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Tackling Antimicrobial Use and Resistance in Pig Production

Lessons Learned in Denmark

image of Tackling Antimicrobial Use and Resistance in Pig Production

This report describes a campaign to limit the use of antimicrobials – specifically antibiotics – in the Danish swine-producing sector. It is a testimony of the collaboration between the regulatory sector within the Ministry of Environment and Food (and its agriculture-focused precursors), private veterinary practitioners and swine producers (large and small), to tackle the unsustainable overuse of antibiotics in the industry, and is a retrospective tribute to all those who had the foresight to make significant changes to ensure consumer protection: improving hygiene at primary sites of swine production, developing options for intervention through a system of surveillance and collation of data from feed mills to veterinary practitioner prescriptions, identifying sites for intervention, setting targets, restructuring the relationship between the veterinary services and farmers, and implementing changes in behaviour for greatest impact. Denmark in many ways laid out a plan before there was any known roadmap to follow; each step was based on continuous analysis and feedback to the operators – private and public – for ongoing monitoring and accountability as a driver for change. It is hoped that this historical guide may serve other countries, food producers, regulators, veterinarians and those responsible for veterinary structures, as well as academia, to identify ways forward to limit the emergence and spread of antimicrobial resistance, which is threatening public health, animal health and safe food production worldwide.

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Public call for change

Most antimicrobials used in the treatment of pigs are identical, or closely related, to antimicrobials used for therapy in humans. Use of antimicrobials in humans and food-producing animals — such as pigs — can potentially lead to development of antimicrobial-resistant bacteria as well as selection and dissemination of existing resistance traits. Resistant bacteria can spread from animals to humans, where they can lead to infections and treatment failure. Once resistant bacteria are established in the human population, the risk of dissemination through human-to-human contact increases significantly. Human-to-animal dissemination should also not be ignored. Resistant bacteria can spread across borders via international trade and travel, making AMR a global issue. The world has seen several examples of drug-resistant infections in humans, some of which are associated with resistance traits transferred from livestock. Examples include mobile ESBL- or colistin-resistance genes in Escherichia coli, and livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA CC398). Often these transferable resistant bacteria or resistance genes cause public concern, resulting in a raised public profile and corresponding public calls for action. In Denmark, the emergence and transmission of LA-MRSA CC398 among pigs is an example of a specific resistance trait leading to an increased focus on AMR.

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