Much has been done to reduce the use of medicines in the veterinary field, and in Italian livestock farming, the use of antibiotics has collapsed. The latest ESVAC report confirms this trend.

The animal health sector, with farmers and veterinarians at the forefront, is preparing for the appointment of 28 January 2022, when the new rules for the prescription of veterinary medicines will be published. In fact, from that date, the obligation to use the electronic register of veterinary treatments of animals in livestock production will come into force.

So, we will know how many and which prescriptions have been signed (the electronic prescription already exists). We will also know precisely the quantity and type of drug used and the species of animal treated. The monitoring of the use of antibiotics (and not only them) will be so complete, and we will know who uses them and in what quantities.

This is an important step forward in the fight against antibiotic resistance (AMR – antimicrobial resistance), a growing phenomenon responsible for many victims, meant to increase if no decisive action is taken. And the first step is a targeted and minimal use of antibiotics.

In the veterinary field, much has already been done to reduce the use of these drugs, and this is demonstrated by the data distributed at the European level by EMA, the European Medicines Agency, in the recent ESVAC report (European Surveillance of Veterinary Antimicrobial Consumption). Between 2011 and 2020, antibiotics in European farms decreased by 43.2%. It should be noted that for “strategic” antibiotics, such as cephalosporins and fluoroquinolones, priority is given to human use. The reduction was 33% for the former and almost 13% for the latter.

The reduction of polymixin is also significant, whose use in the European farms is drastically dropped (-76%). European farms have therefore taken very seriously the recommendations of the One Health philosophy promoted by the WHO, which indicates the reduction of the use of antibiotics as one of the solutions to fight the antibiotic resistance from bacteria.

Italian farms, in some cases, have managed it even better than their European colleagues. In Italy, the reduction in sales of antimicrobials in the period examined exceeded 51%, almost 8% more than the European average. The case of polymixin is emblematic, whose use in zootechnics has been nearly zero compared to 2011 (-97,7%). With these positive data, EMA’s still high consumption of antibiotics in Italy sounds strange.

EMA uses a complicated algorithm that relates drug sales data to the number of animals raised to make this comparison. EMA itself warns that numbers should not be taken in absolute terms, but they position us in third place, behind Cyprus and Poland for the number of active ingredients used. Too much. So much to imagine some error in the “formulas” adopted.

While waiting for the electronic prescription and electronic register of the drug to tell us precisely how things are (it is also necessary to consider the exports of drugs and their actual use in pets), it is interesting to know how these antibiotics are administered.

For this analysis, the routes of administration were divided by EMA into six groups. The most used are oral solutions (57%), premixtures (22.5%), injectable products (12%), and powder (7.4%). According to this division, it could be inferred that a large proportion of antimicrobials are intended for monogastric, such as chickens and pigs, and only a tiny proportion are designed for adult cattle and sheep. The following EMA report, which for Italy will report the exact data from computer databases on drugs, will also respond to these inconsistencies.

In the meantime, we can recognize the excellent work done so far in the Italian farms to counter the development of AMR, but that risks having little results if it is not followed with equal determination by human medicine. And on this front, there are still many critical issues to be resolved. According to the Italian Medicines Agency (Aifa) complaint, there is too often improper use of antibiotic therapies in human medicine, inappropriate in one out of four cases.

So, there is much work to be done. But now we know that we must not point the finger at farms only when we talk about antibiotic resistance.