03antibiotics r aerts
TRANSCRIPT
4TH MERIAL FORUM
HAVE WE GOT PCVD &
SWINE INFLUENZA UNDER
CONTROL?
Higher Health
Frans Dirven
Vet. Practice Lintjeshof
Nederweert, The Netherlands
2 2
Reduction of antibiotics in the Netherlands, field cases
Rob Aerts DVM Lintjeshof Netherlands
Agenda • 1 introduction
• 2 reduction of antibiotics; why? how much?
• 3 reduction of antibiotics; how? results
• 4 moment of consideration
• 5 conclusions
1 introduction;Lintjeshof practice • 25 vets/16 specialized in Swine, 4 locations covering
the Netherlands, 2 locations in Germany (1 in Belgium)
• The service we offer:
– Vet expertise /consultancy
– Diagnostic lab and monitoring
– Pharmacy with product display
5
6
Lintjeshof practice
• approximately 25 % market share in NL
• swine ( 80 % ) • cattle ( 8 % ) • poultry ( 7 % ) • companion Animals (5 %)
• 25 vets, 3 laboratory assistants • 14 Secretarial staff • MT (operational-,financial manager and
managing director) • Iso-nen certified
• 14 vets • 3 vets • 1 vet • 4 vets
• All Specialized
8 6/5/2012 lintjeshof 8
Pharmacy, operation and management
Vet practice and lab
9
Vet. Pharma companies wholesalers
Veterinary clinic+ pharmacy Veterinary pharmacy Licence traders
Farmer
prescription Antihelmintics under prescription
Farmvet
Current situation • Farms are becoming bigger (1000-2000 sows),
small breeding farms disappear
• Productivity is going up to 30 piglets / sow / year
• Total piglet production is rising
• Producer is more dependant on export (large units up to 5000 sows)
• Family farms, closed herds ( 300- 500 sows, 2500 – 5000 fatteners) rather independent
Data
• 900.000 sows
• 7 million piglets exported Germany!
• Production cost piglet 25kg: 49 euro
• Per sow highest production of meat (kg)/year
(followed by Denmark and France)
• Production cost of 1kg porc: 1,46 euro
12
Total of farms decreasing, total animals pro farm increasing
Facts • Strong focus on costs
• Continuous system (many movement of pigs)
• Higher health difficult to obtain (many diseases)
• SPF difficult to maintain (swine density)
• No support for “megafarms”
• High usage of antibiotics (political statement)
• Highly dependant on export!!! Health is most important topic
Agenda • 1 introduction
• 2 reduction of antibiotics; why? how much?
• 3 reduction of antibiotics; how?
• 4 moment of consideration
• 5 conclusions
2 reduction of antibiotics; why? how much?
• High usage of ab has become a political item
• Increasing resistance (MRSA,Klebsiella, E Coli)
• ESB-L issues…..
• Transfer of resistant bacteria/ genes
direct; poor hygiene
indirect; environment (soil,surface waters)
• vet held responsible for increase in usage…
presentatie f.dirven lintjeshof 16 6/5/2012 16
Volkskrant 2007
17
Average daily doses per animal/year
18
Antibiotic-resistance
Prevalence of MRSA
Moment of consideration
• How much reduction? 2008-2013: 50%
• Separation between vet practice and pharmacy?
• Vet is gatekeeper for animal and human health
• Curative use only, preventive use prohibited?
• Separation of human/ animal ab
(cephalosporines, quinolones banned since 1jan2012)
(ab for human use only and vice versa)
Agenda
Lintjeshof, 30 maart 2011
• 1 introduction
• 2 reduction of antibiotics; why? How much?
• 3 reduction of antibiotics; how? results
• 4 moment of consideration
• 5 conclusions
reduction of antibiotics; how? results
• Introducing ddy
• Introducing vetcis (databank)
• Introducing SDA (vet drugs authority)
• Benchmark farmers and vets (penalties?)
• Separation vet pharmacy and practice (pervert)?
• Income of vet independent margin on drugs
vetcis
reduction of antibiotics; how? results
• Prudent use (dosage, days, diagnosis)
• Alternatives : MCFA’s, probiotics , immune stimulating products, vitamines, antioxydantia, mycotoxin binders
• Vaccines (circo, myco, prrs, flu, parvo….)
• Symptomatic therapies in case of acute illness ( nasa, metacam, paracetamol)
• Focus on higher health
Strategy to higher health
• Improvement veterinary strategy
• Improvement management at farmlevel
• Improvement feed strategy
Improvement veterinary strategy No more “old school”:
• lots of emergency therapies
• farewell and entry medications
• vaccination at entry fattening unit because of mistrust between breeder, fattener and trader
• Many combinations of ab
We are producing food, not only kg of meat
Improvement veterinary strategy • Proper diagnosis!! Define the primary agent
• Vaccinate against primary diseases
(prrs, flu, circo, mhyo, parvo)
• Antibiotics just for secondary infections
(pasteurella, app, glässer….strep suis???)
• Painkillers in case of fever/ severe illness to increase feed/water intake
• Blood monitoring for diagnostics and herd-health-passport
• Improving of general farm management
36 6/5/2012 lintjeshof 36
Improvement of veterinary strategy
Prevention by vaccination:
• New vaccins (mycoplasma, flu, prrs, circo, glasser etc) combi vaccins
• Top down (young gilts, sows,piglet, fatteners)
• Decrease of antibiotics (kg) is the objective and improvement of technical results
• Higher healthstatus (prrs neg piglets)
• Return on investment !!!(proper diagnosis)
Improvement of veterinary strategy
Lintjeshof, 30 maart 2011
Painkillers
• Symptomatic, mostly viral infections
• Less anorexia (dg fatteners)
• Reducing fever (most sows abort due to fever)
• Total health at higher level
• Less secondary infections ( combination management)
• If so, individual antibiotic use.
Serological monitoring by spc
Fieldcases antibiotic reduction
Case 1:
• Closed herd (500 sows, 4000 fatteners)
• Problems fatteners: diarrhea, runts, high mortality (5-6%), no lung problems
• Tiamutin used on regular basis
• Brachyspira-, salmonella-, pia+
• Bloodsampling and necropsy: high viral load pcv2
• Vaccination against pcv at 3 weeks of age
Results case 1
0,0
10,0
20,0
30,0
40,0
50,0
60,0
0
1
2
3
4
5
6
7
8
Jan - April 09 May - Aug 09 Sept - Dec 09 Jan - April 10 May - Aug 10 Sept - Nov 10
mortality % Average number of Daily Dosage per animal year
before vaccination all vaccinated animals transition
Fieldcases antibiotic reduction
Lintjeshof, 30 maart 2011
Case 2
• Sow farm (expanding from 900-1800 sows)
• 30 piglets sow/year (weekly production)
• Positive on prrs and influenza
• Vaccination:
piglets: circo 3 wk, sows: prrs and influenza
• 2010 (august) reproductive problems (abortions, fever, reduced feed intake, 3% mortality)
• No effect antibiotics, only pracetam (fever)
Fieldcases antibiotic reduction
Case 2
• PCR fetus: parvovirus- (vaccinated), prrs-, circo-
• Bloodsamples: csf-
• Bloodsamples: influenza, prrs, app, circo
• Extra influenza vaccination started no effect
diagnostics case 2
0
1
2
3
4
5
6
7
8
9
1 2 3 4 5 6 7 8 9 10
HI-
waard
e
buisnummer
0
1
2
3
4
5
6
7
8
9
1 2 3 4 5 6 7 8 9 10 11 12 13 14
HI-
waard
e
buisnummer
Influenza no seroconversion
diagnostics case 2
0,0
0,5
1,0
1,5
2,0
2,5
3,0
3,5
4,0
1 2 3 4 5 6 7 8 9 10
S/P
rati
o
buisnummer
0,0
0,5
1,0
1,5
2,0
2,5
3,0
3,5
4,0
1 2 3 4 5 6 7 8 9 10 11 12 13 14
S/P
rati
o
buisnummer
Prrs no seroconversion
diagnostics case 2
0,0
0,2
0,4
0,6
0,8
1,0
1,2
1,4
1,6
1,8
2,0
2,2
1 2 3 4 5 6 7 8 9 10
S/P
rati
o
buisnummer
0,0
0,2
0,4
0,6
0,8
1,0
1,2
1,4
1,6
1,8
2,0
2,2
1 2 3 4 5 6 7 8 9 10 11 12 13 14
S/P
rati
o
buisnummer
App no seroconversion
diagnostics case 2
0,0
0,2
0,4
0,6
0,8
1,0
1,2
1,4
1,6
1,8
2,0
2,2
1 2 3 4 5 6 7 8 9 10
OD
buisnummer
0,0
0,2
0,4
0,6
0,8
1,0
1,2
1,4
1,6
1,8
2,0
2,2
1 2 3 4 5 6 7 8 9 10 11 12 13 14
OD
buisnummer
Circo IgM/IgG seroconversion
Results case 2 • After 6 weeks increase of problems • No effect extra SIV vaccination or antibiotics • Lab results: herd vaccination circovac after 2 weeks strong improvement (until today) • Vaccination scheme: gilts: 3 weeks and before first insemination sows: at 10 weeks of gestation piglets: 3 weeks of age
Fieldcases antibiotic reduction
Case 3
• The effect of the application of mono-lauric acid with glycerol mono-laurate in weaned piglets on the use of antimicrobials in sow herds.
• Effect against gram+ bacteria ( streptococcus, staphylococcus)
• Product used for 6 months in nursery feed
• Effect on use of trimethoprim/sulfa, amoxicillin
Results case 3; 34 farm with la/gml
0
20
40
60
80
100
120
140
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
dagdosering zeugen voor
dagdosering zeugen na
Results case 3; 37 farms without la/gml
0
50
100
150
200
250
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37
dagdosering zeug 1e periode
dagdosering zeug 2e periode
Results case 3
Lintjeshof, 30 maart 2011
• Significant reduction in antibiotic use on farms using LZ/GML
• De Snoeck1*, S., van der Wolf2 P.,, Swart2, W., Heiiman3, E., Ebbinge3, B.
• 1 Veterinary Practice Lintjeshof, Nederweert, The Netherlands
• 2 Animal Health Service, Deventer, The Netherlands
• 3 Daavision B.V., Oss, The Netherlands
0 1
-50
-20
10
40
Box and Whisker Plot
de
lta
DD
laur
62 cases
Fieldcases antibiotic reduction
Case 4 • Breeding herd 800 sows , high health • Piglets: seronegative (prrs, app, mhyo, pia) monitoring every 4 months
• Vaccination: sow: prrs, influenza, ery/parvo, app, e.coli piglets: glässer, pcv2 • Problems in nursery (light coughing, low feedintake after
weaning, mortality 3%, high use of ab (tetracyclin, trim/sulf)
• Week 1+2 after weaning pracetam in feed
Results case 4 Product amount Period 1 Period 2
Doxycyclin 100% 1kg 2 2
Trim/sulfa 80/420 5kg 12 2
Ampicillin 100ml 204 114
Draxxin 50ml 23 18
Powerflox 100ml 30 12
Florkem 100ml 15 10
Oxytetracyclin 100% 5kg 17 0
ADD 46 7
Improvement of general farm management
• Very important, not only health-management also total farm-management
• Without good management every veterinary therapy is useless
• Labour hours will be decreasing (more hours to spent for other subjects such as fertility)
• Employees have a higher labour moral
Improvement of general farm management
Structural changes in housing systems; • continuous productionsystems vs fixed week production system (poultry) • no mixing up animals from different origins • animals of same age • all in all out • strictly 1 to 1 • multisite production
ADD fixed week production system
57
Improvement of general farm management
• Stock density!! Many farms +10-20%
• SPF monitoring system (Denmark)
• Eradication of diseases (auj, prrs, mhyo, app)
• New farms start SPF
Agenda • 1 introduction
• 2 reduction of antibiotics; why? how much?
• 3 reduction of antibiotics; how? results
• 4 moment of consideration
• 5 conclusions
4 moment of consideration • vetcis: reduction about 32 % • Sda gives ddy (sows+piglets 20, fatteners 13) • No more preventive medication (poor management) • Discussion quinolones, cephalosporines (01-01-2012) • No antibiotic mixing at feedmill (01-09-2011) • Political discussion about split (vetclinic/pharmacy) • Veterinarian most involved person at farm (farmspecific healthplan, welfare, control zoonotic diseases and art 1 diseases) 1 to 1 contract with farmer.
• Income; margin drugs? and hourly fee ? Contract ? Sector? Ministry ?
tete
ten
62
Challenge
Lintjeshof, 30 maart 2011
• New decrease 20% (with swine sector)
• Veterinarian becomes “health” director at farmlevel
(1 on 1 relation) with help from government to act independant
• System higher health and pig pass
• Sustainable swine production
• More alternatives (vaccines, feed additives, antioxydantia, herbs, toxin binders...........)
• Partner for financial returns
Another challenge:
Big Challenge
TEAM LINTJESHOF
Threats?
Lintjeshof, 30 maart 2011
• Therapeutic bandwidth
• Are certain problems without antibiotics kept under control (e.g. strep. suis)
• Unable to go to higher health (density of farms and animals)
• Cost price meat in W. Europe? International competition
• Is consumer willing to pay for better and safer meat ?
• Will the vet be sufficiently paid for advice to keep his quality and know how
Agenda • 1 introduction
• 2 reduction of antibiotics; why? how much?
• 3 reduction of antibiotics; how? results
• 4 moment of consideration
• 5 conclusions
Conclusions • Profitability in swine production strongly influenced by
farm health status • Food producers (decrease of antibiotics) • Reduction of ab strongly depending on farm health
status • End 2012 50% ab reduction (32% is obtained) • Alternatives for antibiotics…………. • Strong improvement general management and sector
structure • In the end a higher return on investment at farmlevel • Swineproducers need to improve their competitiveness
Thank you for your attention