Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals

An increasing variety of indicators of antimicrobial usage has become available in human and veterinary medicine, with no consensus on the most appropriate indicators to be used. The objective of this review is therefore to provide guidance on the selection of indicators, intended for those aiming to quantify antimicrobial usage based on sales, deliveries or reimbursement data. Depending on the study objective, different requirements apply to antimicrobial usage quantification in terms of resolution, comprehensiveness, stability over time, ability to assess exposure and comparability. If the aim is to monitor antimicrobial usage trends, it is crucial to use a robust quantification system that allows stability over time in terms of required data and provided output; to compare usage between different species or countries, comparability must be ensured between the different populations. If data are used for benchmarking, the system comprehensiveness is particularly crucial, while data collected to study the association between usage and resistance should express the exposure level and duration as a measurement of the exerted selection pressure. Antimicrobial usage is generally described as the number of technical units consumed normalized by the population at risk of being treated in a defined period. The technical units vary from number of packages to number of individuals treated daily by adding different levels of complexity such as daily dose or weight at treatment. These technical units are then related to a description of the population at risk, based either on biomass or number of individuals. Conventions and assumptions are needed for all of these calculation steps. However, there is a clear lack of standardization, resulting in poor transparency and comparability. By combining study requirements with available approaches to quantify antimicrobial usage, we provide suggestions on the most appropriate indicators and data sources to be used for a given study objective

Assessment of the network activities and materials. Data analysis and interpretation of the data collected on the existing levels of knowledge on the economics of animal health. Monitoring and final evaluation of the ongoing network activities and materials developed

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One Health Approach to the use of Veterinary Pharmaceuticals

Use of veterinary pharmaceuticals is much greater than is generally appreciated. Based upon annual 2004 data, an estimated 6050 tons of active substances went into the production of veterinary pharmaceuticals for the treatment of food animals in the EU, including 5393 tons of antibiotics and 194 tons of antiparasitics. U.K. data show that the proportion of veterinary pharmaceuticals sold for use in companion animals has increased from 30% to more than 50% in 27 years. Given that global meat production is projected to increase by 57% by 2050 and the market for companion animal pharmaceuticals is still growing, the use of veterinary pharmaceuticals will continue to increase. While veterinary pharmaceuticals may benefit the health and welfare of domestic animals and the efficiency of food animal production, they can contaminate the environment through the manufacturing process, treatment of food animals and companion animals, and disposal of carcasses, offal, urine, faeces, and unused products. This contamination is a threat to non-target species, including humans. The example of diclofenac and its impact on vultures illustrates the inadequacy of the current system of environmental risk assessment for veterinary pharmaceuticals. Current procedures require strengthening and the addition of a more proactive, holistic, One Health approach. We may never have the knowledge required to adequately assess the environ-mental risk of veterinary pharmaceuticals. Therefore, while we need to strengthen current systems of environmental impact assessment where possible, we also need to sensibly foster the precautionary principle and aim to prevent environmental contamination with veterinary pharmaceuticals in the first place. To do so, we advocate a "cradle-to-cradle" stewardship programme for veterinary pharmaceuticals that promotes a culture of environmental responsibility, involves all sectors of society and considers environmental effects during their production, use, and disposa

Human/Animal Relationships in Transformation. Scientific, Moral and Legal Perspectives.

Ethics of Human/Animal Relationships is a growing field of academic research and a topic for public discussion and regulatory interventions from law-makers, government and private institutions (such as scientific societies and farming industries). In our societies human/animal relationships are in transformation and understanding the nature of this process is crucial for all those who believe that the enlargement of moral and legal recognition to non-human animals is part of contemporary civilization and moral/political progress. Understanding the nature of this process means analysing and critically discussing the philosophical/ scientific/legal concepts and arguments embedded in it. This book aims at contributing to such analysis by means of collecting ideas and reflec- tions from leading experts in the fields from different disciplinary approaches and theoretical/scientific perspectives. Scopes of this book are both depicting the state of the art of the transformation of Human/ Animal Relationships and presenting ideas to foster this process. In pur- suing those aims the approach of this book is plural in a double meaning. First, contributors are plural in their backgrounds and expertise in order to provide a rich interpretation of the questions at stake. Second, plural- ity regards the subject matter of the various analyses: Human/Animal Relationships (and transformations affecting them) are not a monolith. Animal species are many and different and human interactions with them are equally many and different. The various contributions to the book move from the awareness of the great variety of human/animal relation- ships in order to foster the theoretical debate and the public discussion about the scientific and ethical reasons underlying the changes in our approaches to animals, a fact that nowadays irreversibly characterizes our societies