Roger Hildreth: Sharing Knowledge to Tackle Antimicrobial Resistance across Europe

In this second blog from my EuroDairy visits, I will take you through my learnings and key points of interest from the antimicrobial workshop I attended in the Netherlands. On the day, industry professionals from across Europe came to present, to show what they country is doing to tackle the issue of antimicrobial use.

Reducing antimicrobial usage is an interest of mine and something I have managed to achieve at Curlew Fields Farm. I have managed to reduce the use of antibiotic dry cow therapy from 100% to 14%, just by switching to selective dry cow therapy.

My visit to the Netherlands had a strong focus on reducing use of antimicrobials. In this blog I will take you through the day, what I found particularly interesting and my learnings from the day.

The Netherlands:

In the Netherlands, the change to sandbeds, bespoke dry cow ration and using selective dry cow therapy have all helped to reduce their use of antimicrobials by over 80 per cent. They have banned the use of third and fourth generation antimicrobials successfully and economically. This is also something that I have banned on my farm too, for over a year now, which has helped us reduce our own antibiotics usage.

Jos Verstraten, from LTO Nederlands, took us through the journey the Netherlands is on to reduce their antimicrobial use. In 2009, Government set a target of reducing antmicrobial use by 70 per cent by 2015. Although instances of MRSA were very low, they could see there could be a problem and took action as prevention.

Jos explained how the agriculture sector took responsibility and looked for solutions, with organisations adding responsible use of antimicrobial to their goals for sustainability. Dairy farmers and vets had to work together and meet required regulations.

Up next, Theo Lam, Universiteit Utrecht presented the Dutch approach to reducing antimicrobial use and set out the RESET Mindset model aimed at changing behaviour:

• Rules and regulations –If rules are clear and if there is a system for monitoring and enforcement in place, they can be very effective.
• Education and information - Education is a very strong method to increase internal motivation. Once a farmer understands the ‘how and why’, behaviour will change.
• Social pressure - Vets and other advisors play an important role here as they have a strong influence on farmers’ opinions about animal health. People mimic behaviour from groups and role models.
• Economic incentives - Economic effects seem to be most powerful if the effect can be sensed directly.
• Tools - One of the important factors influencing and making change easier for farmers.

Cooperation of different stakeholders in the RESET Mindset model led to a fundamental change in knowledge, attitude and behaviour right across the agricultural sector.

On day two, Oscar Meuffels from NZO, the Dutch dairy association, talked about how animal health is top priority and that legal requirements include:

• Good housing climate – ventilation and comfort
• Recording of animal diseases
• The use of medicines prescribed by vets

Sweden:

Ylva Persson, Vaxa Sverige, talked about how Sweden has cut its reliance on antimicrobials. The basis is improving animal welfare and controlling or eradicating several infections.

The Swedish strategy includes:

• Removing unnecessary use, such as growth promoters and routine preventative treatment of disease
• Introducing selective dry cow therapy
• Minimising need for antimicrobials by focusing on keeping animals healthy
• Avoiding spread of infection by biosecurity, infection control and food hygiene
• Optimising use of antimicrobials when needed through diagnosis, correct medication and dose
• Monitoring use and resistance of antimicrobials

One thing I took away from Ylva’s presentation is the fact that every time you use an antimicrobial spray for digital dermatitis you’re inhaling a small amount. I’ve never considered this, and I’m sure many others haven’t either. We need to put safety in place around antimicrobial use. In Sweden they are now using aspirin to treat digital dermatitis.

United Kingdom:

Kristen Reyher, University of Bristol, introduced the UK approach to reducing antimicrobial use, which included:  

• Last resort method – Government restrictions on antimicrobial usage of highest critical importance to human medicine for animal use, when no alternative treatment is available.
• Regulation - increase in regulatory oversight of antimicrobials prescribed by vets, restricting/banning use of antimicrobials most important to human health - critically important antimicrobials - in animals.
• Prevention - improving prevention of disease by focusing on biosecurity and herd health.

What I found interesting was the present thinking that antimicrobial resistance in humans and animals is not as closely connected as previously thought. Human resistance is mainly related to human antimicrobial use. But what is important is that we don’t want antimicrobial resistance in the farmyard, and we must continue to tackle our own use.

On day two, Kristen shared some details of how farmers had reduced reliance on antimicrobials:

• Ensuring the basics are right e.g. housing design to reduce pneumonia risk
• Attention to detail in the dry and transition period. Considering dry cow sealant instead of antimicrobials and breeding for robustness.

Farmer action groups were also a topic for discussion, including the AHDB Dairy sponsored research project with Lisa Morgans from the University of Bristol. These have been set up for farmers to come together to talk about action that can be taken to improve cow welfare and reduce the need for antmicrobials (see here further details).

Denmark:

By 2020, Denmark aims to reduce antimicrobial usage by 20 per cent, as Michael Farre from Seges presented. Additionally, they want to reduce bulk tank average Somatic Cell Count to 150,000 (currently 199,000) and stop using third and fourth generation antimicrobials.

Furthermore, they are setting up a Danish Udder Health Centre, to address the lack of jointed up approach across the industry and fill the knowledge gaps.

All farmers now have to sign a herd health plan with the vet, which means that only under certain conditions can they have antimicrobials for DIY treatment. Pharmacists, not vets, will distribute antimicrobials with the outcome being that vets sell their time and knowledge, with no economic incentive for treatment.

To help tackle the issue, compulsory recording of antimicrobial use collected on a public access national database has been introduced. The official recommendation is to sample all cows and only treat major pathogens, with the first choice being small spectrum Penicillin.

Belgium:

In Belgium a new knowledge centre (AMCRA) was formed in 2012, to propose guidelines to help the industry reduce use.

In 2015/16 the Government banned the use of CIAs, unless susceptibility testing showed it was a last resort. Health and productivity data collection on dairy cows will begin in October 2018. Results so far show a slow and steady decrease in the use of antimicrobials.

They also carried out a trial where some cows received selective dry cow therapy and others blanket dry cow therapy. The results showed there was minimal difference of clinical mastitis at calving.

What was interesting is that they were testing each quarter to see if it was infected. If they only treat need to treat one quarter then you’ve reduced antimicrobial use by 75 per cent for that cow, so that’s a massive gain.

Also speaking, Saren de Vliegher, Universiteit Gent, outlined the Flemish approach to reducing antimicrobial use. Moving forward they aim for:

• 50 per cent less antimicrobial use by 2020
• 75 per cent for, critically important antimicrobials
• Plan in place for every farm
• Vets and farmers to benchmark antimicrobial usage
• No preventative use of antimicrobial

Learning from the visits

I have been amazed by the passion of all the speakers at the two-day antimicrobial workshop, and the innovative ways the countries have been reducing antimicrobial use.

The antimicrobial workshops has really helped me to better understand what I can do on my own farm to further reduce my antimicrobial usage. I am keen to share my new knowledge with others across Europe so that everyone can benefit and look forward to presenting at the EDF congress in June 2018.

The two visits have allowed better accessibility and sharing of information and best practice between European farmers, something that the EuroDairy project as a whole encourages.

Alongside attending the Antimicrobial workshop I also joined the UK branch of European Dairy Farmers (EDF) visit to Northern Ireland in April 2018. Catch up with this visit here.