underway with samples being collected across Australia, and will be completed in 2020. Reporting will become progressively available from mid-2019. The results will be compared to see if there have been any changes from the result of the 2013 survey and to inform the design of future surveillance.

Trusted traceability systems

The National Livestock Identification System (NLIS) ensures traceability of cattle throughout their lives, and can be used to identify other livestock they may have come into contact with. This includes when an animal arrives at, and is dispatched from, a feedlot. This program is critical to maintaining identity and antimicrobial treatment records on individuals in the feedlot, ensuring correct administration of antimicrobials and that export slaughter intervals and withholding period requirements are met.

Prudent regulation and oversight

The Australian Pesticides and Veterinary Medicines Authority (APVMA) approves all antimicrobials for use in beef cattle. All antimicrobials undergo a rigorous pre-approval process under which the safety to animals, humans and environment is assessed, and residues in edible beef products are monitored. The APVMA publishes withholding periods for all antimicrobials and maintains a list of export slaughter intervals for products used in cattle.

The National Residue Survey (NRS) conducted by the Department of Agriculture and Water Resources randomly samples beef products at Australian abattoirs for antimicrobial residues. Over the last decade, compliance in the cattle program has been high (99.9–100%).