Antibiotic use declining in UK livestock
A new report from the Responsible Use of Medicines in Agriculture Alliance (RUMA) says the UK livestock industry is making progress in efforts to meet antibiotic use targets, but a group of leading British clinicians warns that progress could be threatened if the government doesn't commit to changes in the way antibiotics are used in food-producing animals.
According to RUMA's "One Year On" report, the industry overall is making headway in its efforts to reduce antibiotic use. Sales of antibiotics to the livestock industry fell by 40% from 2013 through 2017, including a 52% decrease in sales of the most critical antibiotics for human health, and antibiotic use in food-producing animals is among lowest in the European Union. But progress in reaching 2020 targets varies among different animal sectors.
The report shows that the pig sector in the United Kingdom is on track to meet the 2020 target for reducing antibiotic use, the poultry meat sector is already under the targets set for both chickens and turkeys, the laying hen sector is below its target, and the gamebird sector hit its target 2 years early and is now considering new targets. But the cattle and sheep industries have had issues with data collection that have made it difficult to assess progress, and progress in the fish sector (farmed trout and salmon) has been mixed.
The targets were established in 2017 by RUMA's Targets Task Force, a group that included a specialist veterinary surgeon and a leading farmer for each of the sectors covered.
"Some species have met their targets already but now, with a measure of what's happening in their sector, they know they can go further and are working on new goals," RUMA secretary general Chris Lloyd said in a press release. "For others at or around their optimal level of use, progress is about animal health, continual refinements to what they do and working to overcome new diseases threats as they emerge."
Meanwhile, the Guardian reports that the leaders of the UK's main medical associations have signed a joint letter to the secretaries of state for health and the environment calling on the British government to commit to a ban on the use of antibiotics to prevent diseases in groups of animals. In October, members of the European Parliament voted to limit the use of antibiotics to prevent disease to individual animals (rather than entire herds or flocks), and only in cases where a veterinarian believes there is a high risk of infection.
But that legislation will not become law until 2022, and with the United Kingdom scheduled to leave the European Union in 2019, that means the British government won't be bound by it. The letter asks the government to commit unequivocally to banning preventive antibiotic group treatments.
"If the government allows group prevention to continue, the UK will have some of Europe’s weakest regulatory standards," the letter states. "This could seriously undermine progress being made in reducing UK farm antibiotic use."
Nov 16 RUMA report
Nov 16 RUMA press release
Nov 16 Guardian story
PAHO issues guidance for antibiotic stewardship in Latin America
The Pan American Health Organization (PAHO) has published a new set of recommendations to help governments and healthcare providers in Latin America and the Caribbean set up antimicrobial stewardship programs (ASPs).
The manual, published in conjunction with the Global Health Consortium at Florida International University, aims to provide practical guidelines on implementing ASPs for national health authorities in the region and recommendations for hospital managers and healthcare workers on cost-effective interventions to reduce inappropriate antibiotic use. The recommendations focus on stewardship in acute care and ambulatory settings
"Antibiotics are responsible for having saved millions of lives all over the world, but we are currently experiencing unprecedented rates of resistance to some of the most common treatments,” Marcos Espinal, MD, MPH, director of the Communicable Diseases and Environmental Determinants of Health unit at PAHO, said in a press release. "It is vital that efforts are stepped up to preserve these achievements, reduce the impact of resistance and ensure continued treatment and prevention of infectious disease."
ASPs are a critical part of the World Health Organization (WHO) Global Action Plan on Antimicrobial Resistance and the PAHO Regional Action Plan, but hospitals in the region have been slow to adopt them. According to a 2012 survey, only 46% of hospitals in Latin America and the Caribbean have an ASP in place, compared to 58% in the rest of the world (and 66% and 67% in Europe and North America, respectively.)
Observational studies estimate that the misuse of antibiotics by healthcare providers in Latin America and the Caribbean is around 50%, but there have been no regional studies on antibiotic use in hospitals. The authors of the manual say that standardized systems and indicators are needed at different health care levels in the region to promote benchmarking, guide policy-making, and implement effective strategies to change antibiotic behavior.
Nov 16 PAHO press release
Nov 16 PAHO manual
FDA approves new antibiotic for travelers' diarrhea
The US Food and Drug Administration (FDA) approved a new antibiotic for adults with uncomplicated travelers' diarrhea caused by non-invasive strains of Escherichia coli.
Aemcolo (rifamycin), developed by Cosmo Pharmaceuticals, is an orally administered, minimally absorbed antibiotic that releases its active ingredient in the colon. It was approved based on results from two randomized, controlled phase 3 clinical trials of adult patients with travelers' diarrhea, which showed that Aemcolo significantly reduced symptoms compared to a placebo and was well-tolerated, with headache and constipation being the most common adverse events.
Aemcolo was not shown to be effective in patients with diarrhea complicated by fever and/or bloody stool or diarrhea caused by pathogens other than non-invasive strains of E coli. It should not be used by patients with a known sensitivity to rifamycin.
Travelers' diarrhea affects an estimated 10% to 40% of travelers worldwide each year and is commonly caused by bacteria found in food or water. The highest-risk destinations are in Asia, the Middle East, Africa, Mexico, and Central and South America.
Aemcolo was granted priority review under the FDA's Qualified Infectious Disease Product designation, given to antibacterial and antifungal drug products that treat serious or life-threatening infections. It will be available in pharmacies in the first quarter of 2019.
Nov 19 Cosmo Pharmaceuticals press release
Nov 16 FDA press release